[Legal quality criteria of expert opinions in liability for medical malpractice].

PubMed

Neu, Johann

2017-09-01

In litigation regarding to liability for medical malpractice the court itself for lack of medical expert knowledge cannot judge a claimed error in treatment. That applies too for the question if there is causation between the error in treatment and claimed damage to patient's health. In this respect, the court is dependent on a medical expert and is bound to his assessment, unless there is no quality deficit in respect of medical and/or legal criteria. The more the medical expert knows the legal background of physician's liability for medical malpractice, the less is the risk of legal quality deficits in his expert opinion and thereby also of judicial errors by court. Georg Thieme Verlag KG Stuttgart · New York.

Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis.

PubMed

Kjeken, Ingvild

2011-12-01

The aims of this study were to develop recommendations for occupational therapy assessment and design of hand exercise programmes in patients with hand osteoarthritis. An expert group followed a Delphi procedure to reach consensus for up to 10 recommendations for assessment and exercises, respectively. Thereafter, an evidence-based approach was used to identify and appraise research evidence supporting each recommendation, before the recommendations were validated by the expert group. The process resulted in 10 recommendations for assessment and eight for design of exercise programmes. The literature search revealed that there is a paucity of clinical trials to guide recommendations for hand osteoarthritis, and the evidence for the majority of the recommendations was based on expert opinions. Also, even if a systematic review demonstrates some evidence for the efficacy of strength training exercises in hand OA, the evidence for any specific exercise is limited to expert opinions. A first set of recommendations for assessment and exercise in hand osteoarthritis has been developed. For many of the recommendations there is a paucity of research evidence. High-quality studies are therefore needed to establish a high level of evidence concerning functional assessment and the effect of hand exercises in hand osteoarthritis.

Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in The Netherlands Cohort Study.

PubMed

Offermans, Nadine S M; Vermeulen, Roel; Burdorf, Alex; Peters, Susan; Goldbohm, R Alexandra; Koeman, Tom; van Tongeren, Martie; Kauppinen, T; Kant, Ijmert; Kromhout, Hans; van den Brandt, Piet A

2012-10-01

Reliable retrospective exposure assessment continues to be a challenge in most population-based studies. Several methodologies exist for estimating exposures retrospectively, of which case-by-case expert assessment and job-exposure matrices (JEMs) are commonly used. This study evaluated the reliability of exposure estimates for selected carcinogens obtained through three JEMs by comparing the estimates with case-by-case expert assessment within the Netherlands Cohort Study (NLCS). The NLCS includes 58,279 men aged 55-69 years at enrolment in 1986. For a subcohort of these men (n=1630), expert assessment is available for exposure to asbestos, polycyclic aromatic hydrocarbons (PAHs) and welding fumes. Reliability of the different JEMs (DOMJEM (asbestos, PAHs), FINJEM (asbestos, PAHs and welding fumes) and Asbestos JEM (asbestos) was determined by assessing the agreement between these JEMs and the expert assessment. Expert assessment revealed the lowest prevalence of exposure for all three exposures (asbestos 9.3%; PAHs 5.3%; welding fumes 11.7%). The DOMJEM showed the highest level of agreement with the expert assessment for asbestos and PAHs (κs=0.29 and 0.42, respectively), closely followed by the FINJEM. For welding fumes, concordance between the expert assessment and FINJEM was high (κ=0.70). The Asbestos JEM showed poor agreement with the expert asbestos assessment (κ=0.10). This study shows case-by-case expert assessment to result in the lowest prevalence of occupational exposure in the NLCS. Furthermore, the DOMJEM and FINJEM proved to be rather similar in agreement when compared with the expert assessment. The Asbestos JEM appeared to be less appropriate for use in the NLCS.

Evaluation by Expert Dancers of a Robot That Performs Partnered Stepping via Haptic Interaction.

PubMed

Chen, Tiffany L; Bhattacharjee, Tapomayukh; McKay, J Lucas; Borinski, Jacquelyn E; Hackney, Madeleine E; Ting, Lena H; Kemp, Charles C

2015-01-01

Our long-term goal is to enable a robot to engage in partner dance for use in rehabilitation therapy, assessment, diagnosis, and scientific investigations of two-person whole-body motor coordination. Partner dance has been shown to improve balance and gait in people with Parkinson's disease and in older adults, which motivates our work. During partner dance, dance couples rely heavily on haptic interaction to convey motor intent such as speed and direction. In this paper, we investigate the potential for a wheeled mobile robot with a human-like upper-body to perform partnered stepping with people based on the forces applied to its end effectors. Blindfolded expert dancers (N=10) performed a forward/backward walking step to a recorded drum beat while holding the robot's end effectors. We varied the admittance gain of the robot's mobile base controller and the stiffness of the robot's arms. The robot followed the participants with low lag (M=224, SD=194 ms) across all trials. High admittance gain and high arm stiffness conditions resulted in significantly improved performance with respect to subjective and objective measures. Biomechanical measures such as the human hand to human sternum distance, center-of-mass of leader to center-of-mass of follower (CoM-CoM) distance, and interaction forces correlated with the expert dancers' subjective ratings of their interactions with the robot, which were internally consistent (Cronbach's α=0.92). In response to a final questionnaire, 1/10 expert dancers strongly agreed, 5/10 agreed, and 1/10 disagreed with the statement "The robot was a good follower." 2/10 strongly agreed, 3/10 agreed, and 2/10 disagreed with the statement "The robot was fun to dance with." The remaining participants were neutral with respect to these two questions.

Evaluation by Expert Dancers of a Robot That Performs Partnered Stepping via Haptic Interaction

PubMed Central

Chen, Tiffany L.; Bhattacharjee, Tapomayukh; McKay, J. Lucas; Borinski, Jacquelyn E.; Hackney, Madeleine E.; Ting, Lena H.; Kemp, Charles C.

2015-01-01

Our long-term goal is to enable a robot to engage in partner dance for use in rehabilitation therapy, assessment, diagnosis, and scientific investigations of two-person whole-body motor coordination. Partner dance has been shown to improve balance and gait in people with Parkinson's disease and in older adults, which motivates our work. During partner dance, dance couples rely heavily on haptic interaction to convey motor intent such as speed and direction. In this paper, we investigate the potential for a wheeled mobile robot with a human-like upper-body to perform partnered stepping with people based on the forces applied to its end effectors. Blindfolded expert dancers (N=10) performed a forward/backward walking step to a recorded drum beat while holding the robot's end effectors. We varied the admittance gain of the robot's mobile base controller and the stiffness of the robot's arms. The robot followed the participants with low lag (M=224, SD=194 ms) across all trials. High admittance gain and high arm stiffness conditions resulted in significantly improved performance with respect to subjective and objective measures. Biomechanical measures such as the human hand to human sternum distance, center-of-mass of leader to center-of-mass of follower (CoM-CoM) distance, and interaction forces correlated with the expert dancers' subjective ratings of their interactions with the robot, which were internally consistent (Cronbach's α=0.92). In response to a final questionnaire, 1/10 expert dancers strongly agreed, 5/10 agreed, and 1/10 disagreed with the statement "The robot was a good follower." 2/10 strongly agreed, 3/10 agreed, and 2/10 disagreed with the statement "The robot was fun to dance with." The remaining participants were neutral with respect to these two questions. PMID:25993099

SU-G-201-09: Evaluation of a Novel Machine-Learning Algorithm for Permanent Prostate Brachytherapy Treatment Planning

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

Nicolae, A; Department of Physics, Ryerson University, Toronto, ON; Lu, L

Purpose: A novel, automated, algorithm for permanent prostate brachytherapy (PPB) treatment planning has been developed. The novel approach uses machine-learning (ML), a form of artificial intelligence, to substantially decrease planning time while simultaneously retaining the clinical intuition of plans created by radiation oncologists. This study seeks to compare the ML algorithm against expert-planned PPB plans to evaluate the equivalency of dosimetric and clinical plan quality. Methods: Plan features were computed from historical high-quality PPB treatments (N = 100) and stored in a relational database (RDB). The ML algorithm matched new PPB features to a highly similar case in the RDB;more » this initial plan configuration was then further optimized using a stochastic search algorithm. PPB pre-plans (N = 30) generated using the ML algorithm were compared to plan variants created by an expert dosimetrist (RT), and radiation oncologist (MD). Planning time and pre-plan dosimetry were evaluated using a one-way Student’s t-test and ANOVA, respectively (significance level = 0.05). Clinical implant quality was evaluated by expert PPB radiation oncologists as part of a qualitative study. Results: Average planning time was 0.44 ± 0.42 min compared to 17.88 ± 8.76 min for the ML algorithm and RT, respectively, a significant advantage [t(9), p = 0.01]. A post-hoc ANOVA [F(2,87) = 6.59, p = 0.002] using Tukey-Kramer criteria showed a significantly lower mean prostate V150% for the ML plans (52.9%) compared to the RT (57.3%), and MD (56.2%) plans. Preliminary qualitative study results indicate comparable clinical implant quality between RT and ML plans with a trend towards preference for ML plans. Conclusion: PPB pre-treatment plans highly comparable to those of an expert radiation oncologist can be created using a novel ML planning model. The use of an ML-based planning approach is expected to translate into improved PPB accessibility and plan uniformity.« less

Energy Policy: Ask the Experts.

ERIC Educational Resources Information Center

Nuclear Industry, 1991

1991-01-01

Twelve U.S. experts on energy policies individually offer perspectives about which priorities should be enlisted with respect to the current energy policy of the United States. In their analyses, these experts unanimously agree that the biggest U.S. problem is an increasing dependence upon imported oil. (JJK)

Knowing when not to swing: EEG evidence that enhanced perception-action coupling underlies baseball batter expertise.

PubMed

Muraskin, Jordan; Sherwin, Jason; Sajda, Paul

2015-12-01

Given a decision that requires less than half a second for evaluating the characteristics of the incoming pitch and generating a motor response, hitting a baseball potentially requires unique perception-action coupling to achieve high performance. We designed a rapid perceptual decision-making experiment modeled as a Go/No-Go task yet tailored to reflect a real scenario confronted by a baseball hitter. For groups of experts (Division I baseball players) and novices (non-players), we recorded electroencephalography (EEG) while they performed the task. We analyzed evoked EEG single-trial variability, contingent negative variation (CNV), and pre-stimulus alpha power with respect to the expert vs. novice groups. We found strong evidence for differences in inhibitory processes between the two groups, specifically differential activity in supplementary motor areas (SMA), indicative of enhanced inhibitory control in the expert (baseball player) group. We also found selective activity in the fusiform gyrus (FG) and orbital gyrus in the expert group, suggesting an enhanced perception-action coupling in baseball players that differentiates them from matched controls. In sum, our results show that EEG correlates of decision formation can be used to identify neural markers of high-performance athletes. Copyright © 2015 Elsevier Inc. All rights reserved.

Development of an expert system for fractography of environmentally assisted cracking

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

Minoshima, Kohji; Komai, Kenjiro; Yamasaki, Norimasa

1997-12-31

An expert system that diagnoses the causes of failure of environmentally assisted cracking (EAC) based upon fractography has been developed. The system uses the OPS83 programming language, expressing rules in the manner of production rules, and is composed of three independent subsystems, which respectively deal with EACs of high-strength or high-tensile-strength steel, aluminum alloy, and stainless steel in dry and humidified air, water, and aqueous solutions containing Cl, Br, or I ions. The concerned EAC issues cover stress corrosion cracking (SCC), hydrogen embrittlement, cyclic SCC, dynamic SCC, and corrosion fatigue as well as fatigue and overload fracture. The knowledge basemore » covers the rules relating to not only environments, materials, and loading conditions, but also macroscopic and microscopic fracture surface morphology. In order to deal with vague expressions of fracture surface morphology, fuzzy set theory is used in the system, and the description of rules about vague fracture surface appearance is thereby possible. Applying the developed expert system to case histories, accurate diagnoses were made. The authors discuss the related diagnosis results and usefulness of the developed system.« less

Equating an expert system to a classifier in order to evaluate the expert system

NASA Technical Reports Server (NTRS)

Odell, Patrick L.

1989-01-01

A strategy to evaluate an expert system is formulated. The strategy proposed is based on finding an equivalent classifier to an expert system and evaluate that classifier with respect to an optimal classifier, a Bayes classifier. Here it is shown that for the rules considered an equivalent classifier exists. Also, a brief consideration of meta and meta-meta rules is included. Also, a taxonomy of expert systems is presented and an assertion made that an equivalent classifier exists for each type of expert system in the taxonomy with associated sets of underlying assumptions.

A LISP-Ada connection

NASA Technical Reports Server (NTRS)

Jaworski, Allan; Lavallee, David; Zoch, David

1987-01-01

The prototype demonstrates the feasibility of using Ada for expert systems and the implementation of an expert-friendly interface which supports knowledge entry. In the Ford LISP-Ada Connection (FLAC) system LISP and Ada are used in ways which complement their respective capabilities. Future investigation will concentrate on the enhancement of the expert knowledge entry/debugging interface and on the issues associated with multitasking and real-time expert systems implementation in Ada.

Conservation Compromises: The MAB and the Legacy of the International Biological Program, 1964-1974.

PubMed

Schleper, Simone

2017-02-01

This article looks at the International Biological Program (IBP) as the predecessor of UNESCO's well-known and highly successful Man and the Biosphere Programme (MAB). It argues that international conservation efforts of the 1970s, such as the MAB, must in fact be understood as a compound of two opposing attempts to reform international conservation in the 1960s. The scientific framework of the MAB has its origins in disputes between high-level conservationists affiliated with the International Union for the Conservation of Nature and Natural Resources (IUCN) about what the IBP meant for the future of conservation. Their respective visions entailed different ecological philosophies as much as diverging sets of political ideologies regarding the global implementation of conservation. Within the IBP's Conservation Section, one group propagated a universal systems approach to conservation with a centralized, technocratic management of nature and society by an elite group of independent scientific experts. Within IUCN, a second group based their notion of environmental expert roles on a more descriptive and local ecology of resource mapping as practiced by UNESCO. When the IBP came to an end in 1974, both groups' ecological philosophies played into the scientific framework underlying the MAB's World Network or Biosphere Reserves. The article argues that it is impossible to understand the course of conservation within the MAB without studying the dynamics and discourses between the two underlying expert groups and their respective visions for reforming conservation.

Spacelab data processing facility (SLDPF) quality assurance (QA)/data accounting (DA) expert systems - Transition from prototypes to operational systems

NASA Technical Reports Server (NTRS)

Basile, Lisa

1988-01-01

The SLDPF is responsible for the capture, quality monitoring processing, accounting, and shipment of Spacelab and/or Attached Shuttle Payloads (ASP) telemetry data to various user facilities. Expert systems will aid in the performance of the quality assurance and data accounting functions of the two SLDPF functional elements: the Spacelab Input Processing System (SIPS) and the Spacelab Output Processing System (SOPS). Prototypes were developed for each as independent efforts. The SIPS Knowledge System Prototype (KSP) used the commercial shell OPS5+ on an IBM PC/AT; the SOPS Expert System Prototype used the expert system shell CLIPS implemented on a Macintosh personal computer. Both prototypes emulate the duties of the respective QA/DA analysts based upon analyst input and predetermined mission criteria parameters, and recommended instructions and decisions governing the reprocessing, release, or holding for further analysis of data. These prototypes demonstrated feasibility and high potential for operational systems. Increase in productivity, decrease of tedium, consistency, concise historical records, and a training tool for new analyses were the principal advantages. An operational configuration, taking advantage of the SLDPF network capabilities, is under development with the expert systems being installed on SUN workstations. This new configuration in conjunction with the potential of the expert systems will enhance the efficiency, in both time and quality, of the SLDPF's release of Spacelab/AST data products.

Spacelab data processing facility (SLDPF) Quality Assurance (QA)/Data Accounting (DA) expert systems: Transition from prototypes to operational systems

NASA Technical Reports Server (NTRS)

Basile, Lisa

1988-01-01

The SLDPF is responsible for the capture, quality monitoring processing, accounting, and shipment of Spacelab and/or Attached Shuttle Payloads (ASP) telemetry data to various user facilities. Expert systems will aid in the performance of the quality assurance and data accounting functions of the two SLDPF functional elements: the Spacelab Input Processing System (SIPS) and the Spacelab Output Processing System (SOPS). Prototypes were developed for each as independent efforts. The SIPS Knowledge System Prototype (KSP) used the commercial shell OPS5+ on an IBM PC/AT; the SOPS Expert System Prototype used the expert system shell CLIPS implemented on a Macintosh personal computer. Both prototypes emulate the duties of the respective QA/DA analysts based upon analyst input and predetermined mission criteria parameters, and recommended instructions and decisions governing the reprocessing, release, or holding for further analysis of data. These prototypes demonstrated feasibility and high potential for operational systems. Increase in productivity, decrease of tedium, consistency, concise historial records, and a training tool for new analyses were the principal advantages. An operational configuration, taking advantage of the SLDPF network capabilities, is under development with the expert systems being installed on SUN workstations. This new configuration in conjunction with the potential of the expert systems will enhance the efficiency, in both time and quality, of the SLDPF's release of Spacelab/AST data products.

Evaluation of Visual Field Progression in Glaucoma: Quasar Regression Program and Event Analysis.

PubMed

Díaz-Alemán, Valentín T; González-Hernández, Marta; Perera-Sanz, Daniel; Armas-Domínguez, Karintia

2016-01-01

To determine the sensitivity, specificity and agreement between the Quasar program, glaucoma progression analysis (GPA II) event analysis and expert opinion in the detection of glaucomatous progression. The Quasar program is based on linear regression analysis of both mean defect (MD) and pattern standard deviation (PSD). Each series of visual fields was evaluated by three methods; Quasar, GPA II and four experts. The sensitivity, specificity and agreement (kappa) for each method was calculated, using expert opinion as the reference standard. The study included 439 SITA Standard visual fields of 56 eyes of 42 patients, with a mean of 7.8 ± 0.8 visual fields per eye. When suspected cases of progression were considered stable, sensitivity and specificity of Quasar, GPA II and the experts were 86.6% and 70.7%, 26.6% and 95.1%, and 86.6% and 92.6% respectively. When suspected cases of progression were considered as progressing, sensitivity and specificity of Quasar, GPA II and the experts were 79.1% and 81.2%, 45.8% and 90.6%, and 85.4% and 90.6% respectively. The agreement between Quasar and GPA II when suspected cases were considered stable or progressing was 0.03 and 0.28 respectively. The degree of agreement between Quasar and the experts when suspected cases were considered stable or progressing was 0.472 and 0.507. The degree of agreement between GPA II and the experts when suspected cases were considered stable or progressing was 0.262 and 0.342. The combination of MD and PSD regression analysis in the Quasar program showed better agreement with the experts and higher sensitivity than GPA II.

The Achievement Gap in Reading: Complex Causes, Persistent Issues, Possible Solutions

ERIC Educational Resources Information Center

Horowitz, Rosalind, Ed.; Samuels, S. Jay, Ed.

2017-01-01

In this volume prominent scholars, experts in their respective fields and highly skilled in the research they conduct, address educational and reading research from varied perspectives and address what it will take to close the achievement gap--with specific attention to reading. The achievement gap is redefined as a level at which all groups can…

Quality versus Quantity Debate in Swimming: Perceptions and Training Practices of Expert Swimming Coaches.

PubMed

Nugent, Frank J; Comyns, Thomas M; Warrington, Giles D

2017-06-01

The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches' perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches' perspective which was not currently available in the research literature.

Quality versus Quantity Debate in Swimming: Perceptions and Training Practices of Expert Swimming Coaches

PubMed Central

Nugent, Frank J; Comyns, Thomas M; Warrington, Giles D

2017-01-01

Abstract The debate over low-volume, high-intensity training versus high-volume, low-intensity training, commonly known as Quality versus Quantity, respectively, is a frequent topic of discussion among swimming coaches and academics. The aim of this study was to explore expert coaches’ perceptions of quality and quantity coaching philosophies in competitive swimming and to investigate their current training practices. A purposeful sample of 11 expert swimming coaches was recruited for this study. The study was a mixed methods design and involved each coach participating in 1 semi-structured interview and completing 1 closed-ended questionnaire. The main findings of this study were that coaches felt quality training programmes would lead to short term results for youth swimmers, but were in many cases more appropriate for senior swimmers. The coaches suggested that quantity training programmes built an aerobic base for youth swimmers, promoted technical development through a focus on slower swimming and helped to enhance recovery from training or competition. However, the coaches continuously suggested that quantity training programmes must be performed with good technique and they felt this was a misunderstood element. This study was a critical step towards gaining a richer and broader understanding on the debate over Quality versus Quantity training from an expert swimming coaches’ perspective which was not currently available in the research literature. PMID:28713467

[Relevance of a driving simulator in the assessment of handicapped individuals].

PubMed

Carroz, A; Comte, P-A; Nicolo, D; Dériaz, O; Vuadens, P

2008-06-01

To evaluate the value of our driving simulator in deciding whether or not to allow patients with physical and/or cognitive deficits to resuming driving and to analyze whether or not the medical expert's final decision is based more on the results of the driving simulator than those of the neuropsychological examination. One hundred and twenty-three patients were evaluated with the driving simulator. Thirty-five of those with cognitive deficits also underwent a neuropsychological examination prior to the medical expert's decision on driving aptitude. In cases of uncertainty or disagreement, a driving assessment in real conditions was performed by a driving instructor. In cases of physical handicap, the medical expert's decision concurred with that of the occupational therapist. For brain-injured patients, there was a significant correlation between the neuropsychologist's opinion and that of the occupational therapist (kappa=0.33; P=0.01). However, the sensibility and specificity were only 55 and 80%, respectively. The correlation between an occupational therapy decision based on the driving simulator and that of the medical expert was very significant (kappa=0.81; P<0.0001) and the sensibility and specificity were 84 and 100%, respectively. In contrast, these values were lower (63 and 71%, respectively) for the correlation between the neuropsychologist's opinion and that of the medical expert. Our driving simulator enables the danger-free evaluation of driving aptitude. The results mirror an in situ assessment and are more sensitive than neuropsychological examination. In fact, the neuropsychologist's opinion often is more negative or uncertain with respect to the patient's real driving aptitude. When taking a decision on a patient's driving aptitude, the medical expert is more inclined to trust the results of the driving simulator.

A Teacher's Guide to Including Students with Disabilities in General Physical Education, Third Edition

ERIC Educational Resources Information Center

Block, Martin E.

2007-01-01

This book, provides a comprehensive guide to making phys. ed. inclusion work for students of all ages. In this new edition of the trusted bestseller, renowned expert Martin E. Block and a select group of highly respected contributors provide: (1) new information reflecting all the latest updates to IDEA, other disability-related legislation, and…

Construction of a web-based questionnaire for longitudinal investigation of work exposure, musculoskeletal pain and performance impairments in high-performance marine craft populations

PubMed Central

de Alwis, Manudul Pahansen; Äng, Björn Olov; Garme, Karl

2017-01-01

Objective High-performance marine craft personnel (HPMCP) are regularly exposed to vibration and repeated shock (VRS) levels exceeding maximum limitations stated by international legislation. Whereas such exposure reportedly is detrimental to health and performance, the epidemiological data necessary to link these adverse effects causally to VRS are not available in the scientific literature, and no suitable tools for acquiring such data exist. This study therefore constructed a questionnaire for longitudinal investigations in HPMCP. Methods A consensus panel defined content domains, identified relevant items and outlined a questionnaire. The relevance and simplicity of the questionnaire’s content were then systematically assessed by expert raters in three consecutive stages, each followed by revisions. An item-level content validity index (I-CVI) was computed as the proportion of experts rating an item as relevant and simple, and a scale-level content validity index (S-CVI/Ave) as the average I-CVI across items. The thresholds for acceptable content validity were 0.78 and 0.90, respectively. Finally, a dynamic web version of the questionnaire was constructed and pilot tested over a 1-month period during a marine exercise in a study population sample of eight subjects, while accelerometers simultaneously quantified VRS exposure. Results Content domains were defined as work exposure, musculoskeletal pain and human performance, and items were selected to reflect these constructs. Ratings from nine experts yielded S-CVI/Ave of 0.97 and 1.00 for relevance and simplicity, respectively, and the pilot test suggested that responses were sensitive to change in acceleration and that the questionnaire, following some adjustments, was feasible for its intended purpose. Conclusions A dynamic web-based questionnaire for longitudinal survey of key variables in HPMCP was constructed. Expert ratings supported that the questionnaire content is relevant, simple and sufficiently comprehensive, and the pilot test suggested that the questionnaire is feasible for longitudinal measurements in the study population. PMID:28729320

System perspectives of experts and farmers regarding the role of livelihood assets in risk perception: results from the structured mental model approach.

PubMed

Schoell, Regina; Binder, Claudia R

2009-02-01

Pesticide application is increasing and despite extensive educational programs farmers continue to take high health and environmental risks when applying pesticides. The structured mental model approach (SMMA) is a new method for risk perception analysis. It embeds farmers' risk perception into their livelihood system in the elaboration of a mental model (MM). Results from its first application are presented here. The study region is Vereda la Hoya (Colombia), an area characterized by subsistence farming, high use of pesticides, and a high incidence of health problems. Our hypothesis was that subsistence farmers were constrained by economic, environmental, and sociocultural factors, which consequently should influence their mental models. Thirteen experts and 10 farmers were interviewed and their MMs of the extended pesticide system elicited. The interviews were open-ended with the questions structured in three parts: (i) definition and ranking of types of capital with respect to their importance for the sustainability of farmers' livelihood; (ii) understanding the system and its dynamics; and (iii) importance of the agents in the farmers' agent network. Following this structure, each part of the interview was analyzed qualitatively and statistically. Our analyses showed that the mental models of farmers and experts differed significantly from each other. By applying the SMMA, we were also able to identify reasons for the divergence of experts' and farmers' MMs. Of major importance are the following factors: (i) culture and tradition; (ii) trust in the source of information; and (iii) feedback on knowledge.

Early esophageal cancer detection using RF classifiers

NASA Astrophysics Data System (ADS)

Janse, Markus H. A.; van der Sommen, Fons; Zinger, Svitlana; Schoon, Erik J.; de With, Peter H. N.

2016-03-01

Esophageal cancer is one of the fastest rising forms of cancer in the Western world. Using High-Definition (HD) endoscopy, gastroenterology experts can identify esophageal cancer at an early stage. Recent research shows that early cancer can be found using a state-of-the-art computer-aided detection (CADe) system based on analyzing static HD endoscopic images. Our research aims at extending this system by applying Random Forest (RF) classification, which introduces a confidence measure for detected cancer regions. To visualize this data, we propose a novel automated annotation system, employing the unique characteristics of the previous confidence measure. This approach allows reliable modeling of multi-expert knowledge and provides essential data for real-time video processing, to enable future use of the system in a clinical setting. The performance of the CADe system is evaluated on a 39-patient dataset, containing 100 images annotated by 5 expert gastroenterologists. The proposed system reaches a precision of 75% and recall of 90%, thereby improving the state-of-the-art results by 11 and 6 percentage points, respectively.

The ALICE-HMPID Detector Control System: Its evolution towards an expert and adaptive system

NASA Astrophysics Data System (ADS)

De Cataldo, G.; Franco, A.; Pastore, C.; Sgura, I.; Volpe, G.

2011-05-01

The High Momentum Particle IDentification (HMPID) detector is a proximity focusing Ring Imaging Cherenkov (RICH) for charged hadron identification. The HMPID is based on liquid C 6F 14 as the radiator medium and on a 10 m 2 CsI coated, pad segmented photocathode of MWPCs for UV Cherenkov photon detection. To ensure full remote control, the HMPID is equipped with a detector control system (DCS) responding to industrial standards for robustness and reliability. It has been implemented using PVSS as Slow Control And Data Acquisition (SCADA) environment, Programmable Logic Controller as control devices and Finite State Machines for modular and automatic command execution. In the perspective of reducing human presence at the experiment site, this paper focuses on DCS evolution towards an expert and adaptive control system, providing, respectively, automatic error recovery and stable detector performance. HAL9000, the first prototype of the HMPID expert system, is then presented. Finally an analysis of the possible application of the adaptive features is provided.

The American Nurses Association Code of Ethics: a reflection on the ethics of respect and human dignity with nurse as expert.

PubMed

Milton, Constance L

2003-10-01

The American Nurses Association Code of Ethics for Nurses calls for the nurse to practice with compassion and respect for every individual. What are the ethics and challenges of practicing professional nursing with expertise and educating a new generation of nurses while incorporating the interpretive statements into practice? This column differentiates the traditional biomedical views on human dignity and respect while exploring the embedded ethics of respect and self-determination and what it truly means to be an expert of nursing from the theoretical perspective of the human becoming school of thought.

Facial profile preferences, self-awareness and perception among groups of people in the United Arab Emirates

PubMed Central

Al Taki, Amjad; Guidoum, Amina

2014-01-01

Objectives: The objective of this study is to assess the differences in facial profile preference among different layers of people in the United Arab Emirates. Facial profile self-awareness among the different groups was also evaluated. Materials and Methods: A total sample of 222 participants (mean [standard deviation] age = 25.71 [8.3] years, almost 80% of the participants were of Arab origin and 55% were males); consisting of 60 laypersons, 60 dental students, 60 general practitioners, 16 oral surgeons, and 26 orthodontists. Facial profile photographs of a male and female adult with straight profiles and a Class I skeletal relationship were used as a baseline template. Computerized photographic image modification was carried out on the templates to obtain seven different facial profile silhouettes for each gender. To assess differences in facial profile perception, participants were asked to rank the profiles of each gender on a scale from most to least attractive (1 [highest score] and 7 [least score]). Awareness and satisfaction with the facial appearance on a profile view was assessed using questionnaires completed by the non-expert groups. Results: The straight facial profile was perceived to be highly attractive by all five groups. The least attractive profiles were the bimaxillary protrusion and the mandibular retrusion for the male and the female profiles, respectively. Lip protrusion was more esthetically acceptable in females. Significant differences in perception existed among groups. The female profile esthetic perception was highly correlated between the expert groups (P > 0.05). Overall agreement between the non-expert group's perceptions of their own profiles and evaluation by the expert orthodontist was 51% (κ = 0.089). Candidates who perceived themselves as having a Class III facial profile were the least satisfied with their profile. Conclusions: Dental professionals, dental students, and laypersons had a similar perception trends in female and male aesthetic preference. Laypersons were more tolerant to profiles with bi-maxillary retrusion. The expert group's esthetic perception was highly correlated only for the female profiles. Most of the non-experts were unable to correctly identify their facial profile. PMID:24987664

Objective Assessment of the Interfrontal Angle for Severity Grading and Operative Decision-Making in Metopic Synostosis.

PubMed

Anolik, Rachel A; Allori, Alexander C; Pourtaheri, Navid; Rogers, Gary F; Marcus, Jeffrey R

2016-05-01

The purpose of this study was to evaluate the utility of a previously validated interfrontal angle for classification of severity of metopic synostosis and as an aid to operative decision-making. An expert panel was asked to study 30 cases ranging from minor to severe metopic synostosis. Based on computed tomographic images of the skull and clinical photographs, they classified the severity of trigonocephaly (1 = normal, 2 = mild, 3 = moderate, and 4 = severe) and management (0 = nonoperative and 1 = operative). The severity scores and management reported by experts were then pooled and matched with the interfrontal angle computed from each respective computed tomographic scan. A threshold was identified at which most experts agree on operative management. Expert severity scores were higher for more acute interfrontal angles. There was a high concordance at the extremes of classifications, severe (4) and normal (1) (p < 0.0001); however, between interfrontal angles of 114.3 and 136.1 degrees, there exists a "gray zone," with severe discordance in expert rankings. An operative threshold of 118.2 degrees was identified, with the interfrontal angle able to predict the expert panel's decision to proceed with surgery 87.6 percent of the time. The interfrontal angle has been previously validated as a simple, accurate, and reproducible means for diagnosing trigonocephaly, but must be obtained from computed tomographic data. In this article, the authors demonstrate that the interfrontal angle can be used to further characterize the severity of trigonocephaly. It also correlated with expert decision-making for operative versus nonoperative management. This tool may be used as an adjunct to clinical decision-making when the decision to proceed with surgery may not be straightforward. Diagnostic, V.

Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems.

PubMed

Isajevs, Sergejs; Liepniece-Karele, Inta; Janciauskas, Dainius; Moisejevs, Georgijs; Putnins, Viesturs; Funka, Konrads; Kikuste, Ilze; Vanags, Aigars; Tolmanis, Ivars; Leja, Marcis

2014-04-01

Atrophic gastritis remains a difficult histopathological diagnosis with low interobserver agreement. The aim of our study was to compare gastritis staging and interobserver agreement between general and expert gastrointestinal (GI) pathologists using Operative Link for Gastritis Assessment (OLGA) and Operative Link on Gastric Intestinal Metaplasia (OLGIM). We enrolled 835 patients undergoing upper endoscopy in the study. Two general and two expert gastrointestinal pathologists graded biopsy specimens according to the Sydney classification, and the stage of gastritis was assessed by OLGA and OLGIM system. Using OLGA, 280 (33.4 %) patients had gastritis (stage I-IV), whereas with OLGIM this was 167 (19.9 %). OLGA stage III- IV gastritis was observed in 25 patients, whereas by OLGIM stage III-IV was found in 23 patients. Interobserver agreement between expert GI pathologists for atrophy in the antrum, incisura angularis, and corpus was moderate (kappa = 0.53, 0.57 and 0.41, respectively, p < 0.0001), but almost perfect for intestinal metaplasia (kappa = 0.82, 0.80 and 0.81, respectively, p < 0.0001). However, interobserver agreement between general pathologists was poor for atrophy, but moderate for intestinal metaplasia. OLGIM staging provided the highest interobserver agreement, but a substantial proportion of potentially high-risk individuals would be missed if only OLGIM staging is applied. Therefore, we recommend to use a combination of OLGA and OLGIM for staging of chronic gastritis.

Adversarial allegiance: The devil is in the evidence details, not just on the witness stand.

PubMed

McAuliff, Bradley D; Arter, Jeana L

2016-10-01

This study examined the potential influence of adversarial allegiance on expert testimony in a simulated child sexual abuse case. A national sample of 100 witness suggestibility experts reviewed a police interview of an alleged 5-year-old female victim. Retaining party (prosecution, defense) and interview suggestibility (low, high) varied across experts. Experts were very willing to testify, but more so for the prosecution than the defense when interview suggestibility was low and vice versa when interview suggestibility was high. Experts' anticipated testimony focused more on prodefense aspects of the police interview and child's memory overall (negativity bias), but favored retaining party only when interview suggestibility was low. Prosecution-retained experts shifted their focus from prodefense aspects of the case in the high suggestibility interview to proprosecution aspects in the low suggestibility interview; defense experts did not. Blind raters' perceptions of expert focus mirrored those findings. Despite an initial bias toward retaining party, experts' evaluations of child victim accuracy and police interview quality were lower in the high versus low interview suggestibility condition only. Our data suggest that adversarial allegiance exists, that it can (but not always) influence how experts process evidence, and that it may be more likely in cases involving evidence that is not blatantly flawed. Defense experts may evaluate this type of evidence more negatively than prosecution experts because of negativity bias and positive testing strategies associated with confirmation bias. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Adversarial Allegiance: The Devil is in the Evidence Details, Not Just on the Witness Stand

PubMed Central

McAuliff, Bradley D.; Arter, Jeana L.

2016-01-01

This study examined the potential influence of adversarial allegiance on expert testimony in a simulated child sexual abuse case. A national sample of 100 witness suggestibility experts reviewed a police interview of an alleged 5 year-old female victim. Retaining party (prosecution, defense) and interview suggestibility (low, high) varied across experts. Experts were very willing to testify, but more so for the prosecution than the defense when interview suggestibility was low and vice versa when interview suggestibility was high. Experts' anticipated testimony focused more on pro-defense aspects of the police interview and child's memory overall (negativity bias), but favored retaining party only when interview suggestibility was low. Unlike prosecution-retained experts who shifted their focus from pro-defense aspects of the case in the high suggestibility interview to pro-prosecution aspects in the low suggestibility interview, defense experts did not. Blind raters' perceptions of expert focus mirrored those findings. Despite an initial bias toward retaining party, experts' evaluations of child victim accuracy and interview quality were lower in the high versus low interview suggestibility condition only. Our data suggest that adversarial allegiance exists, that it can (but not always) influence how experts process evidence, and that it may be more likely in cases involving evidence that is not blatantly flawed. Defense experts may evaluate this type of evidence more negatively than prosecution experts due to negativity bias and positive testing strategies associated with confirmation bias. PMID:27243362

Toward high-throughput phenotyping: unbiased automated feature extraction and selection from knowledge sources.

PubMed

Yu, Sheng; Liao, Katherine P; Shaw, Stanley Y; Gainer, Vivian S; Churchill, Susanne E; Szolovits, Peter; Murphy, Shawn N; Kohane, Isaac S; Cai, Tianxi

2015-09-01

Analysis of narrative (text) data from electronic health records (EHRs) can improve population-scale phenotyping for clinical and genetic research. Currently, selection of text features for phenotyping algorithms is slow and laborious, requiring extensive and iterative involvement by domain experts. This paper introduces a method to develop phenotyping algorithms in an unbiased manner by automatically extracting and selecting informative features, which can be comparable to expert-curated ones in classification accuracy. Comprehensive medical concepts were collected from publicly available knowledge sources in an automated, unbiased fashion. Natural language processing (NLP) revealed the occurrence patterns of these concepts in EHR narrative notes, which enabled selection of informative features for phenotype classification. When combined with additional codified features, a penalized logistic regression model was trained to classify the target phenotype. The authors applied our method to develop algorithms to identify patients with rheumatoid arthritis and coronary artery disease cases among those with rheumatoid arthritis from a large multi-institutional EHR. The area under the receiver operating characteristic curves (AUC) for classifying RA and CAD using models trained with automated features were 0.951 and 0.929, respectively, compared to the AUCs of 0.938 and 0.929 by models trained with expert-curated features. Models trained with NLP text features selected through an unbiased, automated procedure achieved comparable or slightly higher accuracy than those trained with expert-curated features. The majority of the selected model features were interpretable. The proposed automated feature extraction method, generating highly accurate phenotyping algorithms with improved efficiency, is a significant step toward high-throughput phenotyping. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Diagnostic accuracy of automatic normalization of CBV in glioma grading using T1- weighted DCE-MRI.

PubMed

Sahoo, Prativa; Gupta, Rakesh K; Gupta, Pradeep K; Awasthi, Ashish; Pandey, Chandra M; Gupta, Mudit; Patir, Rana; Vaishya, Sandeep; Ahlawat, Sunita; Saha, Indrajit

2017-12-01

Aim of this retrospective study was to compare diagnostic accuracy of proposed automatic normalization method to quantify the relative cerebral blood volume (rCBV) with existing contra-lateral region of interest (ROI) based CBV normalization method for glioma grading using T1-weighted dynamic contrast enhanced MRI (DCE-MRI). Sixty patients with histologically confirmed gliomas were included in this study retrospectively. CBV maps were generated using T1-weighted DCE-MRI and are normalized by contralateral ROI based method (rCBV_contra), unaffected white matter (rCBV_WM) and unaffected gray matter (rCBV_GM), the latter two of these were generated automatically. An expert radiologist with >10years of experience in DCE-MRI and a non-expert with one year experience were used independently to measure rCBVs. Cutoff values for glioma grading were decided from ROC analysis. Agreement of histology with rCBV_WM, rCBV_GM and rCBV_contra respectively was studied using Kappa statistics and intra-class correlation coefficient (ICC). The diagnostic accuracy of glioma grading using the measured rCBV_contra by expert radiologist was found to be high (sensitivity=1.00, specificity=0.96, p<0.001) compared to the non-expert user (sensitivity=0.65, specificity=0.78, p<0.001). On the other hand, both the expert and non-expert user showed similar diagnostic accuracy for automatic rCBV_WM (sensitivity=0.89, specificity=0.87, p=0.001) and rCBV_GM (sensitivity=0.81, specificity=0.78, p=0.001) measures. Further, it was also observed that, contralateral based method by expert user showed highest agreement with histological grading of tumor (kappa=0.96, agreement 98.33%, p<0.001), however; automatic normalization method showed same percentage of agreement for both expert and non-expert user. rCBV_WM showed an agreement of 88.33% (kappa=0.76,p<0.001) with histopathological grading. It was inferred from this study that, in the absence of expert user, automated normalization of CBV using the proposed method could provide better diagnostic accuracy compared to the manual contralateral based approach. Copyright © 2017 Elsevier Inc. All rights reserved.

Application of expert-notice dialogue (END) method to assess students’ science communication ability on biology

NASA Astrophysics Data System (ADS)

Sriyati, S.; Amelia, D. N.; Soniyana, G. T.

2018-05-01

Student’s science communication ability can be assessed by the Expert-Notice Dialogue (END) method which focusing on verbal explanations using graphs or images as a tool. This study aims to apply the END method to assess students’ science communication ability. The study was conducted in two high schools with each sample of one class at each school (A and B). The number of experts in class A is 8 students and 7 in class B, the number of notice in class A 24 students and 30 in class B. The material chosen for explanation by expert is Ecosystem in class A and plant classification in class B. Research instruments are rubric of science communication ability, observation rubric, notice concept test and notice questionnaire. The implementation recorded with a video camera and then transcribed based on rubric science communication ability. The results showed that the average of science communication ability in class A and B was 60% and 61.8%, respectively, in enough categories. Mastery of the notice concept is in good category with 79.10 averages in class A and 94.64 in class B. Through the questionnaire notice it is known that the END method generally helps notice in understanding the concept.

Experiments with microcomputer-based artificial intelligence environments

USGS Publications Warehouse

Summers, E.G.; MacDonald, R.A.

1988-01-01

The U.S. Geological Survey (USGS) has been experimenting with the use of relatively inexpensive microcomputers as artificial intelligence (AI) development environments. Several AI languages are available that perform fairly well on desk-top personal computers, as are low-to-medium cost expert system packages. Although performance of these systems is respectable, their speed and capacity limitations are questionable for serious earth science applications foreseen by the USGS. The most capable artificial intelligence applications currently are concentrated on what is known as the "artificial intelligence computer," and include Xerox D-series, Tektronix 4400 series, Symbolics 3600, VAX, LMI, and Texas Instruments Explorer. The artificial intelligence computer runs expert system shells and Lisp, Prolog, and Smalltalk programming languages. However, these AI environments are expensive. Recently, inexpensive 32-bit hardware has become available for the IBM/AT microcomputer. USGS has acquired and recently completed Beta-testing of the Gold Hill Systems 80386 Hummingboard, which runs Common Lisp on an IBM/AT microcomputer. Hummingboard appears to have the potential to overcome many of the speed/capacity limitations observed with AI-applications on standard personal computers. USGS is a Beta-test site for the Gold Hill Systems GoldWorks expert system. GoldWorks combines some high-end expert system shell capabilities in a medium-cost package. This shell is developed in Common Lisp, runs on the 80386 Hummingboard, and provides some expert system features formerly available only on AI-computers including frame and rule-based reasoning, on-line tutorial, multiple inheritance, and object-programming. ?? 1988 International Association for Mathematical Geology.

An evaluation of the lamb vision system as a predictor of lamb carcass red meat yield percentage.

PubMed

Brady, A S; Belk, K E; LeValley, S B; Dalsted, N L; Scanga, J A; Tatum, J D; Smith, G C

2003-06-01

An objective method for predicting red meat yield in lamb carcasses is needed to accurately assess true carcass value. This study was performed to evaluate the ability of the lamb vision system (LVS; Research Management Systems USA, Fort Collins, CO) to predict fabrication yields of lamb carcasses. Lamb carcasses (n = 246) were evaluated using LVS and hot carcass weight (HCW), as well as by USDA expert and on-line graders, before fabrication of carcass sides to either bone-in or boneless cuts. On-line whole number, expert whole-number, and expert nearest-tenth USDA yield grades and LVS + HCW estimates accounted for 53, 52, 58, and 60%, respectively, of the observed variability in boneless, saleable meat yields, and accounted for 56, 57, 62, and 62%, respectively, of the variation in bone-in, saleable meat yields. The LVS + HCW system predicted 77, 65, 70, and 87% of the variation in weights of boneless shoulders, racks, loins, and legs, respectively, and 85, 72, 75, and 86% of the variation in weights of bone-in shoulders, racks, loins, and legs, respectively. Addition of longissimus muscle area (REA), adjusted fat thickness (AFT), or both REA and AFT to LVS + HCW models resulted in improved prediction of boneless saleable meat yields by 5, 3, and 5 percentage points, respectively. Bone-in, saleable meat yield estimations were improved in predictive accuracy by 7.7, 6.6, and 10.1 percentage points, and in precision, when REA alone, AFT alone, or both REA and AFT, respectively, were added to the LVS + HCW output models. Use of LVS + HCW to predict boneless red meat yields of lamb carcasses was more accurate than use of current on-line whole-number, expert whole-number, or expert nearest-tenth USDA yield grades. Thus, LVS + HCW output, when used alone or in combination with AFT and/or REA, improved on-line estimation of boneless cut yields from lamb carcasses. The ability of LVS + HCW to predict yields of wholesale cuts suggests that LVS could be used as an objective means for pricing carcasses in a value-based marketing system.

Terminology and definitions on groin pain in athletes: building agreement using a short Delphi method.

PubMed

Weir, Adam; Hölmich, Per; Schache, Anthony G; Delahunt, Eamonn; de Vos, Robert-Jan

2015-06-01

Groin pain in athletes occurs frequently and can be difficult to treat, which may partly be due to the lack of agreement on diagnostic terminology. To perform a short Delphi survey on terminology agreement for groin pain in athletes by a group of experts. A selected number of experts were invited to participate in a Delphi questionnaire. The study coordinator sent a questionnaire, which consisted of demographic questions and two 'real-life' case reports of athletes with groin pain. The experts were asked to complete the questionnaire and to provide the most likely diagnosis for each case. Questionnaire responses were analysed by an independent researcher. The Cohen's κ statistic was used to evaluate the level of agreement between the diagnostic terms provided by the experts. Twenty-three experts participated (96% of those invited). For case 1, experts provided 9 different terms to describe the most likely diagnosis; for case 2, 11 different terms were provided to describe the most likely diagnosis. With respect to the terms provided for the most likely diagnosis, the Cohen's κ was 0.06 and 0.002 for case 1 and 2, respectively. This heterogeneous taxonomy reflects only a slight agreement between the various diagnostic terms provided by the selected experts. This short Delphi survey of two 'typical, straightforward' cases demonstrated major inconsistencies in the diagnostic terminology used by experts for groin pain in athletes. These results underscore the need for consensus on definitions and terminology on groin pain in athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Expert opinion on landslide susceptibility elicted by probabilistic inversion from scenario rankings

NASA Astrophysics Data System (ADS)

Lee, Katy; Dashwood, Claire; Lark, Murray

2016-04-01

For many natural hazards the opinion of experts, with experience in assessing susceptibility under different circumstances, is a valuable source of information on which to base risk assessments. This is particularly important where incomplete process understanding, and limited data, limit the scope to predict susceptibility by mechanistic or statistical modelling. The expert has a tacit model of a system, based on their understanding of processes and their field experience. This model may vary in quality, depending on the experience of the expert. There is considerable interest in how one may elicit expert understanding by a process which is transparent and robust, to provide a basis for decision support. One approach is to provide experts with a set of scenarios, and then to ask them to rank small overlapping subsets of these with respect to susceptibility. Methods of probabilistic inversion have been used to compute susceptibility scores for each scenario, implicit in the expert ranking. It is also possible to model these scores as functions of measurable properties of the scenarios. This approach has been used to assess susceptibility of animal populations to invasive diseases, to assess risk to vulnerable marine environments and to assess the risk in hypothetical novel technologies for food production. We will present the results of a study in which a group of geologists with varying degrees of expertise in assessing landslide hazards were asked to rank sets of hypothetical simplified scenarios with respect to land slide susceptibility. We examine the consistency of their rankings and the importance of different properties of the scenarios in the tacit susceptibility model that their rankings implied. Our results suggest that this is a promising approach to the problem of how experts can communicate their tacit model of uncertain systems to those who want to make use of their expertise.

Communicating Low-Probability High-Consequence Risk, Uncertainty and Expert Confidence: Induced Seismicity of Deep Geothermal Energy and Shale Gas.

PubMed

Knoblauch, Theresa A K; Stauffacher, Michael; Trutnevyte, Evelina

2018-04-01

Subsurface energy activities entail the risk of induced seismicity including low-probability high-consequence (LPHC) events. For designing respective risk communication, the scientific literature lacks empirical evidence of how the public reacts to different written risk communication formats about such LPHC events and to related uncertainty or expert confidence. This study presents findings from an online experiment (N = 590) that empirically tested the public's responses to risk communication about induced seismicity and to different technology frames, namely deep geothermal energy (DGE) and shale gas (between-subject design). Three incrementally different formats of written risk communication were tested: (i) qualitative, (ii) qualitative and quantitative, and (iii) qualitative and quantitative with risk comparison. Respondents found the latter two the easiest to understand, the most exact, and liked them the most. Adding uncertainty and expert confidence statements made the risk communication less clear, less easy to understand and increased concern. Above all, the technology for which risks are communicated and its acceptance mattered strongly: respondents in the shale gas condition found the identical risk communication less trustworthy and more concerning than in the DGE conditions. They also liked the risk communication overall less. For practitioners in DGE or shale gas projects, the study shows that the public would appreciate efforts in describing LPHC risks with numbers and optionally risk comparisons. However, there seems to be a trade-off between aiming for transparency by disclosing uncertainty and limited expert confidence, and thereby decreasing clarity and increasing concern in the view of the public. © 2017 Society for Risk Analysis.

Evaluation of the ICT Malaria P.f/P.v and the OptiMal Rapid Diagnostic Tests for Malaria in Febrile Returned Travellers

PubMed Central

Playford, E. Geoffrey; Walker, John

2002-01-01

Rapid diagnostic tests (RDTs) are less reliant on expert microscopy and have the potential to reduce errors in malaria diagnosis but have not been extensively evaluated in nonimmune persons or in countries where infection is not endemic. We evaluated the ICT P.f/P.v (ICT-Amrad, Sydney, Australia) and OptiMal (Flow Inc., Portland, Oreg.) assays prospectively for the diagnosis of malaria in 158 specimens from 144 febrile returned travellers in Australia by using expert microscopy and PCR as reference standards. Malaria was diagnosed in 93 specimens from 87 patients by expert microscopy, with 3 additional specimens from recently treated patients testing positive for Plasmodium falciparum by PCR. For the diagnosis of asexual-stage P. falciparum malaria, the sensitivity and specificity of the ICT P.f/P.v assay were 97 and 90%, respectively, and those of the OptiMal assay were 85 and 96%, respectively. The ICT P.f/P.v assay missed one infection with a density of 45 parasites/μl, whereas the OptiMal assay missed infections up to 2,500/μl; below 1,000/μl, its sensitivity was only 43%. For the diagnosis of P. vivax malaria, the sensitivity and specificity of the ICT P.f/P.v assay were 44 and 100%, respectively, and those of the OptiMal assay were 80 and 97%, respectively. Both assays missed infections with parasite densities over 5,000/μl: up to 10,000/μl with the former and 5,300/μl with the latter. Despite the high sensitivity of the ICT P.f/P.v assay for P. falciparum malaria, caution is warranted before RDTs are widely adopted for the diagnosis of malaria in nonimmune patients or in countries where malaria is not endemic. PMID:12409392

Construction of a web-based questionnaire for longitudinal investigation of work exposure, musculoskeletal pain and performance impairments in high-performance marine craft populations.

PubMed

Lo Martire, Riccardo; de Alwis, Manudul Pahansen; Äng, Björn Olov; Garme, Karl

2017-07-20

High-performance marine craft personnel (HPMCP) are regularly exposed to vibration and repeated shock (VRS) levels exceeding maximum limitations stated by international legislation. Whereas such exposure reportedly is detrimental to health and performance, the epidemiological data necessary to link these adverse effects causally to VRS are not available in the scientific literature, and no suitable tools for acquiring such data exist. This study therefore constructed a questionnaire for longitudinal investigations in HPMCP. A consensus panel defined content domains, identified relevant items and outlined a questionnaire. The relevance and simplicity of the questionnaire's content were then systematically assessed by expert raters in three consecutive stages, each followed by revisions. An item-level content validity index (I-CVI) was computed as the proportion of experts rating an item as relevant and simple, and a scale-level content validity index (S-CVI/Ave) as the average I-CVI across items. The thresholds for acceptable content validity were 0.78 and 0.90, respectively. Finally, a dynamic web version of the questionnaire was constructed and pilot tested over a 1-month period during a marine exercise in a study population sample of eight subjects, while accelerometers simultaneously quantified VRS exposure. Content domains were defined as work exposure, musculoskeletal pain and human performance, and items were selected to reflect these constructs. Ratings from nine experts yielded S-CVI/Ave of 0.97 and 1.00 for relevance and simplicity, respectively, and the pilot test suggested that responses were sensitive to change in acceleration and that the questionnaire, following some adjustments, was feasible for its intended purpose. A dynamic web-based questionnaire for longitudinal survey of key variables in HPMCP was constructed. Expert ratings supported that the questionnaire content is relevant, simple and sufficiently comprehensive, and the pilot test suggested that the questionnaire is feasible for longitudinal measurements in the study population. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

European Council of Legal Medicine (ECLM) accreditation of forensic pathology services in Europe.

PubMed

Mangin, P; Bonbled, F; Väli, M; Luna, A; Bajanowski, T; Hougen, H P; Ludes, B; Ferrara, D; Cusack, D; Keller, E; Vieira, N

2015-03-01

Forensic experts play a major role in the legal process as they offer professional expert opinion and evidence within the criminal justice system adjudicating on the innocence or alleged guilt of an accused person. In this respect, medico-legal examination is an essential part of the investigation process, determining in a scientific way the cause(s) and manner of unexpected and/or unnatural death or bringing clinical evidence in case of physical, psychological, or sexual abuse in living people. From a legal perspective, these types of investigation must meet international standards, i.e., it should be independent, effective, and prompt. Ideally, the investigations should be conducted by board-certified experts in forensic medicine, endowed with a solid experience in this field, without any hierarchical relationship with the prosecuting authorities and having access to appropriate facilities in order to provide forensic reports of high quality. In this respect, there is a need for any private or public national or international authority including non-governmental organizations seeking experts qualified in forensic medicine to have at disposal a list of specialists working in accordance with high standards of professional performance within forensic pathology services that have been successfully submitted to an official accreditation/certification process using valid and acceptable criteria. To reach this goal, the National Association of Medical Examiners (NAME) has elaborated an accreditation/certification checklist which should be served as decision-making support to assist inspectors appointed to evaluate applicants. In the same spirit than NAME Accreditation Standards, European Council of Legal Medicine (ECLM) board decided to set up an ad hoc working group with the mission to elaborate an accreditation/certification procedure similar to the NAME's one but taking into account the realities of forensic medicine practices in Europe and restricted to post-mortem investigations. This accreditation process applies to services and not to individual practitioners by emphasizing policies and procedures rather than professional performance. In addition, the standards to be complied with should be considered as the minimum standards needed to get the recognition of performing and reliable forensic pathology service.

Elicitation of neurological knowledge with argument-based machine learning.

PubMed

Groznik, Vida; Guid, Matej; Sadikov, Aleksander; Možina, Martin; Georgiev, Dejan; Kragelj, Veronika; Ribarič, Samo; Pirtošek, Zvezdan; Bratko, Ivan

2013-02-01

The paper describes the use of expert's knowledge in practice and the efficiency of a recently developed technique called argument-based machine learning (ABML) in the knowledge elicitation process. We are developing a neurological decision support system to help the neurologists differentiate between three types of tremors: Parkinsonian, essential, and mixed tremor (comorbidity). The system is intended to act as a second opinion for the neurologists, and most importantly to help them reduce the number of patients in the "gray area" that require a very costly further examination (DaTSCAN). We strive to elicit comprehensible and medically meaningful knowledge in such a way that it does not come at the cost of diagnostic accuracy. To alleviate the difficult problem of knowledge elicitation from data and domain experts, we used ABML. ABML guides the expert to explain critical special cases which cannot be handled automatically by machine learning. This very efficiently reduces the expert's workload, and combines expert's knowledge with learning data. 122 patients were enrolled into the study. The classification accuracy of the final model was 91%. Equally important, the initial and the final models were also evaluated for their comprehensibility by the neurologists. All 13 rules of the final model were deemed as appropriate to be able to support its decisions with good explanations. The paper demonstrates ABML's advantage in combining machine learning and expert knowledge. The accuracy of the system is very high with respect to the current state-of-the-art in clinical practice, and the system's knowledge base is assessed to be very consistent from a medical point of view. This opens up the possibility to use the system also as a teaching tool. Copyright © 2012 Elsevier B.V. All rights reserved.

Expert opinion as 'validation' of risk assessment applied to calf welfare.

PubMed

Bracke, Marc B M; Edwards, Sandra A; Engel, Bas; Buist, Willem G; Algers, Bo

2008-07-14

Recently, a Risk Assessment methodology was applied to animal welfare issues in a report of the European Food Safety Authority (EFSA) on intensively housed calves. Because this is a new and potentially influential approach to derive conclusions on animal welfare issues, a so-called semantic-modelling type 'validation' study was conducted by asking expert scientists, who had been involved or quoted in the report, to give welfare scores for housing systems and for welfare hazards. Kendall's coefficient of concordance among experts (n = 24) was highly significant (P < 0.001), but low (0.29 and 0.18 for housing systems and hazards respectively). Overall correlations with EFSA scores were significant only for experts with a veterinary or mixed (veterinary and applied ethological) background. Significant differences in welfare scores were found between housing systems, between hazards, and between experts with different backgrounds. For example, veterinarians gave higher overall welfare scores for housing systems than ethologists did, probably reflecting a difference in their perception of animal welfare. Systems with the lowest scores were veal calves kept individually in so-called "baby boxes" (veal crates) or in small groups, and feedlots. A suckler herd on pasture was rated as the best for calf welfare. The main hazards were related to underfeeding, inadequate colostrum intake, poor stockperson education, insufficient space, inadequate roughage, iron deficiency, inadequate ventilation, poor floor conditions and no bedding. Points for improvement of the Risk Assessment applied to animal welfare include linking information, reporting uncertainty and transparency about underlying values. The study provides novel information on expert opinion in relation to calf welfare and shows that Risk Assessment applied to animal welfare can benefit from a semantic modelling approach.

Inside the black box: starting to uncover the underlying decision rules used in one-by-one expert assessment of occupational exposure in case-control studies

PubMed Central

Wheeler, David C.; Burstyn, Igor; Vermeulen, Roel; Yu, Kai; Shortreed, Susan M.; Pronk, Anjoeka; Stewart, Patricia A.; Colt, Joanne S.; Baris, Dalsu; Karagas, Margaret R.; Schwenn, Molly; Johnson, Alison; Silverman, Debra T.; Friesen, Melissa C.

2014-01-01

Objectives Evaluating occupational exposures in population-based case-control studies often requires exposure assessors to review each study participants' reported occupational information job-by-job to derive exposure estimates. Although such assessments likely have underlying decision rules, they usually lack transparency, are time-consuming and have uncertain reliability and validity. We aimed to identify the underlying rules to enable documentation, review, and future use of these expert-based exposure decisions. Methods Classification and regression trees (CART, predictions from a single tree) and random forests (predictions from many trees) were used to identify the underlying rules from the questionnaire responses and an expert's exposure assignments for occupational diesel exhaust exposure for several metrics: binary exposure probability and ordinal exposure probability, intensity, and frequency. Data were split into training (n=10,488 jobs), testing (n=2,247), and validation (n=2,248) data sets. Results The CART and random forest models' predictions agreed with 92–94% of the expert's binary probability assignments. For ordinal probability, intensity, and frequency metrics, the two models extracted decision rules more successfully for unexposed and highly exposed jobs (86–90% and 57–85%, respectively) than for low or medium exposed jobs (7–71%). Conclusions CART and random forest models extracted decision rules and accurately predicted an expert's exposure decisions for the majority of jobs and identified questionnaire response patterns that would require further expert review if the rules were applied to other jobs in the same or different study. This approach makes the exposure assessment process in case-control studies more transparent and creates a mechanism to efficiently replicate exposure decisions in future studies. PMID:23155187

Integrated Endangered Species Management Recommendations for Army Installations in the Southeastern United States

DTIC Science & Technology

1997-06-11

heritage programs in the respective states, Nature Conservancy state field offices, and with recognized 0 experts in the academic community . A total... community types which we have used in our analysis do not necessarily coincide with any standard classification scheme. Rather, they were selected as...fencelines, and field edges. High impact techniques , such as plow lines and retardants, should be restricted to installation perimeters as much as possible

Models Used to Select Strategic Planning Experts for High Technology Productions

NASA Astrophysics Data System (ADS)

Zakharova, Alexandra A.; Grigorjeva, Antonina A.; Tseplit, Anna P.; Ozgogov, Evgenij V.

2016-04-01

The article deals with the problems and specific aspects in organizing works of experts involved in assessment of companies that manufacture complex high-technology products. A model is presented that is intended for evaluating competences of experts in individual functional areas of expertise. Experts are selected to build a group on the basis of tables used to determine a competence level. An expert selection model based on fuzzy logic is proposed and additional requirements for the expert group composition can be taken into account, with regard to the needed quality and competence related preferences of decision-makers. A Web-based information system model is developed for the interaction between experts and decision-makers when carrying out online examinations.

Prospective evaluation of a rapid nanoparticle-based lateral flow immunoassay (STic Expert(®) HIT) for the diagnosis of heparin-induced thrombocytopenia.

PubMed

Leroux, Dorothée; Hezard, Nathalie; Lebreton, Aurélien; Bauters, Anne; Suchon, Pierre; de Maistre, Emmanuel; Biron, Christine; Huisse, Marie-Genevieve; Ternisien, Catherine; Voisin, Sophie; Gruel, Yves; Pouplard, Claire

2014-09-01

A rapid lateral flow immunoassay (LFIA) (STic Expert(®) HIT), recently developed for the diagnosis of heparin-induced thrombocytopenia (HIT), was evaluated in a prospective multicentre cohort of 334 consecutive patients. The risk of HIT was estimated by the 4Ts score as low, intermediate and high in 28·7%, 61·7% and 9·6% of patients, respectively. Definite HIT was diagnosed in 40 patients (12·0%) with positive results on both enzyme-linked immunosorbent assay (Asserachrom(®) HPIA IgG) and serotonin release assay. The inter-reader reproducibility of results obtained was excellent (kappa ratio > 0·9). The negative predictive value of LFIA with plasma samples was 99·6% with a negative likelihood ratio (LR) of 0·03, and was comparable to those of the particle gel immunoassay (H/PF4-PaGIA(®) ) performed in 124 cases. Positive predictive value and positive LR were 44·4% and 5·87, respectively, and the results were similar for serum samples. The probability of HIT in intermediate risk patients decreased from 11·2% to 0·4% when the LFIA result was negative and increased to 42·5% when it was positive. In conclusion, the STic Expert(®) HIT combined with the 4Ts score is a reliable tool to rule out the diagnosis of HIT. © 2014 John Wiley & Sons Ltd.

Development and Validation of a Tool to Evaluate the Evolution of Clinical Reasoning in Trauma Using Virtual Patients.

PubMed

Fleiszer, David; Hoover, Michael L; Posel, Nancy; Razek, Tarek; Bergman, Simon

Undergraduate medical students at a large academic trauma center are required to manage a series of online virtual trauma patients as a mandatory exercise during their surgical rotation. Clinical reasoning during undergraduate medical education can be difficult to assess. The purpose of the study was to determine whether we could use components of the students' virtual patient management to measure changes in their clinical reasoning over the course of the clerkship year. In order to accomplish this, we decided to determine if the use of scoring rubrics could change the traditional subjective assessment to a more objective evaluation. Two groups of students, one at the beginning of clerkship (Juniors) and one at the end of clerkship (Seniors), were chosen. Each group was given the same virtual patient case, a clinical scenario based on the Advanced Trauma Life Support (ATLS) Primary Trauma Survey, which had to be completed during their trauma rotation. The learner was required to make several key patient management choices based on their clinical reasoning, which would take them along different routes through the case. At the end of the case they had to create a summary report akin to sign-off. These summaries were graded independently by two domain "Experts" using a traditional subjective surgical approach to assessment and by two "Non-Experts" using two internally validated scoring rubrics. One rubric assessed procedural or domain knowledge (Procedural Rubric), while the other rubric highlighted semantic qualifiers (Semantic Rubric). Each of the rubrics was designed to reflect established components of clinical reasoning. Student's t-tests were used to compare the rubric scores for the two groups and Cohen's d was used to determine effect size. Kendall's τ was used to compare the difference between the two groups based on the "Expert's" subjective assessment. Inter-rater reliability (IRR) was determined using Cronbach's alpha. The Seniors did better than the Juniors with respect to "Procedural" issues but not for "Semantic" issues using the rubrics as assessed by the "Non-Experts". The average Procedural rubric score for the Senior group was 59% ± 13% while for the junior group, it was 51% ± 12% (t (80) = 2.715; p = 0.008; Cohen's d = 1.53). The average Semantic rubric score for the Senior group was 31% ± 15% while for the Junior group, it was 28% ± 14% (t (80) = 1.010; p = .316, ns). There was no statistical difference in the marks given to the Senior versus Junior groups by the "Experts" (Kendall's τ = 0.182, p = 0.07). The IRR between the "Non-Experts" using the rubrics was higher than the IRR of the "Experts" using the traditional surgical approach to assessment. The Cronbach's alpha for the Procedural and Semantic rubrics was 0.94 and 0.97, respectively, indicating very high IRR. The correlation between the Procedural rubric scores and "Experts" assessment was approximately r = 0.78, and that between the Semantic rubric and the "Experts" assessment was roughly r = 0.66, indicating high concurrent validity for the Procedural rubric and moderately high validity for the Semantic rubric. Clinical reasoning, as measured by some of its "procedural" features, improves over the course of the clerkship year. Rubrics can be created to objectively assess the summary statement of an online interactive trauma VP for "procedural" issues but not for "semantic" issues. Using IRR as a measure, the quality of assessment is improved using the rubrics. The "Procedural" rubric appears to measure changes in clinical reasoning over the course of 3rd-year undergraduate clinical studies. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Assessing guilt toward the former spouse.

PubMed

Wietzker, Anne; Buysse, Ann

2012-09-01

Divorce is often accompanied by feelings of guilt toward the former spouse. So far, no scale has been available to measure such feelings. For this purpose, the authors developed the Guilt in Separation Scale (GiSS). Content validity was assured by using experts and lay experts to generate and select items. Exploratory analyses were run on samples of 214 divorced individuals and confirmatory analyses on 458 individuals who were in the process of divorcing. Evidence was provided for the reliability and construct validity of the GiSS. The internal consistency was high (α = .91), as were the 6-month and 12-month test-retest reliabilities (r = .72 and r = .76, respectively). The GiSS was related to shame, regret, compassion, locus of cause of the separation, unfaithfulness, and psychological functioning. PsycINFO Database Record (c) 2012 APA, all rights reserved.

International study of expert judgment on therapeutic use of benzodiazepines and other psychotherapeutic medications: VI. Trends in recommendations for the pharmacotherapy of anxiety disorders, 1992-1997.

PubMed

Uhlenhuth, E H; Balter, M B; Ban, T A; Yang, K

1999-01-01

To assemble expert clinical experience and judgment regarding the treatment of anxiety disorders in a systematic, quantitative manner, particularly with respect to changes during the preceding five years. A panel of 73 internationally recognized experts in the pharmacotherapy of anxiety and depression was constituted by multistage peer nomination. Sixty-six completed a questionnaire in 1992, and 51 of those completed a follow-up questionnaire in 1997. This report focuses on the experts' responses to questions about therapeutic options relevant to seven vignettes describing typical cases of different anxiety disorders. The preferred initial treatment strategy in 1992 was a combination of medication with a psychological therapy for all vignettes except simple phobia, where a psychological procedure alone was favored. There was little change in 1997, primarily some decrease in the choice of psychological therapy and some increase in the choice of medication for social phobia. Experts recommending a medication in 1992 most often chose as first-line treatment a benzodiazepine anxiolytic (BZ) for panic disorder (PD), generalized anxiety disorder (GAD), simple phobia, and adjustment disorder. They recommended a beta-blocker most often for social phobia and a tricyclic anti-depressant (TCA) for agoraphobia and obsessive-compulsive disorder (OCD). Nearly a fourth chose a combination of medications, usually a TCA plus a BZ. In 1997, the expert panel's most frequent recommendation for agoraphobia, PD, and OCD changed to a specific serotonin reuptake inhibitor (SSRI); and they also recommended these compounds more often for GAD, social phobia, and simple phobia. Fewer experts chose BZs or TCAs. However, in 1997 many again chose a combination of medications, often a BZ plus a SSRI, so that, overall, there was only a small decline in recommendations for BZs. As second-line medications (1997 only), the experts recommended SSRIs most often for most vignettes, but a TCA for PD and GAD. Recommendations for a combination of medications rose substantially for most vignettes, usually a BZ plus an antidepressant. Combined cognitive-behavioral therapy plus medication was highly favored by the experts as the initial treatment strategy for anxiety disorders. During the preceding five years, SSRIs displaced older antidepressants as the experts' first-line choices for the pharmacotherapy of anxiety disorders. In case of an unsatisfactory response, the experts' second-line choices more often were an older antidepressant or a combination of an antidepressant plus a BZ. According to the experts' judgements, the BZs, especially combined with an antidepressant, remain mainstays of pharmacotherapy for anxiety disorders.

Esophageal cancer screening in achalasia: is there a consensus?

PubMed

Ravi, K; Geno, D M; Katzka, D A

2015-04-01

Achalasia is an important but relatively uncommon disorder. While highly effective therapeutic options exist, esophageal cancer remains a long-term potential complication. The risk of esophageal cancer in achalasia remains unclear, with current guidelines recommending against routine endoscopic screening. However, given limited data and conflicting opinion, it is unknown whether consensus regarding screening practices in achalasia among experts exists. A 10-question survey to assess screening practices in achalasia was created and distributed to 28 experts in the area of achalasia. Experts were identified based on publications and meeting presentations in the field. Survey responses were received from 17 of 28 (61%) experts. Wide geographic distribution was seen among respondents, with eight (47%) from Europe or Australia, seven (41%) from the United States, and two (12%) from Asia. Screening for esophageal cancer was inconsistent, with nine (53%) experts endorsing the practice and eight (47%) not. Screening practices did not differ among geographic regions. No consensus regarding the risk for esophageal cancer in achalasia was seen, with three experts reporting no increased risk compared with the general population, eight experts a lifetime risk of 0.1-0.5%, three experts a 0.5-1% risk, two experts a 1-2% risk, and one expert a 3-5% risk. However, these differences in perception of risk did not influence screening practices. Upper endoscopy was utilized among all experts who endorsed screening. However, practices still varied with screening commencing at or within 1 year of diagnosis in two practices compared with 5 and 10 years in three respective practices each. Surveillance intervals also varied, performed every 2 years in four practices, every 3 years in four practices, and every 5 years in one practice. Practice variation in the management of achalasia itself was also seen, with initial treatment with Heller myotomy endorsed by eight experts, pneumatic dilation by five experts, and two each endorsing peroral endoscopic myotomy or no specific preference. In addition, while 82% (14/17) of experts endorsed long-term follow up of patients, no consensus regarding long-term follow up existed, with annual follow up in eight practices, every 3-6 months in three practices, and every 2 years in three practices. Large practice variation in the long-term management of achalasia exists among experts in the field. Only a slight majority of experts endorse screening for esophageal cancer in achalasia, and no consensus exists regarding how surveillance should be structured even among this group. Interestingly, the lack of consensus on cancer screening parallels a lack of agreement on initial treatment of achalasia. These findings suggest a need for greater homogeneity in the management of longstanding achalasia and cancer screening. Further, this study highlights the need for more data on this topic to foster greater agreement. © 2014 International Society for Diseases of the Esophagus.

Telemedicine diagnosis of cytomegalovirus retinitis by nonophthalmologists.

PubMed

Yen, Michael; Ausayakhun, Somsanguan; Chen, Jenny; Ausayakhun, Sakarin; Jirawison, Choeng; Heiden, David; Holland, Gary N; Margolis, Todd P; Keenan, Jeremy D

2014-09-01

Cytomegalovirus (CMV) retinitis continues to be a leading cause of blindness in many developing countries. Telemedicine holds the potential to increase the number of people screened for CMV retinitis, but it is unclear whether nonophthalmologists could be responsible for interpreting fundus photographs captured in a telemedicine program. To determine the accuracy of nonophthalmologist photographic graders in diagnosing CMV retinitis from digital fundus photographs. Fifteen nonexpert graders each evaluated 182 mosaic retinal images taken from the eyes of patients with AIDS who were evaluated at the Ocular Infectious Diseases Clinic at Chiang Mai University in Chiang Mai, Thailand. Graders diagnosed each image as CMV retinitis present, CMV retinitis absent, or unknown. The results from each grader were compared with those of an indirect ophthalmoscopic examination from an experienced on-site ophthalmologist as well as with the consensus grade given by a panel of CMV retinitis experts. Relative to the on-site ophthalmologist, the sensitivity of remote CMV retinitis diagnosis by nonexpert graders ranged from 64.0% to 95.5% (mean, 84.1%; 95% CI, 78.6%-89.6%)), and the specificity ranged from 65.6% to 92.5% (mean, 82.3%; 95% CI, 76.6%-88.0%)). Agreement between nonexpert and expert graders was high: the mean sensitivity and specificity values of nonexpert diagnosis using expert consensus as the reference standard were 93.2% (95% CI, 90.6%-95.8%) and 88.4% (95% CI, 85.4%-91.1%), respectively. Mean intrarater reliability also was high (mean Cohen κ, 0.83; 95% CI, 0.78-0.87). The sensitivity and specificity of remote diagnosis of CMV retinitis by nonexpert graders was variable, although several nonexperts achieved a level of accuracy comparable to that of CMV retinitis experts. More intensive training and periodic evaluations would be required if nonexperts are to be used in clinical practice.

Validation and verification of expert systems

NASA Technical Reports Server (NTRS)

Gilstrap, Lewey

1991-01-01

Validation and verification (V&V) are procedures used to evaluate system structure or behavior with respect to a set of requirements. Although expert systems are often developed as a series of prototypes without requirements, it is not possible to perform V&V on any system for which requirements have not been prepared. In addition, there are special problems associated with the evaluation of expert systems that do not arise in the evaluation of conventional systems, such as verification of the completeness and accuracy of the knowledge base. The criticality of most NASA missions make it important to be able to certify the performance of the expert systems used to support these mission. Recommendations for the most appropriate method for integrating V&V into the Expert System Development Methodology (ESDM) and suggestions for the most suitable approaches for each stage of ESDM development are presented.

Unicorns or Tiger Woods: are lie detection experts myths or rarities? A response to on lie detection "wizards" by Bond and Uysal.

PubMed

O'Sullivan, Maureen

2007-02-01

Bond and Uysal (this issue) complain that expert lie detectors identified by O'Sullivan and Ekman (2004) are statistical flukes. They ignore one class of experts we have identified and misrepresent the procedures we use to identify the others. They also question the psychometric validity of the measures and protocol used. Many of their points are addressed in the chapter they criticize. The fruitfulness of the O'Sullivan-Ekman protocol is illustrated with respect to improved identification of expert lie detectors, as well as a replicated pattern of errors made by experts from different professional groups. The statistical arguments offered confuse the theoretical use of the binomial with the empirical use of the normal distribution. Data are provided that may clarify this distinction.

Towards a Fuzzy Expert System on Toxicological Data Quality Assessment.

PubMed

Yang, Longzhi; Neagu, Daniel; Cronin, Mark T D; Hewitt, Mark; Enoch, Steven J; Madden, Judith C; Przybylak, Katarzyna

2013-01-01

Quality assessment (QA) requires high levels of domain-specific experience and knowledge. QA tasks for toxicological data are usually performed by human experts manually, although a number of quality evaluation schemes have been proposed in the literature. For instance, the most widely utilised Klimisch scheme1 defines four data quality categories in order to tag data instances with respect to their qualities; ToxRTool2 is an extension of the Klimisch approach aiming to increase the transparency and harmonisation of the approach. Note that the processes of QA in many other areas have been automatised by employing expert systems. Briefly, an expert system is a computer program that uses a knowledge base built upon human expertise, and an inference engine that mimics the reasoning processes of human experts to infer new statements from incoming data. In particular, expert systems have been extended to deal with the uncertainty of information by representing uncertain information (such as linguistic terms) as fuzzy sets under the framework of fuzzy set theory and performing inferences upon fuzzy sets according to fuzzy arithmetic. This paper presents an experimental fuzzy expert system for toxicological data QA which is developed on the basis of the Klimisch approach and the ToxRTool in an effort to illustrate the power of expert systems to toxicologists, and to examine if fuzzy expert systems are a viable solution for QA of toxicological data. Such direction still faces great difficulties due to the well-known common challenge of toxicological data QA that "five toxicologists may have six opinions". In the meantime, this challenge may offer an opportunity for expert systems because the construction and refinement of the knowledge base could be a converging process of different opinions which is of significant importance for regulatory policy making under the regulation of REACH, though a consensus may never be reached. Also, in order to facilitate the implementation of Weight of Evidence approaches and in silico modelling proposed by REACH, there is a higher appeal of numerical quality values than nominal (categorical) ones, where the proposed fuzzy expert system could help. Most importantly, the deriving processes of quality values generated in this way are fully transparent, and thus comprehensible, for final users, which is another vital point for policy making specified in REACH. Case studies have been conducted and this report not only shows the promise of the approach, but also demonstrates the difficulties of the approach and thus indicates areas for future development. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Expertise facilitates the transfer of anticipation skill across domains.

PubMed

Rosalie, Simon M; Müller, Sean

2014-02-01

It is unclear whether perceptual-motor skill transfer is based upon similarity between the learning and transfer domains per identical elements theory, or facilitated by an understanding of underlying principles in accordance with general principle theory. Here, the predictions of identical elements theory, general principle theory, and aspects of a recently proposed model for the transfer of perceptual-motor skill with respect to expertise in the learning and transfer domains are examined. The capabilities of expert karate athletes, near-expert karate athletes, and novices to anticipate and respond to stimulus skills derived from taekwondo and Australian football were investigated in ecologically valid contexts using an in situ temporal occlusion paradigm and complex whole-body perceptual-motor skills. Results indicated that the karate experts and near-experts are as capable of using visual information to anticipate and guide motor skill responses as domain experts and near-experts in the taekwondo transfer domain, but only karate experts could perform like domain experts in the Australian football transfer domain. Findings suggest that transfer of anticipation skill is based upon expertise and an understanding of principles but may be supplemented by similarities that exist between the stimulus and response elements of the learning and transfer domains.

Roadmap of optical communications

NASA Astrophysics Data System (ADS)

Agrell, Erik; Karlsson, Magnus; Chraplyvy, A. R.; Richardson, David J.; Krummrich, Peter M.; Winzer, Peter; Roberts, Kim; Fischer, Johannes Karl; Savory, Seb J.; Eggleton, Benjamin J.; Secondini, Marco; Kschischang, Frank R.; Lord, Andrew; Prat, Josep; Tomkos, Ioannis; Bowers, John E.; Srinivasan, Sudha; Brandt-Pearce, Maïté; Gisin, Nicolas

2016-06-01

Lightwave communications is a necessity for the information age. Optical links provide enormous bandwidth, and the optical fiber is the only medium that can meet the modern society's needs for transporting massive amounts of data over long distances. Applications range from global high-capacity networks, which constitute the backbone of the internet, to the massively parallel interconnects that provide data connectivity inside datacenters and supercomputers. Optical communications is a diverse and rapidly changing field, where experts in photonics, communications, electronics, and signal processing work side by side to meet the ever-increasing demands for higher capacity, lower cost, and lower energy consumption, while adapting the system design to novel services and technologies. Due to the interdisciplinary nature of this rich research field, Journal of Optics has invited 16 researchers, each a world-leading expert in their respective subfields, to contribute a section to this invited review article, summarizing their views on state-of-the-art and future developments in optical communications.

Discriminatory power of handwriting

NASA Astrophysics Data System (ADS)

Srihari, Sargur N.; Cha, Sung-Hyuk; Lee, Sangjik

2001-12-01

A study was undertaken to determine the power of handwriting to distinguish between individuals. Handwriting samples of one thousand five hundred individuals, representative of the US population with respect to gender, age, ethnic groups, etc., were obtained. Analyzing differences in handwriting was done by using computer algorithms for extracting features from scanned images of handwriting. Attributes characteristic of the handwriting were obtained, e.g., line separation, slant, character shapes, etc. These attributes, which are a subset of attributes used by expert document examiners, were used to quantitatively establish individuality by using machine learning approaches. Using global attributes of hadwriting and very few characters in the writing, the ability to determine the writer with a high degree of confidence was established. The work is a step towards providing scientific support for admitting handwriting evidence in court. The mathematical approach and the resulting software also have the promise of aiding the expert document examiner.

A unified approach for debugging is-a structure and mappings in networked taxonomies

PubMed Central

2013-01-01

Background With the increased use of ontologies and ontology mappings in semantically-enabled applications such as ontology-based search and data integration, the issue of detecting and repairing defects in ontologies and ontology mappings has become increasingly important. These defects can lead to wrong or incomplete results for the applications. Results We propose a unified framework for debugging the is-a structure of and mappings between taxonomies, the most used kind of ontologies. We present theory and algorithms as well as an implemented system RepOSE, that supports a domain expert in detecting and repairing missing and wrong is-a relations and mappings. We also discuss two experiments performed by domain experts: an experiment on the Anatomy ontologies from the Ontology Alignment Evaluation Initiative, and a debugging session for the Swedish National Food Agency. Conclusions Semantically-enabled applications need high quality ontologies and ontology mappings. One key aspect is the detection and removal of defects in the ontologies and ontology mappings. Our system RepOSE provides an environment that supports domain experts to deal with this issue. We have shown the usefulness of the approach in two experiments by detecting and repairing circa 200 and 30 defects, respectively. PMID:23548155

Emerging Technologies for Environmental Remediation: Integrating Data and Judgment.

PubMed

Bates, Matthew E; Grieger, Khara D; Trump, Benjamin D; Keisler, Jeffrey M; Plourde, Kenton J; Linkov, Igor

2016-01-05

Emerging technologies present significant challenges to researchers, decision-makers, industry professionals, and other stakeholder groups due to the lack of quantitative risk, benefit, and cost data associated with their use. Multi-criteria decision analysis (MCDA) can support early decisions for emerging technologies when data is too sparse or uncertain for traditional risk assessment. It does this by integrating expert judgment with available quantitative and qualitative inputs across multiple criteria to provide relative technology scores. Here, an MCDA framework provides preliminary insights on the suitability of emerging technologies for environmental remediation by comparing nanotechnology and synthetic biology to conventional remediation methods. Subject matter experts provided judgments regarding the importance of criteria used in the evaluations and scored the technologies with respect to those criteria. The results indicate that synthetic biology may be preferred over nanotechnology and conventional methods for high expected benefits and low deployment costs but that conventional technology may be preferred over emerging technologies for reduced risks and development costs. In the absence of field data regarding the risks, benefits, and costs of emerging technologies, structuring evidence-based expert judgment through a weighted hierarchy of topical questions may be helpful to inform preliminary risk governance and guide emerging technology development and policy.

How to establish endoscopic submucosal dissection in Western countries.

PubMed

Oyama, Tsuneo; Yahagi, Naohisa; Ponchon, Thierry; Kiesslich, Tobias; Berr, Frieder

2015-10-28

Endoscopic submucosal dissection (ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy (IEE) to make correct indications for ESD, and high skills in endoscopic electrosurgical dissection. In Japan, endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles: (1) inadequate expectations as to the complexity of IEE and ESD; and (2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second stage, the upcoming Western experts must commit themselves to teach skilled endoscopists from other referral centers, in order to spread ESD in Western countries. Respect for patients with early gastrointestinal cancer asks for best efforts to learn endoscopic categorization of early neoplasias and skills for ESD based on sustained cooperation with the masters in Japan. The strategy is discussed here.

Research priorities in the field of HIV and AIDS in Iran

PubMed Central

Haghdoost, AliAkbar; Sadeghi, Masoomeh; Nasirian, Maryam; Mirzazadeh, Ali; Navadeh, Soodabeh

2012-01-01

Background: HIV is a multidimensional problem. Therefore, prioritization of research topics in this field is a serious challenge. We decided to prioritize the major areas of research on HIV/AIDS in Iran. Materials ans Methods: In a brain-storming session with the main national and provincial stakeholders and experts from different relevant fields, the direct and indirect dimensions of HIV/AIDS and its related research issues were explored. Afterward, using the Delphi method, we sent questionnaires to 20 experts (13 respondents) from different sectors. In this electronic based questioner, we requested experts to evaluate main topics and their subtopics. The ranges of scores were between 0 and 100. Results: The score of priorities of main themes were preventive activities (43.2), large scale planning (25.4), the estimation of the HIV/AIDS burden (20.9), and basic scientific research (10.5). The most important priority in each main theme was education particularly in high risk groups (52.5), developing the national strategy to address the epidemic (31.8), estimation of the incidence and prevalence among high-risk groups (59.5) and developing new preventive methods (66.7), respectively. Conclusions: The most important priorities of researches on HIV/AIDS were preventive activities and developing national strategy. As high risk groups are the most involved people in the epidemic, and they are also the most hard-to-reach sub-populations, a national well designated comprehensive strategy is essential. However, we believe with a very specific and directed scheme, special attention to research in basic sciences is necessary, at least in limited number of institutes. PMID:23626616

Segmentation of Brain Lesions in MRI and CT Scan Images: A Hybrid Approach Using k-Means Clustering and Image Morphology

NASA Astrophysics Data System (ADS)

Agrawal, Ritu; Sharma, Manisha; Singh, Bikesh Kumar

2018-04-01

Manual segmentation and analysis of lesions in medical images is time consuming and subjected to human errors. Automated segmentation has thus gained significant attention in recent years. This article presents a hybrid approach for brain lesion segmentation in different imaging modalities by combining median filter, k means clustering, Sobel edge detection and morphological operations. Median filter is an essential pre-processing step and is used to remove impulsive noise from the acquired brain images followed by k-means segmentation, Sobel edge detection and morphological processing. The performance of proposed automated system is tested on standard datasets using performance measures such as segmentation accuracy and execution time. The proposed method achieves a high accuracy of 94% when compared with manual delineation performed by an expert radiologist. Furthermore, the statistical significance test between lesion segmented using automated approach and that by expert delineation using ANOVA and correlation coefficient achieved high significance values of 0.986 and 1 respectively. The experimental results obtained are discussed in lieu of some recently reported studies.

How visual search relates to visual diagnostic performance: a narrative systematic review of eye-tracking research in radiology.

PubMed

van der Gijp, A; Ravesloot, C J; Jarodzka, H; van der Schaaf, M F; van der Schaaf, I C; van Schaik, J P J; Ten Cate, Th J

2017-08-01

Eye tracking research has been conducted for decades to gain understanding of visual diagnosis such as in radiology. For educational purposes, it is important to identify visual search patterns that are related to high perceptual performance and to identify effective teaching strategies. This review of eye-tracking literature in the radiology domain aims to identify visual search patterns associated with high perceptual performance. Databases PubMed, EMBASE, ERIC, PsycINFO, Scopus and Web of Science were searched using 'visual perception' OR 'eye tracking' AND 'radiology' and synonyms. Two authors independently screened search results and included eye tracking studies concerning visual skills in radiology published between January 1, 1994 and July 31, 2015. Two authors independently assessed study quality with the Medical Education Research Study Quality Instrument, and extracted study data with respect to design, participant and task characteristics, and variables. A thematic analysis was conducted to extract and arrange study results, and a textual narrative synthesis was applied for data integration and interpretation. The search resulted in 22 relevant full-text articles. Thematic analysis resulted in six themes that informed the relation between visual search and level of expertise: (1) time on task, (2) eye movement characteristics of experts, (3) differences in visual attention, (4) visual search patterns, (5) search patterns in cross sectional stack imaging, and (6) teaching visual search strategies. Expert search was found to be characterized by a global-focal search pattern, which represents an initial global impression, followed by a detailed, focal search-to-find mode. Specific task-related search patterns, like drilling through CT scans and systematic search in chest X-rays, were found to be related to high expert levels. One study investigated teaching of visual search strategies, and did not find a significant effect on perceptual performance. Eye tracking literature in radiology indicates several search patterns are related to high levels of expertise, but teaching novices to search as an expert may not be effective. Experimental research is needed to find out which search strategies can improve image perception in learners.

BAYESIAN META-ANALYSIS ON MEDICAL DEVICES: APPLICATION TO IMPLANTABLE CARDIOVERTER DEFIBRILLATORS

PubMed Central

Youn, Ji-Hee; Lord, Joanne; Hemming, Karla; Girling, Alan; Buxton, Martin

2012-01-01

Objectives: The aim of this study is to describe and illustrate a method to obtain early estimates of the effectiveness of a new version of a medical device. Methods: In the absence of empirical data, expert opinion may be elicited on the expected difference between the conventional and modified devices. Bayesian Mixed Treatment Comparison (MTC) meta-analysis can then be used to combine this expert opinion with existing trial data on earlier versions of the device. We illustrate this approach for a new four-pole implantable cardioverter defibrillator (ICD) compared with conventional ICDs, Class III anti-arrhythmic drugs, and conventional drug therapy for the prevention of sudden cardiac death in high risk patients. Existing RCTs were identified from a published systematic review, and we elicited opinion on the difference between four-pole and conventional ICDs from experts recruited at a cardiology conference. Results: Twelve randomized controlled trials were identified. Seven experts provided valid probability distributions for the new ICDs compared with current devices. The MTC model resulted in estimated relative risks of mortality of 0.74 (0.60–0.89) (predictive relative risk [RR] = 0.77 [0.41–1.26]) and 0.83 (0.70–0.97) (predictive RR = 0.84 [0.55–1.22]) with the new ICD therapy compared to Class III anti-arrhythmic drug therapy and conventional drug therapy, respectively. These results showed negligible differences from the preliminary results for the existing ICDs. Conclusions: The proposed method incorporating expert opinion to adjust for a modification made to an existing device may play a useful role in assisting decision makers to make early informed judgments on the effectiveness of frequently modified healthcare technologies. PMID:22559753

“Can It Read My Mind?” – What Do the Public and Experts Think of the Current (Mis)Uses of Neuroimaging?

PubMed Central

Wardlaw, Joanna M.; O'Connell, Garret; Shuler, Kirsten; DeWilde, Janet; Haley, Jane; Escobar, Oliver; Murray, Shaun; Rae, Robert; Jarvie, Donald; Sandercock, Peter; Schafer, Burkhard

2011-01-01

Emerging applications of neuroimaging outside medicine and science have received intense public exposure through the media. Media misrepresentations can create a gulf between public and scientific understanding of the capabilities of neuroimaging and raise false expectations. To determine the extent of this effect and determine public opinions on acceptable uses and the need for regulation, we designed an electronic survey to obtain anonymous opinions from as wide a range of members of the public and neuroimaging experts as possible. The surveys ran from 1st June to 30 September 2010, asked 10 and 21 questions, respectively, about uses of neuroimaging outside traditional medical diagnosis, data storage, science communication and potential methods of regulation. We analysed the responses using descriptive statistics; 660 individuals responded to the public and 303 individuals responded to the expert survey. We found evidence of public skepticism about the use of neuroimaging for applications such as lie detection or to determine consumer preferences and considerable disquiet about use by employers or government and about how their data would be stored and used. While also somewhat skeptical about new applications of neuroimaging, experts grossly underestimated how often neuroimaging had been used as evidence in court. Although both the public and the experts rated highly the importance of a better informed public in limiting the inappropriate uses to which neuroimaging might be put, opinions differed on the need for, and mechanism of, actual regulation. Neuroscientists recognized the risks of inaccurate reporting of neuroimaging capabilities in the media but showed little motivation to engage with the public. The present study also emphasizes the need for better frameworks for scientific engagement with media and public education. PMID:21991367

Characterizing Forest Change Using Community-Based Monitoring Data and Landsat Time Series

PubMed Central

DeVries, Ben; Pratihast, Arun Kumar; Verbesselt, Jan; Kooistra, Lammert; Herold, Martin

2016-01-01

Increasing awareness of the issue of deforestation and degradation in the tropics has resulted in efforts to monitor forest resources in tropical countries. Advances in satellite-based remote sensing and ground-based technologies have allowed for monitoring of forests with high spatial, temporal and thematic detail. Despite these advances, there is a need to engage communities in monitoring activities and include these stakeholders in national forest monitoring systems. In this study, we analyzed activity data (deforestation and forest degradation) collected by local forest experts over a 3-year period in an Afro-montane forest area in southwestern Ethiopia and corresponding Landsat Time Series (LTS). Local expert data included forest change attributes, geo-location and photo evidence recorded using mobile phones with integrated GPS and photo capabilities. We also assembled LTS using all available data from all spectral bands and a suite of additional indices and temporal metrics based on time series trajectory analysis. We predicted deforestation, degradation or stable forests using random forest models trained with data from local experts and LTS spectral-temporal metrics as model covariates. Resulting models predicted deforestation and degradation with an out of bag (OOB) error estimate of 29% overall, and 26% and 31% for the deforestation and degradation classes, respectively. By dividing the local expert data into training and operational phases corresponding to local monitoring activities, we found that forest change models improved as more local expert data were used. Finally, we produced maps of deforestation and degradation using the most important spectral bands. The results in this study represent some of the first to combine local expert based forest change data and dense LTS, demonstrating the complementary value of both continuous data streams. Our results underpin the utility of both datasets and provide a useful foundation for integrated forest monitoring systems relying on data streams from diverse sources. PMID:27018852

An Interpretable Machine Learning Model for Accurate Prediction of Sepsis in the ICU.

PubMed

Nemati, Shamim; Holder, Andre; Razmi, Fereshteh; Stanley, Matthew D; Clifford, Gari D; Buchman, Timothy G

2018-04-01

Sepsis is among the leading causes of morbidity, mortality, and cost overruns in critically ill patients. Early intervention with antibiotics improves survival in septic patients. However, no clinically validated system exists for real-time prediction of sepsis onset. We aimed to develop and validate an Artificial Intelligence Sepsis Expert algorithm for early prediction of sepsis. Observational cohort study. Academic medical center from January 2013 to December 2015. Over 31,000 admissions to the ICUs at two Emory University hospitals (development cohort), in addition to over 52,000 ICU patients from the publicly available Medical Information Mart for Intensive Care-III ICU database (validation cohort). Patients who met the Third International Consensus Definitions for Sepsis (Sepsis-3) prior to or within 4 hours of their ICU admission were excluded, resulting in roughly 27,000 and 42,000 patients within our development and validation cohorts, respectively. None. High-resolution vital signs time series and electronic medical record data were extracted. A set of 65 features (variables) were calculated on hourly basis and passed to the Artificial Intelligence Sepsis Expert algorithm to predict onset of sepsis in the proceeding T hours (where T = 12, 8, 6, or 4). Artificial Intelligence Sepsis Expert was used to predict onset of sepsis in the proceeding T hours and to produce a list of the most significant contributing factors. For the 12-, 8-, 6-, and 4-hour ahead prediction of sepsis, Artificial Intelligence Sepsis Expert achieved area under the receiver operating characteristic in the range of 0.83-0.85. Performance of the Artificial Intelligence Sepsis Expert on the development and validation cohorts was indistinguishable. Using data available in the ICU in real-time, Artificial Intelligence Sepsis Expert can accurately predict the onset of sepsis in an ICU patient 4-12 hours prior to clinical recognition. A prospective study is necessary to determine the clinical utility of the proposed sepsis prediction model.

Individual versus group decision making: Jurors' reliance on central and peripheral information to evaluate expert testimony.

PubMed

Salerno, Jessica M; Bottoms, Bette L; Peter-Hagene, Liana C

2017-01-01

To investigate dual-process persuasion theories in the context of group decision making, we studied low and high need-for-cognition (NFC) participants within a mock trial study. Participants considered plaintiff and defense expert scientific testimony that varied in argument strength. All participants heard a cross-examination of the experts focusing on peripheral information (e.g., credentials) about the expert, but half were randomly assigned to also hear central information highlighting flaws in the expert's message (e.g., quality of the research presented by the expert). Participants rendered pre- and post-group-deliberation verdicts, which were considered "scientifically accurate" if the verdicts reflected the strong (versus weak) expert message, and "scientifically inaccurate" if they reflected the weak (versus strong) expert message. For individual participants, we replicated studies testing classic persuasion theories: Factors promoting reliance on central information (i.e., central cross-examination, high NFC) improved verdict accuracy because they sensitized individual participants to the quality discrepancy between the experts' messages. Interestingly, however, at the group level, the more that scientifically accurate mock jurors discussed peripheral (versus central) information about the experts, the more likely their group was to reach the scientifically accurate verdict. When participants were arguing for the scientifically accurate verdict consistent with the strong expert message, peripheral comments increased their persuasiveness, which made the group more likely to reach the more scientifically accurate verdict.

MYC Immunohistochemistry to Identify MYC-Driven B-Cell Lymphomas in Clinical Practice.

PubMed

Kluk, Michael J; Ho, Caleb; Yu, Hongbo; Chen, Benjamin J; Neuberg, Donna S; Dal Cin, Paola; Woda, Bruce A; Pinkus, Geraldine S; Rodig, Scott J

2016-02-01

Immunohistochemistry with anti-MYC antibody (MYC IHC) detects MYC protein in fixed samples of aggressive B-cell lymphomas and, according to the number of positive staining tumor nuclei, facilitates tumor subclassification, predicts underlying MYC rearrangements, and stratifies patient outcome. We aimed to determine the performance of MYC IHC in clinical practice. We reviewed MYC IHC performed on control specimens and 256 aggressive B-cell lymphomas and compared clinically reported IHC scores with experts' review. Control tissues showed less than 5% variation in daily IHC staining. Reported and expert IHC scores were well correlated (r = 0.86) with an SD of 14.2%. Reported IHC scores 30% or less and 70% or more were accurate (94.5%) compared with experts in categorizing tumors as "MYC IHC-Low" and "MYC IHC-High," respectively, but scores 40% to 60% were not (60.3%). The mean IHC score among lymphomas with MYC rearrangements was 80%, but with a large range of scores (20%-100%). There was no statistically significant association between IHC score and MYC copy number. Under optimal conditions, clinically reported MYC IHC scores are concordant with expert scores within 15%. MYC IHC does not capture all B-cell lymphomas with MYC rearrangements, however. MYC IHC and MYC fluorescence in situ hybridization are both recommended to identify MYC-driven B-cell lymphomas. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluation of Screening for Retinopathy of Prematurity by ROPtool or a Lay Reader.

PubMed

Abbey, Ashkan M; Besirli, Cagri G; Musch, David C; Andrews, Chris A; Capone, Antonio; Drenser, Kimberly A; Wallace, David K; Ostmo, Susan; Chiang, Michael; Lee, Paul P; Trese, Michael T

2016-02-01

To determine if (1) tortuosity assessment by a computer program (ROPtool, developed at the University of North Carolina, Chapel Hill, and Duke University, and licensed by FocusROP) that traces retinal blood vessels and (2) assessment by a lay reader are comparable with assessment by a panel of 3 retinopathy of prematurity (ROP) experts for remote clinical grading of vascular abnormalities such as plus disease. Validity and reliability analysis of diagnostic tools. Three hundred thirty-five fundus images of prematurely born infants. Three hundred thirty-five fundus images of prematurely born infants were obtained by neonatal intensive care unit nurses. A panel of 3 ROP experts graded 84 images showing vascular dilatation, tortuosity, or both and 251 images showing no evidence of vascular abnormalities. These images were sent electronically to an experienced lay reader who independently graded them for vascular abnormalities. The images also were analyzed using the ROPtool, which assigns a numerical value to the level of vascular abnormality and tortuosity present in each of 4 quadrants or sectors. The ROPtool measurements of vascular abnormalities were graded and compared with expert panel grades with a receiver operating characteristic (ROC) curve. Grades between human readers were cross-tabulated. The area under the ROC curve was calculated for the ROPtool, and sensitivity and specificity were computed for the lay reader. Measurements of vascular abnormalities by ROPtool and grading of vascular abnormalities by 3 ROP experts and 1 experienced lay reader. The ROC curve for ROPtool's tortuosity assessment had an area under the ROC curve of 0.917. Using a threshold value of 4.97 for the second most tortuous quadrant, ROPtool's sensitivity was 91% and its specificity was 82%. Lay reader sensitivity and specificity were 99% and 73%, respectively, and had high reliability (κ, 0.87) in repeated measurements. ROPtool had very good accuracy for detection of vascular abnormalities suggestive of plus disease when compared with expert physician graders. The lay reader's results showed excellent sensitivity and good specificity when compared with those of the expert graders. These options for remote reading of images to detect vascular abnormalities deserve consideration in the quest to use telemedicine with remote reading for efficient delivery of high-quality care and to detect infants requiring bedside examination. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Diagnostic value of a pancreatic mass on computed tomography in patients undergoing pancreatoduodenectomy for presumed pancreatic cancer.

PubMed

Gerritsen, Arja; Bollen, Thomas L; Nio, C Yung; Molenaar, I Quintus; Dijkgraaf, Marcel G W; van Santvoort, Hjalmar C; Offerhaus, G Johan; Brosens, Lodewijk A; Biermann, Katharina; Sieders, Egbert; de Jong, Koert P; van Dam, Ronald M; van der Harst, Erwin; van Goor, Harry; van Ramshorst, Bert; Bonsing, Bert A; de Hingh, Ignace H; Gerhards, Michael F; van Eijck, Casper H; Gouma, Dirk J; Borel Rinkes, Inne H M; Busch, Olivier R C; Besselink, Marc G H

2015-07-01

Previous studies have shown that 5-14% of patients undergoing pancreatoduodenectomy for suspected malignancy ultimately are diagnosed with benign disease. A "pancreatic mass" on computed tomography (CT) is considered to be the strongest predictor of malignancy, but studies describing its diagnostic value are lacking. The aim of this study was to determine the diagnostic value of a pancreatic mass on CT in patients with presumed pancreatic cancer, as well as the interobserver agreement among radiologists and the additional value of reassessment by expert-radiologists. Reassessment of preoperative CT scans was performed within a previously described multicenter retrospective cohort study in 344 patients undergoing pancreatoduodenectomy for suspected malignancy (2003-2010). Preoperative CT scans were reassessed by 2 experienced abdominal radiologists separately and subsequently in a consensus meeting, after defining a pancreatic mass as "a measurable space occupying soft tissue density, except for an enlarged papilla or focal steatosis". CT scans of 86 patients with benign and 258 patients with (pre)malignant disease were reassessed. In 66% of patients a pancreatic mass was reported in the original CT report, versus 48% and 50% on reassessment by the 2 expert radiologists separately and 44% in consensus (P < .001 vs original report). Interobserver agreement between the original CT report and expert consensus was fair (kappa = 0.32, 95% confidence interval 0.23-0.42). Among both expert-radiologists agreement was moderate (kappa = 0.47, 95% confidence interval 0.38-0.56), with disagreement on the presence of a pancreatic mass in 29% of cases. The specificity for malignancy of pancreatic masses identified in expert consensus was twice as high compared with the original CT report (87% vs 42%, respectively). Positive predictive value increased to 98% after expert consensus, but negative predictive value was low (12%). Clinicians need to be aware of potential considerable disagreement among radiologists about the presence of a pancreatic mass. The specificity for malignancy doubled by expert radiologist reassessment when a uniform definition of "pancreatic mass" was used. Copyright © 2015 Elsevier Inc. All rights reserved.

Using hybrid expert system approaches for engineering applications

NASA Technical Reports Server (NTRS)

Allen, R. H.; Boarnet, M. G.; Culbert, C. J.; Savely, R. T.

1987-01-01

In this paper, the use of hybrid expert system shells and hybrid (i.e., algorithmic and heuristic) approaches for solving engineering problems is reported. Aspects of various engineering problem domains are reviewed for a number of examples with specific applications made to recently developed prototype expert systems. Based on this prototyping experience, critical evaluations of and comparisons between commercially available tools, and some research tools, in the United States and Australia, and their underlying problem-solving paradigms are made. Characteristics of the implementation tool and the engineering domain are compared and practical software engineering issues are discussed with respect to hybrid tools and approaches. Finally, guidelines are offered with the hope that expert system development will be less time consuming, more effective, and more cost-effective than it has been in the past.

Re-Codified Standards from the Perspective of Language Experts: Credentials, Practice and Attitudes Amongst Translators and Interpreters of the Bosnian, Croatian and Serbian Languages

ERIC Educational Resources Information Center

Hlavac, Jim

2015-01-01

This article examines aspects of linguistic behaviour, attitudes and professional practices amongst a group of 47 "expert users" who are translators or interpreters for one, two or three of the following languages: Bosnian, Croatian and Serbian. The official terms for these languages in the respective successor states of Socialist…

Study the Current and Optimal Status of Teaching Environment at High Schools with Emphasis on Curriculum Experts' and Teachers' Viewpoints

ERIC Educational Resources Information Center

Parishani, Neda; Jafari, Seyed Ebrahim Mir Shah; Sharifian, Fereydoon; Farhadian, Mehrdad

2016-01-01

The purpose of present research was to study the current and optimal status of teaching environment at high schools in Iran with emphasis on curriculum experts and teachers' viewpoints. Research method was mixed method. In the qualitative part, experts' viewpoints were gathered through a semi-structured interview. In the quantitative part, 258…

Accidents and undetermined deaths: re-evaluation of nationwide samples from the Scandinavian countries.

PubMed

Tøllefsen, Ingvild Maria; Thiblin, Ingemar; Helweg-Larsen, Karin; Hem, Erlend; Kastrup, Marianne; Nyberg, Ullakarin; Rogde, Sidsel; Zahl, Per-Henrik; Østevold, Gunvor; Ekeberg, Øivind

2016-05-27

National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic autopsy reports and police reports. In total, 69 % (Sweden and Norway) and 78 % (Denmark) of deaths registered in the official mortality statistics as accidents were confirmed by the experts. In the majority of the cases where disagreement was seen, the experts reclassified accidents to undetermined manner of death, in 26, 25 and 19 % of cases, respectively. Few cases were reclassified as suicides or natural deaths. Among the extracted accidents, the experts agreed least with the official mortality statistics concerning drowning and poisoning accidents. They also reported most uncertainty in these categories of accidents. In a second re-evaluation, where more information was made available, the Norwegian psychiatrist and forensic pathologist increased their agreement with the official mortality statistics from 76 to 87 %, and from 85 to 88 %, respectively, regarding the Norwegian and Swedish datasets. Among the extracted undetermined deaths in the Swedish dataset, the two experts reclassified 22 and 51 %, respectively, to accidents. There was moderate agreement in reclassification of accidents between the official mortality statistics and the experts. In the majority of cases where there was disagreement, accidents were reclassified as undetermined manner of death, and only a small proportion as suicides.

Factors Affecting the Location of Road Emergency Bases in Iran Using Analytical Hierarchy Process (AHP).

PubMed

Bahadori, Mohammadkarim; Hajebrahimi, Ahmad; Alimohammadzadeh, Khalil; Ravangard, Ramin; Hosseini, Seyed Mojtaba

2017-10-01

To identify and prioritize factors affecting the location of road emergency bases in Iran using Analytical Hierarchy Process (AHP). This was a mixed method (quantitative-qualitative) study conducted in 2016. The participants in this study included the professionals and experts in the field of pre-hospital and road emergency services issues working in the Health Deputy of Iran Ministry of Health and Medical Education, which were selected using purposive sampling method. In this study at first, the factors affecting the location of road emergency bases in Iran were identified using literature review and conducting interviews with the experts. Then, the identified factors were scored and prioritized using the studied professionals and experts' viewpoints through using the analytic hierarchy process (AHP) technique and its related pair-wise questionnaire. The collected data were analyzed using MAXQDA 10.0 software to analyze the answers given to the open question and Expert Choice 10.0 software to determine the weights and priorities of the identified factors. The results showed that eight factors were effective in locating the road emergency bases in Iran from the viewpoints of the studied professionals and experts in the field of pre-hospital and road emergency services issues, including respectively distance from the next base, region population, topography and geographical situation of the region, the volume of road traffic, the existence of amenities such as water, electricity, gas, etc. and proximity to the village, accident-prone sites, University ownership of the base site, and proximity to toll-house. Among the eight factors which were effective in locating the road emergency bases from the studied professionals and experts' perspectives, "distance from the next base" and "region population" were respectively the most important ones which had great differences with other factors.

Reliability of adherence and competence assessment in cognitive behavioral therapy: influence of clinical experience.

PubMed

Weck, Florian; Hilling, Christine; Schermelleh-Engel, Karin; Rudari, Visar; Stangier, Ulrich

2011-04-01

The use of highly experienced expert judges was suggested for the assessment of therapists' adherence and competence. However, such an approach implies high costs. It can be questioned whether only experts are able to evaluate therapists' adherence and competence reliably. To test this, 4 judges evaluated therapist adherence and competence in 30 randomly selected videotapes of cognitive therapy sessions for depression. In that, 2 judges exhibited high clinical experience (experts), whereas 2 judges did not (novices). We could demonstrate that novices evaluated an aggregated adherence and competence measure with high reliability. However, several adherence and competence aspects were not assessed with satisfactory reliability by novices. Although adherence ratings of experts and novices showed high concordance, the concordance of competence ratings was only moderate. Results revealed that therapists' adherence could be evaluated satisfactorily by trained novices with some restrictions, but not their competence.

An SSME High Pressure Oxidizer Turbopump diagnostic system using G2 real-time expert system

NASA Technical Reports Server (NTRS)

Guo, Ten-Huei

1991-01-01

An expert system which diagnoses various seal leakage faults in the High Pressure Oxidizer Turbopump of the SSME was developed using G2 real-time expert system. Three major functions of the software were implemented: model-based data generation, real-time expert system reasoning, and real-time input/output communication. This system is proposed as one module of a complete diagnostic system for the SSME. Diagnosis of a fault is defined as the determination of its type, severity, and likelihood. Since fault diagnosis is often accomplished through the use of heuristic human knowledge, an expert system based approach has been adopted as a paradigm to develop this diagnostic system. To implement this approach, a software shell which can be easily programmed to emulate the human decision process, the G2 Real-Time Expert System, was selected. Lessons learned from this implementation are discussed.

An SSME high pressure oxidizer turbopump diagnostic system using G2(TM) real-time expert system

NASA Technical Reports Server (NTRS)

Guo, Ten-Huei

1991-01-01

An expert system which diagnoses various seal leakage faults in the High Pressure Oxidizer Turbopump of the SSME was developed using G2(TM) real-time expert system. Three major functions of the software were implemented: model-based data generation, real-time expert system reasoning, and real-time input/output communication. This system is proposed as one module of a complete diagnostic system for Space Shuttle Main Engine. Diagnosis of a fault is defined as the determination of its type, severity, and likelihood. Since fault diagnosis is often accomplished through the use of heuristic human knowledge, an expert system based approach was adopted as a paradigm to develop this diagnostic system. To implement this approach, a software shell which can be easily programmed to emulate the human decision process, the G2 Real-Time Expert System, was selected. Lessons learned from this implementation are discussed.

Using expert opinion surveys to rank threats to endangered species: a case study with sea turtles.

PubMed

Donlan, C Josh; Wingfield, Dana K; Crowder, Larry B; Wilcox, Chris

2010-12-01

Little is known about how specific anthropogenic hazards affect the biology of organisms. Quantifying the effect of regional hazards is particularly challenging for species such as sea turtles because they are migratory, difficult to study, long lived, and face multiple anthropogenic threats. Expert elicitation, a technique used to synthesize opinions of experts while assessing uncertainty around those views, has been in use for several decades in the social science and risk assessment sectors. We conducted an internet-based survey to quantify expert opinion on the relative magnitude of anthropogenic hazards to sea turtle populations at the regional level. Fisheries bycatch and coastal development were most often ranked as the top hazards to sea turtle species in a geographic region. Nest predation and direct take followed as the second and third greatest threats, respectively. Survey results suggest most experts believe sea turtles are threatened by multiple factors, including substantial at-sea threats such as fisheries bycatch. Resources invested by the sea turtle community, however, appear biased toward terrestrial-based impacts. Results from the survey are useful for conservation planning because they provide estimates of relative impacts of hazards on sea turtles and a measure of consensus on the magnitude of those impacts among researchers and practitioners. Our survey results also revealed patterns of expert bias, which we controlled for in our analysis. Respondents with no experience with respect to a sea turtle species tended to rank hazards affecting that sea turtle species higher than respondents with experience. A more-striking pattern was with hazard-based expertise: the more experience a respondent had with a specific hazard, the higher the respondent scored the impact of that hazard on sea turtle populations. Bias-controlled expert opinion surveys focused on threatened species and their hazards can help guide and expedite species recovery plans. © 2010 Society for Conservation Biology.

Goal-directed transthoracic echocardiography during advanced cardiac life support: A pilot study using simulation to assess ability

PubMed Central

Greenstein, Yonatan Y.; Martin, Thomas J.; Rolnitzky, Linda; Felner, Kevin; Kaufman, Brian

2015-01-01

Introduction Goal-directed echocardiography (GDE) is used to answer specific clinical questions which provide invaluable information to physicians managing a hemodynamically unstable patient. We studied perception and ability of housestaff previously trained in GDE to accurately diagnose common causes of cardiac arrest during simulated advanced cardiac life support (ACLS); we compared their results to those of expert echocardiographers. Methods Eleven pulmonary and critical care medicine fellows, seven emergency medicine residents, and five cardiologists board-certified in echocardiography were enrolled. Baseline ability to acquire four transthoracic echocardiography views was assessed and participants were exposed to six simulated cardiac arrests and were asked to perform a GDE during ACLS. Housestaff performance was compared to the performance of five expert echocardiographers. Results Average baseline and scenario views by housestaff were of good or excellent quality 89% and 83% of the time, respectively. Expert average baseline and scenario views were always of good or excellent quality. Housestaff and experts made the correct diagnosis in 68% and 77% of cases, respectively. On average, participants required 1.5 pulse checks to make the correct diagnosis. 94% of housestaff perceived this study as an accurate assessment of ability. Conclusions In an ACLS compliant manner, housestaff are capable of diagnosing management altering pathologies the majority of the time and they reach similar diagnostic conclusions in the same amount of time as expert echocardiographers in a simulated cardiac arrest scenario. PMID:25932707

Goal-Directed Transthoracic Echocardiography During Advanced Cardiac Life Support: A Pilot Study Using Simulation to Assess Ability.

PubMed

Greenstein, Yonatan Y; Martin, Thomas J; Rolnitzky, Linda; Felner, Kevin; Kaufman, Brian

2015-08-01

Goal-directed echocardiography (GDE) is used to answer specific clinical questions that provide invaluable information to physicians managing a hemodynamically unstable patient. We studied perception and ability of house staff previously trained in GDE to accurately diagnose common causes of cardiac arrest during simulated advanced cardiac life support (ACLS); we compared their results with those of expert echocardiographers. Eleven pulmonary and critical care medicine fellows, 7 emergency medicine residents, and 5 cardiologists board certified in echocardiography were enrolled. Baseline ability to acquire 4 transthoracic echocardiography views was assessed, and participants were exposed to 6 simulated cardiac arrests and were asked to perform a GDE during ACLS. House staff performance was compared with the performance of 5 expert echocardiographers. Average baseline and scenario views by house staff were of good or excellent quality 89% and 83% of the time, respectively. Expert average baseline and scenario views were always of good or excellent quality. House staff and experts made the correct diagnosis in 68% and 77% of cases, respectively. On average, participants required 1.5 pulse checks to make the correct diagnosis. Of house staff, 94% perceived this study as an accurate assessment of ability. In an ACLS-compliant manner, house staff are capable of diagnosing management-altering pathologies the majority of the time, and they reach similar diagnostic conclusions in the same amount of time as expert echocardiographers in a simulated cardiac arrest scenario.

Prevention of sexually transmitted diseases among visually impaired people: educational text validation 1

PubMed Central

Oliveira, Giselly Oseni Barbosa; Cavalcante, Luana Duarte Wanderley; Pagliuca, Lorita Marlena Freitag; de Almeida, Paulo César; Rebouças, Cristiana Brasil de Almeida

2016-01-01

ABSTRACT Objective: to validate an educational text in the context of Sexually Transmitted Diseases (STD) for visually impaired persons, making it accessible to this population. Method: a validation study, in a virtual environment. Data collection occurred from May to September 2012 by emailing the subjects, and was composed by seven content experts about STDs. Analysis was based on the considerations of the experts about Objectives, Structure and Presentation, and Relevance. Results: on the Objectives and Structure and Presentation blocks, 77 (84.6%) and 48 (85.7%) were fully adequate or appropriate, respectively. In the Relevance block, items 3.2 - Allows transfer and generalization of learning, and 3.5 - Portrays aspects needed to clarify the family, showed bad agreement indices of 0.42 and 0.57, respectively. The analysis was followed by reformulating the text according to the relevant suggestions. Conclusion: the text was validated regarding the content of sexually transmitted diseases. A total of 35 stanzas were removed and nine others included, following the recommendations of the experts. PMID:27556880

Rapid Automated Quantification of Cerebral Leukoaraiosis on CT Images: A Multicenter Validation Study.

PubMed

Chen, Liang; Carlton Jones, Anoma Lalani; Mair, Grant; Patel, Rajiv; Gontsarova, Anastasia; Ganesalingam, Jeban; Math, Nikhil; Dawson, Angela; Aweid, Basaam; Cohen, David; Mehta, Amrish; Wardlaw, Joanna; Rueckert, Daniel; Bentley, Paul

2018-05-15

Purpose To validate a random forest method for segmenting cerebral white matter lesions (WMLs) on computed tomographic (CT) images in a multicenter cohort of patients with acute ischemic stroke, by comparison with fluid-attenuated recovery (FLAIR) magnetic resonance (MR) images and expert consensus. Materials and Methods A retrospective sample of 1082 acute ischemic stroke cases was obtained that was composed of unselected patients who were treated with thrombolysis or who were undergoing contemporaneous MR imaging and CT, and a subset of International Stroke Thrombolysis-3 trial participants. Automated delineations of WML on images were validated relative to experts' manual tracings on CT images, and co-registered FLAIR MR imaging, and ratings were performed by using two conventional ordinal scales. Analyses included correlations between CT and MR imaging volumes, and agreements between automated and expert ratings. Results Automated WML volumes correlated strongly with expert-delineated WML volumes at MR imaging and CT (r 2 = 0.85 and 0.71 respectively; P < .001). Spatial-similarity of automated maps, relative to WML MR imaging, was not significantly different to that of expert WML tracings on CT images. Individual expert WML volumes at CT correlated well with each other (r 2 = 0.85), but varied widely (range, 91% of mean estimate; median estimate, 11 mL; range of estimated ranges, 0.2-68 mL). Agreements (κ) between automated ratings and consensus ratings were 0.60 (Wahlund system) and 0.64 (van Swieten system) compared with agreements between individual pairs of experts of 0.51 and 0.67, respectively, for the two rating systems (P < .01 for Wahlund system comparison of agreements). Accuracy was unaffected by established infarction, acute ischemic changes, or atrophy (P > .05). Automated preprocessing failure rate was 4%; rating errors occurred in a further 4%. Total automated processing time averaged 109 seconds (range, 79-140 seconds). Conclusion An automated method for quantifying CT cerebral white matter lesions achieves a similar accuracy to experts in unselected and multicenter cohorts. © RSNA, 2018 Online supplemental material is available for this article.

Combining Decision Rules from Classification Tree Models and Expert Assessment to Estimate Occupational Exposure to Diesel Exhaust for a Case-Control Study

PubMed Central

Friesen, Melissa C.; Wheeler, David C.; Vermeulen, Roel; Locke, Sarah J.; Zaebst, Dennis D.; Koutros, Stella; Pronk, Anjoeka; Colt, Joanne S.; Baris, Dalsu; Karagas, Margaret R.; Malats, Nuria; Schwenn, Molly; Johnson, Alison; Armenti, Karla R.; Rothman, Nathanial; Stewart, Patricia A.; Kogevinas, Manolis; Silverman, Debra T.

2016-01-01

Objectives: To efficiently and reproducibly assess occupational diesel exhaust exposure in a Spanish case-control study, we examined the utility of applying decision rules that had been extracted from expert estimates and questionnaire response patterns using classification tree (CT) models from a similar US study. Methods: First, previously extracted CT decision rules were used to obtain initial ordinal (0–3) estimates of the probability, intensity, and frequency of occupational exposure to diesel exhaust for the 10 182 jobs reported in a Spanish case-control study of bladder cancer. Second, two experts reviewed the CT estimates for 350 jobs randomly selected from strata based on each CT rule’s agreement with the expert ratings in the original study [agreement rate, from 0 (no agreement) to 1 (perfect agreement)]. Their agreement with each other and with the CT estimates was calculated using weighted kappa (κ w) and guided our choice of jobs for subsequent expert review. Third, an expert review comprised all jobs with lower confidence (low-to-moderate agreement rates or discordant assignments, n = 931) and a subset of jobs with a moderate to high CT probability rating and with moderately high agreement rates (n = 511). Logistic regression was used to examine the likelihood that an expert provided a different estimate than the CT estimate based on the CT rule agreement rates, the CT ordinal rating, and the availability of a module with diesel-related questions. Results: Agreement between estimates made by two experts and between estimates made by each of the experts and the CT estimates was very high for jobs with estimates that were determined by rules with high CT agreement rates (κ w: 0.81–0.90). For jobs with estimates based on rules with lower agreement rates, moderate agreement was observed between the two experts (κ w: 0.42–0.67) and poor-to-moderate agreement was observed between the experts and the CT estimates (κ w: 0.09–0.57). In total, the expert review of 1442 jobs changed 156 probability estimates, 128 intensity estimates, and 614 frequency estimates. The expert was more likely to provide a different estimate when the CT rule agreement rate was <0.8, when the CT ordinal ratings were low to moderate, or when a module with diesel questions was available. Conclusions: Our reliability assessment provided important insight into where to prioritize additional expert review; as a result, only 14% of the jobs underwent expert review, substantially reducing the exposure assessment burden. Overall, we found that we could efficiently, reproducibly, and reliably apply CT decision rules from one study to assess exposure in another study. PMID:26732820

Exploration of Teaching Skills of Pre-Service High School Teachers' through Self-Regulated Learning Based on Learning Style

ERIC Educational Resources Information Center

Habibi; Kuswanto, Heru; Yanti, Fitri April

2017-01-01

An expert in the field of science is often difficult to teach his knowledge to students. Conversely someone who is expert in the field of education is certainly more expert in transferring knowledge. The purpose of this research is to explore the skill of teaching skill preservice of physics teacher of High School. Samples were taken randomly as…

[Principles of intervertebral disc assessment in private accident insurance].

PubMed

Steinmetz, M; Dittrich, V; Röser, K

2015-09-01

Due to the spread of intervertebral disc degeneration, insurance companies and experts are regularly confronted with related assessments of insured persons under their private accident insurance. These claims pose a particular challenge for experts, since, in addition to the clinical assessment of the facts, extensive knowledge of general accident insurance conditions, case law and current study findings is required. Each case can only be properly assessed through simultaneous consideration of both the medical and legal facts. These guidelines serve as the basis for experts and claims.managers with respect to the appropriate individual factual assessment of intervertebral disc degeneration in private accident insurance.

Bonneville Power Administration Communication Alarm Processor expert system:

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

Goeltz, R.; Purucker, S.; Tonn, B.

This report describes the Communications Alarm Processor (CAP), a prototype expert system developed for the Bonneville Power Administration by Oak Ridge National Laboratory. The system is designed to receive and diagnose alarms from Bonneville's Microwave Communications System (MCS). The prototype encompasses one of seven branches of the communications network and a subset of alarm systems and alarm types from each system. The expert system employs a backward chaining approach to diagnosing alarms. Alarms are fed into the expert system directly from the communication system via RS232 ports and sophisticated alarm filtering and mailbox software. Alarm diagnoses are presented to operatorsmore » for their review and concurrence before the diagnoses are archived. Statistical software is incorporated to allow analysis of archived data for report generation and maintenance studies. The delivered system resides on a Digital Equipment Corporation VAX 3200 workstation and utilizes Nexpert Object and SAS for the expert system and statistical analysis, respectively. 11 refs., 23 figs., 7 tabs.« less

Diagnostic accuracy of ultrasonography in detection of blunt abdominal trauma and comparison of early and late ultrasonography 24 hours after trauma.

PubMed

Feyzi, Ali; Rad, Masoud Pezeshki; Ahanchi, Navid; Firoozabadi, Jalil

2015-01-01

Despite the advantages of ultrasound scan, its use as a screening tool in blunt abdominal trauma is controversial. The aim of this study was to evaluate the diagnostic value of early and late ultrasound in patients with blunt abdominal trauma (BAT). In this study which was performed in a level I trauma center, firstly, 2418 patients with BAT had ultrasound (US) examination by two trauma expert radiologists. Results were compared with the best available gold standards such as laparotomy, CT, repeated ultrasound or clinical course follow-up. Then, 400 patients with BAT were examined by a trained residency student. In the first phase, sensitivity, specificity, negative predictive value, positive predictive value and accuracy of ultrasound were 97%, 98.1%, 99.7%, 83% and 98% respectively. In the second phase, they were 97.3%, 97.2%, 97.7%, 96.8% and 97.3% for the early and 98.5%, 97.6%, 98.5%, 97.5% and 98% for the late ultrasound respectively. Results obtained from this study indicate that negative ultrasound findings associated with negative clinical observation virtually exclude abdominal injury, and confirmation by performing other tests is unnecessary. High sensitivity and negative predictive value is achieved if ultrasound is performed by expert trauma radiologist.

Does experience in hysteroscopy improve accuracy and inter-observer agreement in the management of abnormal uterine bleeding?

PubMed

Bourdel, Nicolas; Modaffari, Paola; Tognazza, Enrica; Pertile, Riccardo; Chauvet, Pauline; Botchorishivili, Revaz; Savary, Dennis; Pouly, Jean Luc; Rabischong, Benoit; Canis, Michel

2016-12-01

Hysteroscopic reliability may be influenced by the experience of the operator and by a lack of morphological diagnostic criteria for endometrial malignant pathologies. The aim of this study was to evaluate the diagnostic accuracy and the inter-observer agreement (IOA) in the management of abnormal uterine bleeding (AUB) among different experienced gynecologists. Each gynecologist, without any other clinical information, was asked to evaluate the anonymous video recordings of 51 consecutive patients who underwent hysteroscopy and endometrial resection for AUB. Experts (>500 hysteroscopies), seniors (20-499 procedures) and junior (≤19 procedures) gynecologists were asked to judge endometrial macroscopic appearance (benign, suspicious or frankly malignant). They also had to propose the histological diagnosis (atrophic or proliferative endometrium; simple, glandulocystic or atypical endometrial hyperplasia and endometrial carcinoma). Observers were free to indicate whether the quality of recordings were not good enough for adequate assessment. IOA (k coefficient), sensitivity, specificity, predictive value and the likelihood ratio were calculated. Five expert, five senior and six junior gynecologists were involved in the study. Considering endometrial cancer and endometrial atypical hyperplasia, sensitivity and specificity were respectively 55.5 % and 84.5 % for juniors, 66.6 % and 81.2 % for seniors and 86.6 % and 87.3 % for experts. Concerning endometrial macroscopic appearance, IOA was poor for juniors (k = 0.10) and fair for seniors and experts (k = 0.23 and 0.22, respectively). IOA was poor for juniors and experts (k = 0.18 and 0.20, respectively) and fair for seniors (k = 0.30) in predicting the histological diagnosis. Sensitivity improves with the observer's experience, but inter-observer agreement and reproducibility of hysteroscopy for endometrial malignancies are not satisfying no matter the level of expertise. Therefore, an accurate and complete endometrial sampling is still needed.

Unravelling the concept of integrated public health policy: Concept mapping with Dutch experts from science, policy, and practice.

PubMed

Tubbing, Luuk; Harting, Janneke; Stronks, Karien

2015-06-01

While expectations of integrated public health policy (IPHP) promoting public health are high, assessment is hampered by the concept's ambiguity. This paper aims to contribute to conceptual clarification of IPHP as first step in further measurement development. In an online concept mapping procedure, we invited 237 Dutch experts, 62 of whom generated statements on characteristics of IPHP. Next, 100 experts were invited, 24 of whom sorted the statements into piles according to their perceived similarity and rated the statements on relevance and measurability. Data was analyzed using concept mapping software. The concept map consisted of 97 statements, grouped into 11 clusters and five themes. Core themes were 'integration', concerning 'policy coherence' and 'organizing connections', and 'health', concerning 'positioning health' and 'addressing determinants'. Peripheral themes were 'generic aspects', 'capacities', and 'goals and setting', which respectively addressed general notions of integrated policy making, conditions for IPHP, and the variety in manifestations of IPHP. Measurability ratings were low compared to relevance. The concept map gives an overview of interrelated themes, distinguishes core from peripheral dimensions, and provides pointers for theories of the policy process. While low measurability ratings indicate measurement difficulties, the core themes provide pointers for systematic insight into IPHP through measurement. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Mainstream medicine versus complementary and alternative medicine in the witness box: resolving the clash of ideologies.

PubMed

Kune, Randall; Kune, Gabriel

2007-02-01

Mainstream medical philosophy and practice differ in many respects from those of complementary and alternative medicine (CAM), differences which are explored in this article. Because of a resurgence of CAM therapies, courts and tribunals will scrutinise CAM in more and more contexts in the future. Such court cases may require the resolution of conflicts between opinions of CAM and medical experts. This article considers how courts evaluate such opinions where experts hold conflicting ideologies or philosophical approaches, and addresses the following questions: Do the opinions of CAM practitioners qualify as "expert" opinions in court? How do the courts examine the basis of such opinions? Are they systematically given less weight than the opinions of mainstream medical practitioners? Will recent procedural reforms for hearing expert evidence make it easier for courts to resolve these issues?

Disagreeing on Whether Agreement Is Persuasive: Perceptions of Expert Group Decisions

PubMed Central

Votruba, Ashley M.; Kwan, Virginia S. Y.

2015-01-01

While expert groups often make recommendations on a range of non-controversial as well as controversial issues, little is known about how the level of expert consensus—the level of expert agreement—influences perceptions of the recommendations. This research illustrates that for non-controversial issues expert groups that exhibit high levels of agreement are more persuasive than expert groups that exhibit low levels of agreement. This effect is mediated by the perceived entitativity—the perceived cohesiveness or unification of the group—of the expert group. But for controversial issues, this effect is moderated by the perceivers’ implicit assumptions about the group composition. When perceivers are provided no information about a group supporting the Affordable Care Act—a highly controversial piece of U.S. legislation that is divided by political party throughout the country—higher levels of agreement are less persuasive than lower levels of agreement because participants assume there were more democrats and fewer republicans in the group. But when explicitly told that the group was half republicans and half democrats, higher levels of agreement are more persuasive. PMID:25811384

Disagreeing on whether agreement is persuasive: perceptions of expert group decisions.

PubMed

Votruba, Ashley M; Kwan, Virginia S Y

2015-01-01

While expert groups often make recommendations on a range of non-controversial as well as controversial issues, little is known about how the level of expert consensus-the level of expert agreement-influences perceptions of the recommendations. This research illustrates that for non-controversial issues expert groups that exhibit high levels of agreement are more persuasive than expert groups that exhibit low levels of agreement. This effect is mediated by the perceived entitativity-the perceived cohesiveness or unification of the group-of the expert group. But for controversial issues, this effect is moderated by the perceivers' implicit assumptions about the group composition. When perceivers are provided no information about a group supporting the Affordable Care Act-a highly controversial piece of U.S. legislation that is divided by political party throughout the country-higher levels of agreement are less persuasive than lower levels of agreement because participants assume there were more democrats and fewer republicans in the group. But when explicitly told that the group was half republicans and half democrats, higher levels of agreement are more persuasive.

Contact dermatitis is an unrecognized problem in the construction industry: Comparison of four different assessment methods.

PubMed

Timmerman, Johan G; Heederik, Dick; Spee, Ton; van Rooy, Frits G; Krop, Esmeralda J M; Rustemeyer, Thomas; Smit, Lidwien A M

2017-10-01

A high contact dermatitis symptoms prevalence has been observed in Dutch construction workers. Contact dermatitis was diagnosed by an expert panel using questionnaire data and photographs of 751 subjects' hands. A subset was evaluated by two occupational physicians. Their diagnoses were compared to those of the expert panel. In addition, two self-reported questionnaire-based assessment methods were compared to the expert panel evaluation. Associations between contact dermatitis and determinants were assessed using log-binomial regression analysis. Contact dermatitis prevalence was high: 61.4% (expert panel's diagnosis) and 32.9% (self-reported). Agreement between occupational physicians and the expert panel was low but increased after training. Washing hands with solvents and performing job-related tasks at home were related to contact dermatitis. Contact dermatitis prevalence among construction workers is high. Recognition of contact dermatitis by occupational physicians is poor but can be improved by training. Awareness of skin disorders should be raised. © 2017 Wiley Periodicals, Inc.

How Experts' Use of Medical Technical Jargon in Different Types of Online Health Forums Affects Perceived Information Credibility: Randomized Experiment With Laypersons.

PubMed

Zimmermann, Maria; Jucks, Regina

2018-01-23

Online health forums are widely used, but the quality of advice differs as much as the knowledge backgrounds of the audience members who receive the advice. It is important to understand how people judge the information given online. In line with the communication accommodation theory (CAT), online forums represent specific social contexts of communication which can present either accommodative or nonaccommodative language to an audience. Accordingly, use of accommodative or nonaccommodative language might affect people's perceived trust in the communicator. The objective of this study was to investigate how experts who use accommodative (vs nonaccommodative) language are evaluated by passive users of an online forum. Participants (n=98) took part in an online experiment and read experts' posts about 10 nutrition myths. Following a 2 x 2 mixed design, experts' posts were written using either low or high amounts of medical technical jargon (MTJ) (within factor) and were directed at different audiences (mainly other medical experts [in a professional forum] vs a user group mainly comprising laypersons [in an advisory forum]) (between factor). Accommodation occurred where experts used high amounts of MTJ to address other medical experts in the professional forum; it also occurred when experts used low amounts of MTJ to address laypersons in the advisory forum. Conversely, nonaccommodation occurred when experts used high amounts of MTJ in the advisory forum and low amounts of MTJ in the professional forum. In each condition, participants evaluated the credibility of the information, the trustworthiness of the experts, and the accommodation by the experts. Overall, participants judged the credibility of information to be higher when experts used MTJ that was accommodative to the designated audience, F 1,95 =3.10, P=.04, η p 2 =.031. In addition, participants judged the experts in professional forums to be more trustworthy than experts in advisory forums (all F 1,96 ≥3.54, P ≤.03, η p 2 ≥.036). Moreover, participants rated experts who used high amounts of MTJ to have higher competence (F 1,96 =37.54, P<.001, η p 2 =.28], lower integrity (F 1,96 =10.77, P=.001, η p 2 =.101), and lower benevolence (F 1,96 =9.75, P=.002, η p 2 =.092), as well as to have lower perceived accommodation to the audience (all F 1,96 ≥72.17, P<.001, η p 2 ≥.43) compared with experts who used low MTJ. To provide health information online that is perceived as credible, experts should consider using similar language as the language used by the addressed audience. As it is often impossible to determine the exact makeup of an online audience, further research might investigate whether having experts explicitly declare which audience they intend to address can help people to more reliably assess an expert's trustworthiness. Furthermore, as people assess information differently depending on the context of online communication, it would be valuable for research to consider other aspects of the context beyond those of the audience. ©Maria Zimmermann, Regina Jucks. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.01.2018.

The Impact of Moderate and High Intensity Total Body Fatigue on Passing Accuracy in Expert and Novice Basketball Players

PubMed Central

Lyons, Mark; Al-Nakeeb, Yahya; Nevill, Alan

2006-01-01

Despite the acknowledged importance of fatigue on performance in sport, ecologically sound studies investigating fatigue and its effects on sport-specific skills are surprisingly rare. The aim of this study was to investigate the effect of moderate and high intensity total body fatigue on passing accuracy in expert and novice basketball players. Ten novice basketball players (age: 23.30 ± 1.05 yrs) and ten expert basketball players (age: 22.50 ± 0.41 yrs) volunteered to participate in the study. Both groups performed the modified AAHPERD Basketball Passing Test under three different testing conditions: rest, moderate intensity and high intensity total body fatigue. Fatigue intensity was established using a percentage of the maximal number of squat thrusts performed by the participant in one minute. ANOVA with repeated measures revealed a significant (F 2,36 = 5.252, p = 0.01) level of fatigue by level of skill interaction. On examination of the mean scores it is clear that following high intensity total body fatigue there is a significant detriment in the passing performance of both novice and expert basketball players when compared to their resting scores. Fundamentally however, the detrimental impact of fatigue on passing performance is not as steep in the expert players compared to the novice players. The results suggest that expert or skilled players are better able to cope with both moderate and high intensity fatigue conditions and maintain a higher level of performance when compared to novice players. The findings of this research therefore, suggest the need for trainers and conditioning coaches in basketball to include moderate, but particularly high intensity exercise into their skills sessions. This specific training may enable players at all levels of the game to better cope with the demands of the game on court and maintain a higher standard of play. Key Points Aim: to investigate the effect of moderate and high intensity total body fatigue on basketball-passing accuracy in expert and novice basketball players. Fatigue intensity was set as a percentage of the maximal number of squat thrusts performed by the participant in one minute. ANOVA with repeated measures revealed a significant level of fatigue by level of skill interaction. Despite a significant detriment in passing-performance in both novice and expert players following high intensity total body fatigue, this detriment was not as steep in the expert players when compared to the novice players PMID:24259994

Development of an objective assessment tool for total laparoscopic hysterectomy: A Delphi method among experts and evaluation on a virtual reality simulator.

PubMed

Knight, Sophie; Aggarwal, Rajesh; Agostini, Aubert; Loundou, Anderson; Berdah, Stéphane; Crochet, Patrice

2018-01-01

Total Laparoscopic hysterectomy (LH) requires an advanced level of operative skills and training. The aim of this study was to develop an objective scale specific for the assessment of technical skills for LH (H-OSATS) and to demonstrate feasibility of use and validity in a virtual reality setting. The scale was developed using a hierarchical task analysis and a panel of international experts. A Delphi method obtained consensus among experts on relevant steps that should be included into the H-OSATS scale for assessment of operative performances. Feasibility of use and validity of the scale were evaluated by reviewing video recordings of LH performed on a virtual reality laparoscopic simulator. Three groups of operators of different levels of experience were assessed in a Marseille teaching hospital (10 novices, 8 intermediates and 8 experienced surgeons). Correlations with scores obtained using a recognised generic global rating tool (OSATS) were calculated. A total of 76 discrete steps were identified by the hierarchical task analysis. 14 experts completed the two rounds of the Delphi questionnaire. 64 steps reached consensus and were integrated in the scale. During the validation process, median time to rate each video recording was 25 minutes. There was a significant difference between the novice, intermediate and experienced group for total H-OSATS scores (133, 155.9 and 178.25 respectively; p = 0.002). H-OSATS scale demonstrated high inter-rater reliability (intraclass correlation coefficient [ICC] = 0.930; p<0.001) and test retest reliability (ICC = 0.877; p<0.001). High correlations were found between total H-OSATS scores and OSATS scores (rho = 0.928; p<0.001). The H-OSATS scale displayed evidence of validity for assessment of technical performances for LH performed on a virtual reality simulator. The implementation of this scale is expected to facilitate deliberate practice. Next steps should focus on evaluating the validity of the scale in the operating room.

Predicting adherence of patients with HF through machine learning techniques.

PubMed

Karanasiou, Georgia Spiridon; Tripoliti, Evanthia Eleftherios; Papadopoulos, Theofilos Grigorios; Kalatzis, Fanis Georgios; Goletsis, Yorgos; Naka, Katerina Kyriakos; Bechlioulis, Aris; Errachid, Abdelhamid; Fotiadis, Dimitrios Ioannis

2016-09-01

Heart failure (HF) is a chronic disease characterised by poor quality of life, recurrent hospitalisation and high mortality. Adherence of patient to treatment suggested by the experts has been proven a significant deterrent of the above-mentioned serious consequences. However, the non-adherence rates are significantly high; a fact that highlights the importance of predicting the adherence of the patient and enabling experts to adjust accordingly patient monitoring and management. The aim of this work is to predict the adherence of patients with HF, through the application of machine learning techniques. Specifically, it aims to classify a patient not only as medication adherent or not, but also as adherent or not in terms of medication, nutrition and physical activity (global adherent). Two classification problems are addressed: (i) if the patient is global adherent or not and (ii) if the patient is medication adherent or not. About 11 classification algorithms are employed and combined with feature selection and resampling techniques. The classifiers are evaluated on a dataset of 90 patients. The patients are characterised as medication and global adherent, based on clinician estimation. The highest detection accuracy is 82 and 91% for the first and the second classification problem, respectively.

Pansharpening on the Narrow Vnir and SWIR Spectral Bands of SENTINEL-2

NASA Astrophysics Data System (ADS)

Vaiopoulos, A. D.; Karantzalos, K.

2016-06-01

In this paper results from the evaluation of several state-of-the-art pansharpening techniques are presented for the VNIR and SWIR bands of Sentinel-2. A procedure for the pansharpening is also proposed which aims at respecting the closest spectral similarities between the higher and lower resolution bands. The evaluation included 21 different fusion algorithms and three evaluation frameworks based both on standard quantitative image similarity indexes and qualitative evaluation from remote sensing experts. The overall analysis of the evaluation results indicated that remote sensing experts disagreed with the outcomes and method ranking from the quantitative assessment. The employed image quality similarity indexes and quantitative evaluation framework based on both high and reduced resolution data from the literature didn't manage to highlight/evaluate mainly the spatial information that was injected to the lower resolution images. Regarding the SWIR bands none of the methods managed to deliver significantly better results than a standard bicubic interpolation on the original low resolution bands.

[Pre travel advice - a study among Swiss general practitioners].

PubMed

Walz, Alexander; Tschudi, Peter; Badertscher, Nina; Hatz, Christoph

2013-06-01

Up to 65 % of travellers seek pre-travel advice at their general practitioner. Professionals should inform about the most common and most dangerous health threats, requiring up-to-date knowledge about epidemiology of respective disorders. The aim of the present study was to investigate the content of pre-travel advice given by general practitioners in order to provide them with better expert support from travel medicine specialists. One third of them perform pre-travel advice weekly, and some two thirds do so at least monthly. The most frequently discussed topics are malaria, immunisation, insect bite prevention and travellers' diarrhoea. Less than half of the advice sessions included talking about the risk of accidents. Apart from the need for yellow fever vaccination, referral to travel medicine experts was highest for immunocompromised and pregnant travellers, and for trips to "high risk" countries. A considerable number of practitioners do not comply with the Swiss recommendations, continuously updated in the Bulletin of the Federal Office of Public Health, possibly because only 21 % consult them at regular intervals.

System and method for creating expert systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M. (Inventor); Luczak, Edward C. (Inventor)

1998-01-01

A system and method provides for the creation of a highly graphical expert system without the need for programming in code. An expert system is created by initially building a data interface, defining appropriate Mission, User-Defined, Inferred, and externally-generated GenSAA (EGG) data variables whose data values will be updated and input into the expert system. Next, rules of the expert system are created by building appropriate conditions of the rules which must be satisfied and then by building appropriate actions of rules which are to be executed upon corresponding conditions being satisfied. Finally, an appropriate user interface is built which can be highly graphical in nature and which can include appropriate message display and/or modification of display characteristics of a graphical display object, to visually alert a user of the expert system of varying data values, upon conditions of a created rule being satisfied. The data interface building, rule building, and user interface building are done in an efficient manner and can be created without the need for programming in code.

Individual versus group decision making: Jurors’ reliance on central and peripheral information to evaluate expert testimony

PubMed Central

Bottoms, Bette L.; Peter-Hagene, Liana C.

2017-01-01

To investigate dual-process persuasion theories in the context of group decision making, we studied low and high need-for-cognition (NFC) participants within a mock trial study. Participants considered plaintiff and defense expert scientific testimony that varied in argument strength. All participants heard a cross-examination of the experts focusing on peripheral information (e.g., credentials) about the expert, but half were randomly assigned to also hear central information highlighting flaws in the expert’s message (e.g., quality of the research presented by the expert). Participants rendered pre- and post-group-deliberation verdicts, which were considered “scientifically accurate” if the verdicts reflected the strong (versus weak) expert message, and “scientifically inaccurate” if they reflected the weak (versus strong) expert message. For individual participants, we replicated studies testing classic persuasion theories: Factors promoting reliance on central information (i.e., central cross-examination, high NFC) improved verdict accuracy because they sensitized individual participants to the quality discrepancy between the experts’ messages. Interestingly, however, at the group level, the more that scientifically accurate mock jurors discussed peripheral (versus central) information about the experts, the more likely their group was to reach the scientifically accurate verdict. When participants were arguing for the scientifically accurate verdict consistent with the strong expert message, peripheral comments increased their persuasiveness, which made the group more likely to reach the more scientifically accurate verdict. PMID:28931011

Reliability of an Automated High-Resolution Manometry Analysis Program across Expert Users, Novice Users, and Speech-Language Pathologists

ERIC Educational Resources Information Center

Jones, Corinne A.; Hoffman, Matthew R.; Geng, Zhixian; Abdelhalim, Suzan M.; Jiang, Jack J.; McCulloch, Timothy M.

2014-01-01

Purpose: The purpose of this study was to investigate inter- and intrarater reliability among expert users, novice users, and speech-language pathologists with a semiautomated high-resolution manometry analysis program. We hypothesized that all users would have high intrarater reliability and high interrater reliability. Method: Three expert…

Durability of coconut shell powder (CSP) concrete

NASA Astrophysics Data System (ADS)

Leman, A. S.; Shahidan, S.; Senin, M. S.; Shamsuddin, S. M.; Anak Guntor, N. A.; Zuki, S. S. Mohd; Khalid, F. S.; Azhar, A. T. S.; Razak, N. H. S.

2017-11-01

The rising cost of construction in developing countries like Malaysia has led concrete experts to explore alternative materials such as coconut shells which are renewable and possess high potential to be used as construction material. Coconut shell powder in varying percentages of1%, 3% and 5% was used as filler material in concrete grade 30 and evaluated after a curing period of 7 days and 28days respectively. Compressive strength, water absorption and carbonation tests were conducted to evaluate the strength and durability of CSP concrete in comparison with normal concrete. The test results revealed that 1%, 3% and 5% of CSP concrete achieved a compressive strength of 47.65 MPa, 45.6 MPa and 40.55% respectively. The rate of water absorption of CSP concrete was recorded as 3.21%, 2.47%, and 2.73% for 1%, 3% and 5% of CSP concrete respectively. Although CSP contained a carbon composition of 47%, the carbonation test showed that CSP no signs of carbon were detected inside the concrete. To conclude, CSP offers great prospects as it demonstrated relatively high durability as a construction material.

The STAR Data Reporting Guidelines for Clinical High Altitude Research.

PubMed

Brodmann Maeder, Monika; Brugger, Hermann; Pun, Matiram; Strapazzon, Giacomo; Dal Cappello, Tomas; Maggiorini, Marco; Hackett, Peter; Bärtsch, Peter; Swenson, Erik R; Zafren, Ken

2018-03-01

Brodmann Maeder, Monika, Hermann Brugger, Matiram Pun, Giacomo Strapazzon, Tomas Dal Cappello, Marco Maggiorini, Peter Hackett, Peter Baärtsch, Erik R. Swenson, Ken Zafren (STAR Core Group), and the STAR Delphi Expert Group. The STARdata reporting guidelines for clinical high altitude research. High AltMedBiol. 19:7-14, 2018. The goal of the STAR (STrengthening Altitude Research) initiative was to produce a uniform set of key elements for research and reporting in clinical high-altitude (HA) medicine. The STAR initiative was inspired by research on treatment of cardiac arrest, in which the establishment of the Utstein Style, a uniform data reporting protocol, substantially contributed to improving data reporting and subsequently the quality of scientific evidence. The STAR core group used the Delphi method, in which a group of experts reaches a consensus over multiple rounds using a formal method. We selected experts in the field of clinical HA medicine based on their scientific credentials and identified an initial set of parameters for evaluation by the experts. Of 51 experts in HA research who were identified initially, 21 experts completed both rounds. The experts identified 42 key parameters in 5 categories (setting, individual factors, acute mountain sickness and HA cerebral edema, HA pulmonary edema, and treatment) that were considered essential for research and reporting in clinical HA research. An additional 47 supplemental parameters were identified that should be reported depending on the nature of the research. The STAR initiative, using the Delphi method, identified a set of key parameters essential for research and reporting in clinical HA medicine.

Computer-based diagnostic expert systems in rheumatology: where do we stand in 2014?

PubMed

Alder, Hannes; Michel, Beat A; Marx, Christian; Tamborrini, Giorgio; Langenegger, Thomas; Bruehlmann, Pius; Steurer, Johann; Wildi, Lukas M

2014-01-01

Background. The early detection of rheumatic diseases and the treatment to target have become of utmost importance to control the disease and improve its prognosis. However, establishing a diagnosis in early stages is challenging as many diseases initially present with similar symptoms and signs. Expert systems are computer programs designed to support the human decision making and have been developed in almost every field of medicine. Methods. This review focuses on the developments in the field of rheumatology to give a comprehensive insight. Medline, Embase, and Cochrane Library were searched. Results. Reports of 25 expert systems with different design and field of application were found. The performance of 19 of the identified expert systems was evaluated. The proportion of correctly diagnosed cases was between 43.1 and 99.9%. Sensitivity and specificity ranged from 62 to 100 and 88 to 98%, respectively. Conclusions. Promising diagnostic expert systems with moderate to excellent performance were identified. The validation process was in general underappreciated. None of the systems, however, seemed to have succeeded in daily practice. This review identifies optimal characteristics to increase the survival rate of expert systems and may serve as valuable information for future developments in the field.

[Health insurance companies and medical genetics, what do they want to know? Expert opinions concerning medical genetic services].

PubMed

Nippert, Reinhart Peter; Schmidtke, J

2012-03-01

Based on the compilation of medical opinions delivered by a medical genetic expert between 2002 and 2010, solicited by private health insurance companies in Germany, an analysis of the main issues raised was made to identify the information needs of company employees with respect to human and medical genetics. The findings are discussed and recommendations for improvement and further training are suggested.

Testing the validity and acceptability of the diagnostic criteria for Hoarding Disorder: a DSM-5 survey.

PubMed

Mataix-Cols, D; Fernández de la Cruz, L; Nakao, T; Pertusa, A

2011-12-01

The DSM-5 Obsessive-Compulsive Spectrum Sub-Workgroup is recommending the creation of a new diagnostic category named Hoarding Disorder (HD). The validity and acceptability of the proposed diagnostic criteria have yet to be formally tested. Obsessive-compulsive disorder/hoarding experts and random members of the American Psychiatric Association (APA) were shown eight brief clinical vignettes (four cases meeting criteria for HD, three with hoarding behaviour secondary to other mental disorders, and one with subclinical hoarding behaviour) and asked to decide the most appropriate diagnosis in each case. Participants were also asked about the perceived acceptability of the criteria and whether they supported the inclusion of HD in the main manual. Altogether, 211 experts and 48 APA members completed the survey (30% and 10% response rates, respectively). The sensitivity and specificity of the HD diagnosis and the individual criteria were high (80-90%) across various types of professionals, irrespective of their experience with hoarding cases. About 90% of participants in both samples thought the criteria would be very/somewhat acceptable for professionals and sufferers. Most experts (70%) supported the inclusion of HD in the main manual, whereas only 50% of the APA members did. The proposed criteria for HD have high sensitivity and specificity. The criteria are also deemed acceptable for professionals and sufferers alike. Training of professionals and the development and validation of semi-structured diagnostic instruments should improve diagnostic accuracy even further. A field trial is now needed to confirm these encouraging findings with real patients in real clinical settings.

Experts correctly describe demography associated with historical decline of the endangered Indiana bat, but not recent period of stationarity

USGS Publications Warehouse

Thogmartin, Wayne E.; Sanders-Reed, Carol A.; Szymanski, Jennifer; Pruitt, Lori; Runge, Michael C.

2017-01-01

Demographic characteristics of bats are often insufficiently described for modeling populations. In data poor situations, experts are often relied upon for characterizing ecological systems. In concert with the development of a matrix model describing Indiana bat (Myotis sodalis) demography, we elicited estimates for parameterizing this model from 12 experts. We conducted this elicitation in two stages, requesting expert values for 12 demographic rates. These rates were adult and juvenile seasonal (winter, summer, fall) survival rates, pup survival in fall, and propensity and success at breeding. Experts were most in agreement about adult fall survival (3% Coefficient of Variation) and least in agreement about propensity of juveniles to breed (37% CV). The experts showed greater concordance for adult ( mean CV, adult = 6.2%) than for juvenile parameters ( mean CV, juvenile = 16.4%), and slightly more agreement for survival (mean CV, survival = 9.8%) compared to reproductive rates ( mean CV, reproduction = 15.1%). However, survival and reproduction were negatively and positively biased, respectively, relative to a stationary dynamic. Despite the species exhibiting near stationary dynamics for two decades prior to the onset of a potential extinction-causing agent, white-nose syndrome, expert estimates indicated a population decline of -11% per year (95% CI = -2%, -20%); quasi-extinction was predicted within a century ( mean = 61 years to QE, range = 32, 97) by 10 of the 12 experts. Were we to use these expert estimates in our modeling efforts, we would have errantly trained our models to a rapidly declining demography asymptomatic of recent demographic behavior. While experts are sometimes the only source of information, a clear understanding of the temporal and spatial context of the information being elicited is necessary to guard against wayward predictions.

Issues in pediatric vaccine-preventable diseases in low- to middle-income countries

PubMed Central

Dbaibo, Ghassan; Tatochenko, Vladimir; Wutzler, Peter

2016-01-01

ABSTRACT The highest burden of pediatric vaccine-preventable disease is found in developing nations where resource constraints pose the greatest challenge, impacting disease diagnosis and surveillance as well as the implementation of large scale vaccination programmes. In November 2012, a Working Group Meeting convened in Casablanca to describe and discuss the status with respect to 8 vaccine-preventable diseases (pertussis, pneumococcal disease, measles-mumps-rubella-varicella (MMRV), rotavirus and meningococcal meningitis) to identify and consider ways of overcoming obstacles to pediatric vaccine implementation. Experts from Europe, Russia, the Commonwealth of Independent States, the Middle East, Africa and South East Asia participated in the meeting. A range of region-specific needs and barriers to uptake were discussed. The aim of this article is to provide a summary of the ongoing status with respect to pediatric vaccine preventable disease in the countries represented, and the experts' opinions and recommendations with respect to pediatric vaccine implementation. PMID:27322436

Is forceps more useful than visualization for measurement of colon polyp size?

PubMed Central

Kim, Jae Hyun; Park, Seun Ja; Lee, Jong Hoon; Kim, Tae Oh; Kim, Hyun Jin; Kim, Hyung Wook; Lee, Sang Heon; Baek, Dong Hoon; (BIGS), Busan Ulsan Gyeongnam Intestinal Study Group Society

2016-01-01

AIM: To identify whether the forceps estimation is more useful than visual estimation in the measurement of colon polyp size. METHODS: We recorded colonoscopy video clips that included scenes visualizing the polyp and scenes using open biopsy forceps in association with the polyp, which were used for an exam. A total of 40 endoscopists from the Busan Ulsan Gyeongnam Intestinal Study Group Society (BIGS) participated in this study. Participants watched 40 pairs of video clips of the scenes for visual estimation and forceps estimation, and wrote down the estimated polyp size on the exam paper. When analyzing the results of the exam, we assessed inter-observer differences, diagnostic accuracy, and error range in the measurement of the polyp size. RESULTS: The overall intra-class correlation coefficients (ICC) of inter-observer agreement for forceps estimation and visual estimation were 0.804 (95%CI: 0.731-0.873, P < 0.001) and 0.743 (95%CI: 0.656-0.828, P < 0.001), respectively. The ICCs of each group for forceps estimation were higher than those for visual estimation (Beginner group, 0.761 vs 0.693; Expert group, 0.887 vs 0.840, respectively). The overall diagnostic accuracy for visual estimation was 0.639 and for forceps estimation was 0.754 (P < 0.001). In the beginner group and the expert group, the diagnostic accuracy for the forceps estimation was significantly higher than that of the visual estimation (Beginner group, 0.734 vs 0.613, P < 0.001; Expert group, 0.784 vs 0.680, P < 0.001, respectively). The overall error range for visual estimation and forceps estimation were 1.48 ± 1.18 and 1.20 ± 1.10, respectively (P < 0.001). The error ranges of each group for forceps estimation were significantly smaller than those for visual estimation (Beginner group, 1.38 ± 1.08 vs 1.68 ± 1.30, P < 0.001; Expert group, 1.12 ± 1.11 vs 1.42 ± 1.11, P < 0.001, respectively). CONCLUSION: Application of the open biopsy forceps method when measuring colon polyp size could help reduce inter-observer differences and error rates. PMID:27003999

Is forceps more useful than visualization for measurement of colon polyp size?

PubMed

Kim, Jae Hyun; Park, Seun Ja; Lee, Jong Hoon; Kim, Tae Oh; Kim, Hyun Jin; Kim, Hyung Wook; Lee, Sang Heon; Baek, Dong Hoon; Bigs, Busan Ulsan Gyeongnam Intestinal Study Group Society

2016-03-21

To identify whether the forceps estimation is more useful than visual estimation in the measurement of colon polyp size. We recorded colonoscopy video clips that included scenes visualizing the polyp and scenes using open biopsy forceps in association with the polyp, which were used for an exam. A total of 40 endoscopists from the Busan Ulsan Gyeongnam Intestinal Study Group Society (BIGS) participated in this study. Participants watched 40 pairs of video clips of the scenes for visual estimation and forceps estimation, and wrote down the estimated polyp size on the exam paper. When analyzing the results of the exam, we assessed inter-observer differences, diagnostic accuracy, and error range in the measurement of the polyp size. The overall intra-class correlation coefficients (ICC) of inter-observer agreement for forceps estimation and visual estimation were 0.804 (95%CI: 0.731-0.873, P < 0.001) and 0.743 (95%CI: 0.656-0.828, P < 0.001), respectively. The ICCs of each group for forceps estimation were higher than those for visual estimation (Beginner group, 0.761 vs 0.693; Expert group, 0.887 vs 0.840, respectively). The overall diagnostic accuracy for visual estimation was 0.639 and for forceps estimation was 0.754 (P < 0.001). In the beginner group and the expert group, the diagnostic accuracy for the forceps estimation was significantly higher than that of the visual estimation (Beginner group, 0.734 vs 0.613, P < 0.001; Expert group, 0.784 vs 0.680, P < 0.001, respectively). The overall error range for visual estimation and forceps estimation were 1.48 ± 1.18 and 1.20 ± 1.10, respectively (P < 0.001). The error ranges of each group for forceps estimation were significantly smaller than those for visual estimation (Beginner group, 1.38 ± 1.08 vs 1.68 ± 1.30, P < 0.001; Expert group, 1.12 ± 1.11 vs 1.42 ± 1.11, P < 0.001, respectively). Application of the open biopsy forceps method when measuring colon polyp size could help reduce inter-observer differences and error rates.

A portable device for measuring donor corneal transparency in eye banks.

PubMed

Parekh, Mohit; Ferrari, Stefano; Ruzza, Alessandro; Pugliese, Mariarosaria; Ponzin, Diego; Salvalaio, Gianni

2014-03-01

To develop a portable device for measuring the donor corneal transparency and validate its efficacy for corneal evaluation in the eye-banks and for research. The transparency device (TD) has a light source, a detachable system for corneal insertion and a base for light transmission. The probe detects the transmitted light which is measured by a lux-meter. A contact lens was set as 'control' to reduce the light scattering concern, an empty petri-plate as 'blank' and the cornea as 'sample'. Two experts and non-experts (masked) observed the corneas for subjective analysis which was then compared using the TD. The parameters observed were scars, foreign-body, stromal-deformities, folds, thickness and opacity which were then converted to a relative overall percentage by the observer. Twenty corneas were evaluated for correlation, five tissues to obtain standard-deviation and twenty-four pairs for a comparative study. Experts mimicked the eye-banks with long-term experience while non-experts mimicked the emerging eye-banks. Subjective values by the experts closely resembled the measurements by TD. The average correlation between the experts and the non-experts to TD was 0.985 and 0.960 respectively. TD showed higher reproducibility than experts followed by the non-experts. The comparative study showed that increase in thickness reduces the transparency. TD is portable, easy, efficient, maintains sterility and less expensive hence the emerging eye-banks and researchers can use to raise their standards and evaluate the transparency for in vitro tests and comparative studies. The suitable transparency for the cornea deemed for clinical applications was found to be >75 %.

Characteristics of Fluency and Speech in Two Families With High Incidences of Stuttering.

PubMed

Stager, Sheila V; Freeman, Frances J; Braun, Allen

2015-10-01

This study presents data from 2 families with high incidence of stuttering, comparing methods of phenotype assignment and exploring the presence of other fluency disorders and corresponding speech characteristics. Three methods for assigning phenotype of stuttering were used: self-identification, family identification, and expert identification. Agreement on which individuals were assigned by each of these methods was studied. Multiple measures of fluency and speech production were obtained. Self-reports and descriptions of blocking rather than self-identification as a person who stutters demonstrated the best agreement with expert identification of stuttering. Family identification showed poor agreement with both expert and self-identification of stuttering. Using binary categories of fluent or stuttering, 90% of individuals in 1 family were classified by expert consensus. Only 70% of the other family could be similarly categorized. Experts required 2 other categories, cluttering and other fluency disorders, to fully characterize dysfluency within this family. These 2 families also demonstrated differences in speech production. Some families with high incidence of stuttering may also have high incidence of other fluency disorders and other speech-production difficulties. This finding may have ramifications for genetic studies, including criteria for defining phenotype and collapsing data across multiple families.

a New Method for Fmeca Based on Fuzzy Theory and Expert System

NASA Astrophysics Data System (ADS)

Byeon, Yoong-Tae; Kim, Dong-Jin; Kim, Jin-O.

2008-10-01

Failure Mode Effects and Criticality Analysis (FMECA) is one of most widely used methods in modern engineering system to investigate potential failure modes and its severity upon the system. FMECA evaluates criticality and severity of each failure mode and visualize the risk level matrix putting those indices to column and row variable respectively. Generally, those indices are determined subjectively by experts and operators. However, this process has no choice but to include uncertainty. In this paper, a method for eliciting expert opinions considering its uncertainty is proposed to evaluate the criticality and severity. In addition, a fuzzy expert system is constructed in order to determine the crisp value of risk level for each failure mode. Finally, an illustrative example system is analyzed in the case study. The results are worth considering in deciding the proper policies for each component of the system.

Assessment of Expert-Novice Chemistry Problem Solving Using HyperCard: Early Findings.

ERIC Educational Resources Information Center

Kumar, David D.

1993-01-01

Results of a HyperCard method for assessing the performance of expert and novice high school chemistry students solving stoichiometric chemistry problems (balancing chemical equations) is reported. MANOVA results indicate significant difference between expert and novice students solving the five stoichiometric chemistry problems using…

Development of multimedia learning based inquiry on vibration and wave material

NASA Astrophysics Data System (ADS)

Madeali, H.; Prahani, B. K.

2018-03-01

This study aims to develop multimedia learning based inquiry that is interesting, easy to understand by students and streamline the time of teachers in bringing the teaching materials as well as feasible to be used in learning the physics subject matter of vibration and wave. This research is a Research and Development research with reference to ADDIE model that is Analysis, Design, Development, Implementation, and Evaluation. Multimedia based learning inquiry is packaged in hypertext form using Adobe Flash CS6 Software. The inquiry aspect is constructed by showing the animation of the concepts that the student wants to achieve and then followed by questions that will ask the students what is observable. Multimedia learning based inquiry is then validated by 2 learning experts, 3 material experts and 3 media experts and tested on 3 junior high school teachers and 23 students of state junior high school 5 of Kendari. The results of the study include: (1) Validation results by learning experts, material experts and media experts in valid categories; (2) The results of trials by teachers and students fall into the practical category. These results prove that the multimedia learning based inquiry on vibration and waves materials that have been developed feasible use in physics learning by students of junior high school class VIII.

Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support

PubMed Central

2010-01-01

Background Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. Method This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA), which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK) to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1) Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA), and 2) Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR). In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. Results EbCA is a new methodology composed by 6 steps:. 1) Data collection and data preparation; 2) acquisition of "Prior Expert Knowledge" (PEK) and design of the "Prior Knowledge Base" (PKB); 3) PKB-guided analysis; 4) support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited); 5) incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6) post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering), applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. Discussion This paper presents EbCA and shows the convenience of completing classical data analysis with PEK as a mean to extract relevant knowledge in complex health domains. One of the major benefits of EbCA is iterative elicitation of IK.. Both explicit and tacit or implicit expert knowledge are critical to guide the scientific analysis of very complex decisional problems as those found in health system research. PMID:20920289

Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support.

PubMed

Gibert, Karina; García-Alonso, Carlos; Salvador-Carulla, Luis

2010-09-30

Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA), which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK) to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1) Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA), and 2) Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR). In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. EbCA is a new methodology composed by 6 steps:. 1) Data collection and data preparation; 2) acquisition of "Prior Expert Knowledge" (PEK) and design of the "Prior Knowledge Base" (PKB); 3) PKB-guided analysis; 4) support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited); 5) incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6) post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering), applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. This paper presents EbCA and shows the convenience of completing classical data analysis with PEK as a mean to extract relevant knowledge in complex health domains. One of the major benefits of EbCA is iterative elicitation of IK.. Both explicit and tacit or implicit expert knowledge are critical to guide the scientific analysis of very complex decisional problems as those found in health system research.

[Modified Delphi method in the constitution of school sanitation standard].

PubMed

Yin, Xunqiang; Liang, Ying; Tan, Hongzhuan; Gong, Wenjie; Deng, Jing; Luo, Jiayou; Di, Xiaokang; Wu, Yue

2012-11-01

To constitute school sanitation standard using modified Delphi method, and to explore the feasibility and the predominance of Delphi method in the constitution of school sanitation standard. Two rounds of expert consultations were adopted in this study. The data were analyzed with SPSS15.0 to screen indices of school sanitation standard. Thirty-two experts accomplished the 2 rounds of consultations. The average length of expert service was (24.69 ±8.53) years. The authority coefficient was 0.729 ±0.172. The expert positive coefficient was 94.12% (32/34) in the first round and 100% (32/32) in the second round. The harmonious coefficients of importance, feasibility and rationality in the second round were 0.493 (P<0.05), 0.527 (P<0.01), and 0.535 (P<0.01), respectively, suggesting unanimous expert opinions. According to the second round of consultation, 38 indices were included in the framework. Theoretical analysis, literature review, investigation and so on are generally used in health standard constitution currently. Delphi method is a rapid, effective and feasible method in this field.

Expert anticipatory skill in striking sports: a review and a model.

PubMed

Müller, Sean; Abernethy, Bruce

2012-06-01

Expert performers in striking sports can hit objects moving at high speed with incredible precision. Exceptionally well developed anticipation skills are necessary to cope with the severe constraints on interception. In this papr we provide a review of the empirical evidence regarding expert interception in striking sports and propose a preliminary model of expert anticipation. Central to the review and the model is the notion that the visual information used to guide the sequential phases of the striking action is systematically different between experts and nonexperts. Knowing the factors that contribute to expert anticipation, and how anticipation may guide skilled performance in striking sports, has practical implications for assessment and training across skill levels.

Explainable expert systems: A research program in information processing

NASA Technical Reports Server (NTRS)

Paris, Cecile L.

1993-01-01

Our work in Explainable Expert Systems (EES) had two goals: to extend and enhance the range of explanations that expert systems can offer, and to ease their maintenance and evolution. As suggested in our proposal, these goals are complementary because they place similar demands on the underlying architecture of the expert system: they both require the knowledge contained in a system to be explicitly represented, in a high-level declarative language and in a modular fashion. With these two goals in mind, the Explainable Expert Systems (EES) framework was designed to remedy limitations to explainability and evolvability that stem from related fundamental flaws in the underlying architecture of current expert systems.

Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment.

PubMed

de Wit, Maike; Ortner, Petra; Lipp, Hans-Peter; Sehouli, Jalid; Untch, Michael; Ruhnke, Markus; Mayer-Steinacker, Regine; Bokemeyer, Carsten; Jordan, Karin

2013-01-01

Cytotoxic extravasation is a rare but potentially serious and painful complication of intravenous drug administration in oncology. Literature is anecdotal, and systematic clinical trials are scarce. The German working group for Supportive Care in Cancer (ASORS) has prepared an expert opinion for the diagnosis, prophylaxis and management of cytotoxic extravasation based on an interdisciplinary expert panel. A Pubmed search was conducted for diagnosis, risk factors, symptoms, prophylaxis, and treatment of extravasation by the respective responsible expert. A writing committee compiled the manuscript and proposed the level of recommendation. In a consensus meeting, 13 experts reviewed and discussed the current practice in diagnosis and management of cytotoxic extravasation. In a telephone voting among the experts, the level of recommendation by ASORS was determined. Every effort should be made to reduce the risk of extravasation. Staff training, patient education, usage of right materials and infusion techniques have been identified to be mandatory to minimalize the risk of extravasation. Extravasation must be diagnosed as soon as possible, and specific therapy including antidotes dependent on the extravasated drug should be initiated immediately. An extravasation emergency set should be available wherever intravenous cytotoxics are applied. Documentation and post-treatment follow-up are recommended. We have developed a literature- and expert-based consensus recommendation to avoid cytotoxic extravasation. It also provides practical management instructions which should help to avoid surgery and serious late effects. Copyright © 2013 S. Karger AG, Basel.

Development and validation of equations utilizing lamb vision system output to predict lamb carcass fabrication yields.

PubMed

Cunha, B C N; Belk, K E; Scanga, J A; LeValley, S B; Tatum, J D; Smith, G C

2004-07-01

This study was performed to validate previous equations and to develop and evaluate new regression equations for predicting lamb carcass fabrication yields using outputs from a lamb vision system-hot carcass component (LVS-HCC) and the lamb vision system-chilled carcass LM imaging component (LVS-CCC). Lamb carcasses (n = 149) were selected after slaughter, imaged hot using the LVS-HCC, and chilled for 24 to 48 h at -3 to 1 degrees C. Chilled carcasses yield grades (YG) were assigned on-line by USDA graders and by expert USDA grading supervisors with unlimited time and access to the carcasses. Before fabrication, carcasses were ribbed between the 12th and 13th ribs and imaged using the LVS-CCC. Carcasses were fabricated into bone-in subprimal/primal cuts. Yields calculated included 1) saleable meat yield (SMY); 2) subprimal yield (SPY); and 3) fat yield (FY). On-line (whole-number) USDA YG accounted for 59, 58, and 64%; expert (whole-number) USDA YG explained 59, 59, and 65%; and expert (nearest-tenth) USDA YG accounted for 60, 60, and 67% of the observed variation in SMY, SPY, and FY, respectively. The best prediction equation developed in this trial using LVS-HCC output and hot carcass weight as independent variables explained 68, 62, and 74% of the variation in SMY, SPY, and FY, respectively. Addition of output from LVS-CCC improved predictive accuracy of the equations; the combined output equations explained 72 and 66% of the variability in SMY and SPY, respectively. Accuracy and repeatability of measurement of LM area made with the LVS-CCC also was assessed, and results suggested that use of LVS-CCC provided reasonably accurate (R2 = 0.59) and highly repeatable (repeatability = 0.98) measurements of LM area. Compared with USDA YG, use of the dual-component lamb vision system to predict cut yields of lamb carcasses improved accuracy and precision, suggesting that this system could have an application as an objective means for pricing carcasses in a value-based marketing system.

A preference-based approach to deriving breeding objectives: applied to sheep breeding.

PubMed

Byrne, T J; Amer, P R; Fennessy, P F; Hansen, P; Wickham, B W

2012-05-01

Using internet-based software known as 1000Minds, choice-experiment surveys were administered to experts and farmers from the Irish sheep industry to capture their preferences with respect to the relative importance - represented by part-worth utilities - of target traits in the definition of a breeding objective for sheep in Ireland. Sheep production in Ireland can be broadly separated into lowland and hill farming systems; therefore, each expert was asked to answer the survey first as if he or she were a lowland farmer and second as a hill farmer. In addition to the experts, a group of lowland and a group of hill farmers were surveyed to assess whether, and to what extent, the groups' preferences differ from the experts' preferences. The part-worth utilities obtained from the surveys were converted into relative economic value terms per unit change in each trait. These measures - referred to as 'preference economic values' (pEVs) - were compared with economic values for the traits obtained from bio-economic models. The traits 'value per lamb at the meat processor' and 'lamb survival to slaughter' were revealed as being the two most important traits for the surveyed experts responding as lowland and hill farmers, respectively. In contrast, 'number of foot baths per year for ewes' and 'number of anthelmintic treatments per year for ewes' were the two least important traits. With the exception of 'carcase fat class' (P < 0.05), there were no statistically significant differences in the mean pEVs obtained from the surveyed experts under both the lowland and hill farming scenarios. Compared with the economic values obtained from bio-economic models, the pEVs for 'lambing difficulty' when the experts responded as lowland farmers were higher (P < 0.001); and they were lower (P < 0.001) for 'carcase conformation class', 'carcase fat class' (less negative) and 'ewe mature weight' (less negative) under both scenarios. Compared with surveyed experts, pEVs from lowland farmers differed significantly for 'lambing difficulty', 'lamb survival to slaughter', 'average days to slaughter of lambs', 'number of foot baths per year for ewes', 'number of anthelmintic treatments per year for ewes' and 'ewe mature weight'. Compared with surveyed experts, pEVs from hill farmers differed significantly for 'lambing difficulty', 'average days to slaughter of lambs' and 'number of foot baths per year for ewes'. This study indicates that preference-based tools have the potential to contribute to the definition of breeding objectives where production and price data are not available.

How Experts’ Use of Medical Technical Jargon in Different Types of Online Health Forums Affects Perceived Information Credibility: Randomized Experiment With Laypersons

PubMed Central

Jucks, Regina

2018-01-01

Background Online health forums are widely used, but the quality of advice differs as much as the knowledge backgrounds of the audience members who receive the advice. It is important to understand how people judge the information given online. In line with the communication accommodation theory (CAT), online forums represent specific social contexts of communication which can present either accommodative or nonaccommodative language to an audience. Accordingly, use of accommodative or nonaccommodative language might affect people’s perceived trust in the communicator. Objective The objective of this study was to investigate how experts who use accommodative (vs nonaccommodative) language are evaluated by passive users of an online forum. Methods Participants (n=98) took part in an online experiment and read experts’ posts about 10 nutrition myths. Following a 2 x 2 mixed design, experts’ posts were written using either low or high amounts of medical technical jargon (MTJ) (within factor) and were directed at different audiences (mainly other medical experts [in a professional forum] vs a user group mainly comprising laypersons [in an advisory forum]) (between factor). Accommodation occurred where experts used high amounts of MTJ to address other medical experts in the professional forum; it also occurred when experts used low amounts of MTJ to address laypersons in the advisory forum. Conversely, nonaccommodation occurred when experts used high amounts of MTJ in the advisory forum and low amounts of MTJ in the professional forum. In each condition, participants evaluated the credibility of the information, the trustworthiness of the experts, and the accommodation by the experts. Results Overall, participants judged the credibility of information to be higher when experts used MTJ that was accommodative to the designated audience, F1,95=3.10, P=.04, ηp2=.031. In addition, participants judged the experts in professional forums to be more trustworthy than experts in advisory forums (all F1,96≥3.54, P ≤.03, ηp2≥.036). Moreover, participants rated experts who used high amounts of MTJ to have higher competence (F1,96=37.54, P<.001, ηp2=.28], lower integrity (F1,96=10.77, P=.001, ηp2=.101), and lower benevolence (F1,96=9.75, P=.002, ηp2=.092), as well as to have lower perceived accommodation to the audience (all F1,96≥72.17, P<.001, ηp2≥.43) compared with experts who used low MTJ. Conclusions To provide health information online that is perceived as credible, experts should consider using similar language as the language used by the addressed audience. As it is often impossible to determine the exact makeup of an online audience, further research might investigate whether having experts explicitly declare which audience they intend to address can help people to more reliably assess an expert’s trustworthiness. Furthermore, as people assess information differently depending on the context of online communication, it would be valuable for research to consider other aspects of the context beyond those of the audience. PMID:29362212

Expert Anticipatory Skill in Striking Sports: A Review and a Model

ERIC Educational Resources Information Center

Muller, Sean; Abernethy, Bruce

2012-01-01

Expert performers in striking sports can hit objects moving at high speed with incredible precision. Exceptionally well developed anticipation skills are necessary to cope with the severe constraints on interception. In this paper, we provide a review of the empirical evidence regarding expert interception in striking sports and propose a…

The Effect of Expert Performance Microtiming on Listeners' Experience of Groove in Swing or Funk Music

PubMed Central

Senn, Olivier; Kilchenmann, Lorenz; von Georgi, Richard; Bullerjahn, Claudia

2016-01-01

This study tested the influence of expert performance microtiming on listeners' experience of groove. Two professional rhythm section performances (bass/drums) in swing and funk style were recorded, and the performances' original microtemporal deviations from a regular metronomic grid were scaled to several levels of magnitude. Music expert (n = 79) and non-expert (n = 81) listeners rated the groove qualities of stimuli using a newly developed questionnaire that measures three dimensions of the groove experience (Entrainment, Enjoyment, and the absence of Irritation). Findings show that music expert listeners were more sensitive to microtiming manipulations than non-experts. Across both expertise groups and for both styles, groove ratings were high for microtiming magnitudes equal or smaller than those originally performed and decreased for exaggerated microtiming magnitudes. In particular, both the fully quantized music and the music with the originally performed microtiming pattern were rated equally high on groove. This means that neither the claims of PD theory (that microtiming deviations are necessary for groove) nor the opposing exactitude hypothesis (that microtiming deviations are detrimental to groove) were supported by the data. PMID:27761117

The Effect of Expert Performance Microtiming on Listeners' Experience of Groove in Swing or Funk Music.

PubMed

Senn, Olivier; Kilchenmann, Lorenz; von Georgi, Richard; Bullerjahn, Claudia

2016-01-01

This study tested the influence of expert performance microtiming on listeners' experience of groove. Two professional rhythm section performances (bass/drums) in swing and funk style were recorded, and the performances' original microtemporal deviations from a regular metronomic grid were scaled to several levels of magnitude. Music expert ( n = 79) and non-expert ( n = 81) listeners rated the groove qualities of stimuli using a newly developed questionnaire that measures three dimensions of the groove experience ( Entrainment, Enjoyment , and the absence of Irritation ). Findings show that music expert listeners were more sensitive to microtiming manipulations than non-experts. Across both expertise groups and for both styles, groove ratings were high for microtiming magnitudes equal or smaller than those originally performed and decreased for exaggerated microtiming magnitudes. In particular, both the fully quantized music and the music with the originally performed microtiming pattern were rated equally high on groove. This means that neither the claims of PD theory (that microtiming deviations are necessary for groove) nor the opposing exactitude hypothesis (that microtiming deviations are detrimental to groove) were supported by the data.

A multiresolution prostate representation for automatic segmentation in magnetic resonance images.

PubMed

Alvarez, Charlens; Martínez, Fabio; Romero, Eduardo

2017-04-01

Accurate prostate delineation is necessary in radiotherapy processes for concentrating the dose onto the prostate and reducing side effects in neighboring organs. Currently, manual delineation is performed over magnetic resonance imaging (MRI) taking advantage of its high soft tissue contrast property. Nevertheless, as human intervention is a consuming task with high intra- and interobserver variability rates, (semi)-automatic organ delineation tools have emerged to cope with these challenges, reducing the time spent for these tasks. This work presents a multiresolution representation that defines a novel metric and allows to segment a new prostate by combining a set of most similar prostates in a dataset. The proposed method starts by selecting the set of most similar prostates with respect to a new one using the proposed multiresolution representation. This representation characterizes the prostate through a set of salient points, extracted from a region of interest (ROI) that encloses the organ and refined using structural information, allowing to capture main relevant features of the organ boundary. Afterward, the new prostate is automatically segmented by combining the nonrigidly registered expert delineations associated to the previous selected similar prostates using a weighted patch-based strategy. Finally, the prostate contour is smoothed based on morphological operations. The proposed approach was evaluated with respect to the expert manual segmentation under a leave-one-out scheme using two public datasets, obtaining averaged Dice coefficients of 82% ± 0.07 and 83% ± 0.06, and demonstrating a competitive performance with respect to atlas-based state-of-the-art methods. The proposed multiresolution representation provides a feature space that follows a local salient point criteria and a global rule of the spatial configuration among these points to find out the most similar prostates. This strategy suggests an easy adaptation in the clinical routine, as supporting tool for annotation. © 2017 American Association of Physicists in Medicine.

Beyond Moore’s technologies: operation principles of a superconductor alternative

PubMed Central

Klenov, Nikolay V; Bakurskiy, Sergey V; Kupriyanov, Mikhail Yu; Gudkov, Alexander L; Sidorenko, Anatoli S

2017-01-01

The predictions of Moore’s law are considered by experts to be valid until 2020 giving rise to “post-Moore’s” technologies afterwards. Energy efficiency is one of the major challenges in high-performance computing that should be answered. Superconductor digital technology is a promising post-Moore’s alternative for the development of supercomputers. In this paper, we consider operation principles of an energy-efficient superconductor logic and memory circuits with a short retrospective review of their evolution. We analyze their shortcomings in respect to computer circuits design. Possible ways of further research are outlined. PMID:29354341

Estimated spectrum adaptive postfilter and the iterative prepost filtering algirighms

NASA Technical Reports Server (NTRS)

Linares, Irving (Inventor)

2004-01-01

The invention presents The Estimated Spectrum Adaptive Postfilter (ESAP) and the Iterative Prepost Filter (IPF) algorithms. These algorithms model a number of image-adaptive post-filtering and pre-post filtering methods. They are designed to minimize Discrete Cosine Transform (DCT) blocking distortion caused when images are highly compressed with the Joint Photographic Expert Group (JPEG) standard. The ESAP and the IPF techniques of the present invention minimize the mean square error (MSE) to improve the objective and subjective quality of low-bit-rate JPEG gray-scale images while simultaneously enhancing perceptual visual quality with respect to baseline JPEG images.

Inter-reader agreement in HRCT detection of pleural plaques and asbestosis in participants with previous occupational exposure to asbestos.

PubMed

Laurent, François; Paris, Christophe; Ferretti, Gilbert R; Beigelman, Catherine; Montaudon, Michel; Latrabe, Valerie; Jankowski, A; Badachi, Yasmina; Clin, Bénédicte; Gislard, Antoine; Letourneux, Marc; Luc, Amandine; Schorlé, Evelyne; Brochard, Patrick; Ameille, Jacques; Pairon, Jean-Claude

2014-12-01

To investigate inter-reader agreement for the detection of pleural and parenchymal abnormalities using CT in a large cross-sectional study comprising information on individual cumulative exposure to asbestos. The project was approved by the hospital ethics committee, and all patients received information on the study and gave their written informed consent. In 5511 CT scans performed in a cohort of retired workers previously exposed to asbestos and volunteering to participate in a multiregional survey programme (Asbestos Related Diseases Cohort, ARDCO), double randomised standardised readings, triple in case of disagreement, were performed by seven trained expert radiologists specialised in thoracic imaging and blind to the initial interpretation. Inter-reader agreement was evaluated by calculating the κ-weighted coefficient between pairs of expert readers and results of routine practice and final diagnosis after expert reading. κ-Weighted coefficients between trained experts ranged from 0.28 to 0.52 (fair to good), 0.59 to 0.86 (good to excellent) and 0.11 to 0.66 (poor to good) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. κ-Weighted coefficients between results of routine practice and final diagnosis after expert reading were 0.13 (poor), 0.53 (moderate) and 0.11 (poor) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. Interpretation of benign asbestos-related thoracic abnormalities requires standardisation of the reading and trained readers, particularly for participants asking for compensation, and with a view to the longitudinal survey of asbestos-exposed workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Expert consensus on best evaluative practices in community-based rehabilitation.

PubMed

Grandisson, Marie; Thibeault, Rachel; Hébert, Michèle; Cameron, Debra

2016-01-01

The objective of this study was to generate expert consensus on best evaluative practices for community-based rehabilitation (CBR). This consensus includes key features of the evaluation process and methods, and discussion of whether a shared framework should be used to report findings and, if so, which framework should play this role. A Delphi study with two predefined rounds was conducted. Experts in CBR from a wide range of geographical areas and disciplinary backgrounds were recruited to complete the questionnaires. Both quantitative and qualitative analyses were performed to generate the recommendations for best practices in CBR evaluation. A panel of 42 experts reached consensus on 13 recommendations for best evaluative practices in CBR. In regard to the critical qualities of sound CBR evaluation processes, panellists emphasized that these processes should be inclusive, participatory, empowering and respectful of local cultures and languages. The group agreed that evaluators should consider the use of mixed methods and participatory tools, and should combine indicators from a universal list of CBR indicators with locally generated ones. The group also agreed that a common framework should guide CBR evaluations, and that this framework should be a flexible combination between the CBR Matrix and the CBR Principles. An expert panel reached consensus on key features of best evaluative practices in CBR. Knowledge transfer initiatives are now required to develop guidelines, tools and training opportunities to facilitate CBR program evaluations. CBR evaluation processes should strive to be inclusive, participatory, empowering and respectful of local cultures and languages. CBR evaluators should strongly consider using mixed methods, participatory tools, a combination of indicators generated with the local community and with others from a bank of CBR indicators. CBR evaluations should be situated within a shared, but flexible, framework. This shared framework could combine the CBR Matrix and the CBR Principles.

A Regional Decision Support Scheme for Pest Risk Analysis in Southeast Asia.

PubMed

Soliman, T; MacLeod, A; Mumford, J D; Nghiem, T P L; Tan, H T W; Papworth, S K; Corlett, R T; Carrasco, L R

2016-05-01

A key justification to support plant health regulations is the ability of quarantine services to conduct pest risk analyses (PRA). Despite the supranational nature of biological invasions and the close proximity and connectivity of Southeast Asian countries, PRAs are conducted at the national level. Furthermore, some countries have limited experience in the development of PRAs, which may result in inadequate phytosanitary responses that put their plant resources at risk to pests vectored via international trade. We review existing decision support schemes for PRAs and, following international standards for phytosanitary measures, propose new methods that adapt existing practices to suit the unique characteristics of Southeast Asia. Using a formal written expert elicitation survey, a panel of regional scientific experts was asked to identify and rate unique traits of Southeast Asia with respect to PRA. Subsequently, an expert elicitation workshop with plant protection officials was conducted to verify the potential applicability of the developed methods. Rich biodiversity, shortage of trained personnel, social vulnerability, tropical climate, agriculture-dependent economies, high rates of land-use change, and difficulties in implementing risk management options were identified as challenging Southeast Asian traits. The developed methods emphasize local Southeast Asian conditions and could help support authorities responsible for carrying out PRAs within the region. These methods could also facilitate the creation of other PRA schemes in low- and middle-income tropical countries. © 2016 Society for Risk Analysis.

Assessment of the severity of asthma by an expert system. Description and evaluation.

PubMed

Redier, H; Daures, J P; Michel, C; Proudhon, H; Vervloet, D; Charpin, D; Marsac, J; Dusser, D; Brambilla, C; Wallaert, B

1995-02-01

Asthmaexpert, an expert system (ES), was produced at the special request of several clinicians in order to better understand the medical decisions made clinical experts in managing an asthmatic patient. We describe and evaluate this knowledge base, focusing mainly on assessment of the severity of asthma. After compiling data from a patient, Asthmaexpert assesses the severity of the disease and identifies the trigger factors involved, suggests any further investigations that may be required, and offers a treatment strategy. Implemented with Nexpert and Hypercard, it runs on a MacIntosh personal computer. The validation stage involved eight clinical experts who provided 20 case report forms (CRF) with their conclusions about management of asthma. The CRF were then programmed into the ES, which provided its own conclusions about the same subjects. Afterward, all the experts evaluated the conclusions given by ES or by their colleagues in a double-blind manner. One hundred twenty-seven CRF were available. The reliability of the experts' opinions was good, with a substantial consensus between them when assessing severity scores (kappa = 0.27 to 0.54). There was no difference in concordance of opinions on severity scores either between the experts who designed the system and ES or between the other experts and ES (weighted kappa = 0.72 and 0.69, respectively). Experts judged that the severity scores given by ES were as good as those proposed by their colleagues, and that the overall conclusions given by ES were as good as or better than those given by their colleagues. The conclusions drawn by ES were given a good rating.(ABSTRACT TRUNCATED AT 250 WORDS)

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

Gaffney, David K., E-mail: david.gaffney@hci.utah.edu; King, Bronwyn; Viswanathan, Akila N.

Purpose: The purpose of this study was to develop a radiation therapy (RT) contouring atlas and recommendations for women with postoperative and locally advanced vulvar carcinoma. Methods and Materials: An international committee of 35 expert gynecologic radiation oncologists completed a survey of the treatment of vulvar carcinoma. An initial set of recommendations for contouring was discussed and generated by consensus. Two cases, 1 locally advanced and 1 postoperative, were contoured by 14 physicians. Contours were compared and analyzed using an expectation-maximization algorithm for simultaneous truth and performance level estimation (STAPLE), and a 95% confidence interval contour was developed. The levelmore » of agreement among contours was assessed using a kappa statistic. STAPLE contours underwent full committee editing to generate the final atlas consensus contours. Results: Analysis of the 14 contours showed substantial agreement, with kappa statistics of 0.69 and 0.64 for cases 1 and 2, respectively. There was high specificity for both cases (≥99%) and only moderate sensitivity of 71.3% and 64.9% for cases 1 and 2, respectively. Expert review and discussion generated consensus recommendations for contouring target volumes and treatment for postoperative and locally advanced vulvar cancer. Conclusions: These consensus recommendations for contouring and treatment of vulvar cancer identified areas of complexity and controversy. Given the lack of clinical research evidence in vulvar cancer radiation therapy, the committee advocates a conservative and consistent approach using standardized recommendations.« less

Evaluation of a procedure to assess the adverse effects of illicit drugs.

PubMed

van Amsterdam, J G C; Best, W; Opperhuizen, A; de Wolff, F A

2004-02-01

The assessment procedure of new synthetic illicit drugs that are not documented in the UN treaty on psychotropic drugs was evaluated using a modified Electre model. Drugs were evaluated by an expert panel via the open Delphi approach, where the written score was discussed on 16 items, covering medical, health, legal, and criminalistic issues of the drugs. After this face-to-face discussion the drugs were scored again. Taking the assessment of ketamine as an example, it appeared that each expert used its own scale to score, and that policymakers do not score deviant from experts trained in the medical-biological field. Of the five drugs evaluated by the panel, p-methoxy-metamphetamine (PMMA), gamma-hydroxybutyric acid (GHB), and 4-methylthio-amphetamine (MTA) were assessed as more adverse than ketamine and psilocine and psilocybine-containing mushrooms. Whereas some experts slightly adjusted during the assessment procedure their opinion on ketamine and PMMA, the opinion on mushrooms was not affected by the discussion held between the two scoring rounds. All experts rank the five drugs in a similar way on the adverse effect scale i.e., concordance scale of the Electre model, indicating unanimity in the expert panel with respect to the risk classification of these abused drugs.

The analysis of senior high school students' physics HOTS in Bantul District measured using PhysReMChoTHOTS

NASA Astrophysics Data System (ADS)

Istiyono, Edi

2017-08-01

The purpose of this research is to describe the results of higher order thinking skills in physics (PhysHOTS) measurement including: (1) percentage of PhysHOTS level and (2) percentage of the domination of response in the category of students in each analyzing, evaluating, and creating skill. There were 404 10th grade students in Bantul District as the respondents of this research. The instrument used for measurement was PhysReMChoTHOTS. It was divided into two sets consisting of 44 items and including 8 anchor items stated valid by a Physicist, Physics Education Expert, and Physics Education Measurement Expert. The instrument was fit to PCM. The reliability coefficient of this test is 0.71, while the difficulty index of the items ranges from -0.61 to 0.51. The results of the measurement show that: (1) The percentage of each category of PhysHOTS for the 10th grade students in Bantul District for the very low, low, medium, high, and very high category is 4.75 %, 40.30 %, 33.45 %, 19.50 %, and 2.00 %, respectively; and (2) The order in analyzing skills, starts from the weakest, is attributing, differentiating and organizing. The order in evaluating skills, starts from the weakest, is critiquing and checking. Meanwhile, the order in creating skills, starts from the weakest, is producing, planning, and generating.

Characteristics of Fluency and Speech in Two Families With High Incidences of Stuttering

PubMed Central

Freeman, Frances J.; Braun, Allen

2015-01-01

Purpose This study presents data from 2 families with high incidence of stuttering, comparing methods of phenotype assignment and exploring the presence of other fluency disorders and corresponding speech characteristics. Method Three methods for assigning phenotype of stuttering were used: self-identification, family identification, and expert identification. Agreement on which individuals were assigned by each of these methods was studied. Multiple measures of fluency and speech production were obtained. Results Self-reports and descriptions of blocking rather than self-identification as a person who stutters demonstrated the best agreement with expert identification of stuttering. Family identification showed poor agreement with both expert and self-identification of stuttering. Using binary categories of fluent or stuttering, 90% of individuals in 1 family were classified by expert consensus. Only 70% of the other family could be similarly categorized. Experts required 2 other categories, cluttering and other fluency disorders, to fully characterize dysfluency within this family. These 2 families also demonstrated differences in speech production. Conclusion Some families with high incidence of stuttering may also have high incidence of other fluency disorders and other speech-production difficulties. This finding may have ramifications for genetic studies, including criteria for defining phenotype and collapsing data across multiple families. PMID:26126023

What should be included in the assessment of laypersons' paediatric basic life support skills? Results from a Delphi consensus study.

PubMed

Hasselager, Asbjørn Børch; Lauritsen, Torsten; Kristensen, Tim; Bohnstedt, Cathrine; Sønderskov, Claus; Østergaard, Doris; Tolsgaard, Martin Grønnebæk

2018-01-18

Assessment of laypersons' Paediatric Basic Life Support (PBLS) skills is important to ensure acquisition of effective PBLS competencies. However limited evidence exists on which PBLS skills are essential for laypersons. The same challenges exist with respect to the assessment of foreign body airway obstruction management (FBAOM) skills. We aimed to establish international consensus on how to assess laypersons' PBLS and FBAOM skills. A Delphi consensus survey was conducted. Out of a total of 84 invited experts, 28 agreed to participate. During the first Delphi round experts suggested items to assess laypersons' PBLS and FBAOM skills. In the second round, the suggested items received comments from and were rated by 26 experts (93%) on a 5-point scale (1 = not relevant to 5 = essential). Revised items were anonymously presented in a third round for comments and 23 (82%) experts completed a re-rating. Items with a score above 3 by more than 80% of the experts in the third round were included in an assessment instrument. In the first round, 19 and 15 items were identified to assess PBLS and FBAOM skills, respectively. The ratings and comments from the last two rounds resulted in nine and eight essential assessment items for PBLS and FBAOM skills, respectively. The PBLS items included: "Responsiveness"," Call for help", "Open airway"," Check breathing", "Rescue breaths", "Compressions", "Ventilations", "Time factor" and "Use of AED". The FBAOM items included: "Identify different stages of foreign body airway obstruction", "Identify consciousness", "Call for help", "Back blows", "Chest thrusts/abdominal thrusts according to age", "Identify loss of consciousness and change to CPR", "Assessment of breathing" and "Ventilation". For assessment of laypersons some PBLS and FBAOM skills described in guidelines are more important than others. Four out of nine of PBLS skills focus on airway and breathing skills, supporting the major importance of these skills for laypersons' resuscitation attempts. International consensus on how to assess laypersons' paediatric basic life support and foreign body airway obstruction management skills was established. The assessment of these skills may help to determine when laypersons have acquired competencies. Not relevant.

Building confidence and credibility into CAD with belief decision trees

NASA Astrophysics Data System (ADS)

Affenit, Rachael N.; Barns, Erik R.; Furst, Jacob D.; Rasin, Alexander; Raicu, Daniela S.

2017-03-01

Creating classifiers for computer-aided diagnosis in the absence of ground truth is a challenging problem. Using experts' opinions as reference truth is difficult because the variability in the experts' interpretations introduces uncertainty in the labeled diagnostic data. This uncertainty translates into noise, which can significantly affect the performance of any classifier on test data. To address this problem, we propose a new label set weighting approach to combine the experts' interpretations and their variability, as well as a selective iterative classification (SIC) approach that is based on conformal prediction. Using the NIH/NCI Lung Image Database Consortium (LIDC) dataset in which four radiologists interpreted the lung nodule characteristics, including the degree of malignancy, we illustrate the benefits of the proposed approach. Our results show that the proposed 2-label-weighted approach significantly outperforms the accuracy of the original 5- label and 2-label-unweighted classification approaches by 39.9% and 7.6%, respectively. We also found that the weighted 2-label models produce higher skewness values by 1.05 and 0.61 for non-SIC and SIC respectively on root mean square error (RMSE) distributions. When each approach was combined with selective iterative classification, this further improved the accuracy of classification for the 2-weighted-label by 7.5% over the original, and improved the skewness of the 5-label and 2-unweighted-label by 0.22 and 0.44 respectively.

Ovarian and cervical cancer awareness: development of two validated measurement tools.

PubMed

Simon, Alice E; Wardle, Jane; Grimmett, Chloe; Power, Emily; Corker, Elizabeth; Menon, Usha; Matheson, Lauren; Waller, Jo

2012-07-01

The aim of the study was to develop and validate measures of awareness of symptoms and risk factors for ovarian and cervical cancer (Ovarian and Cervical Cancer Awareness Measures). Potentially relevant items were extracted from the literature and generated by experts. Four validation studies were carried out to establish reliability and validity. Women aged 21-67 years (n=146) and ovarian and cervical cancer experts (n=32) were included in the studies. Internal reliability was assessed psychometrically. Test-retest reliability was assessed over a 1-week interval. To establish construct validity, Cancer Awareness Measure (CAM) scores of cancer experts were compared with equally well-educated comparison groups. Sensitivity to change was tested by randomly assigning participants to read either a leaflet giving information about ovarian/cervical cancer or a leaflet with control information, and then completing the ovarian/cervical CAM. Internal reliability (Cronbach's α=0.88 for the ovarian CAM and α=0.84 for the cervical CAM) and test-retest reliability (r=0.84 and r=0.77 for the ovarian and cervical CAMs, respectively) were both high. Validity was demonstrated with cancer experts achieving higher scores than controls [ovarian CAM: t(36)= -5.6, p<0.001; cervical CAM: t(38)= -3.7, p=0.001], and volunteers who were randomised to read a cancer leaflet scored higher than those who received a control leaflet [ovarian CAM: t(49)=7.5, p<0.001; cervical CAM: t(48)= -5.5, p<0.001]. This study demonstrates the psychometric properties of the ovarian and cervical CAMs and supports their utility in assessing ovarian and cervical cancer awareness in the general population.

Ovarian and cervical cancer awareness: development of two validated measurement tools

PubMed Central

Simon, Alice E; Wardle, Jane; Grimmett, Chloe; Power, Emily; Corker, Elizabeth; Menon, Usha; Matheson, Lauren; Waller, Jo

2012-01-01

Background The aim of the study was to develop and validate measures of awareness of symptoms and risk factors for ovarian and cervical cancer (Ovarian and Cervical Cancer Awareness Measures). Methods Potentially relevant items were extracted from the literature and generated by experts. Four validation studies were carried out to establish reliability and validity. Women aged 21–67 years (n=146) and ovarian and cervical cancer experts (n=32) were included in the studies. Internal reliability was assessed psychometrically. Test-retest reliability was assessed over a 1-week interval. To establish construct validity, Cancer Awareness Measure (CAM) scores of cancer experts were compared with equally well-educated comparison groups. Sensitivity to change was tested by randomly assigning participants to read either a leaflet giving information about ovarian/cervical cancer or a leaflet with control information, and then completing the ovarian/cervical CAM. Results Internal reliability (Cronbach's α=0.88 for the ovarian CAM and α=0.84 for the cervical CAM) and test-retest reliability (r=0.84 and r=0.77 for the ovarian and cervical CAMs, respectively) were both high. Validity was demonstrated with cancer experts achieving higher scores than controls [ovarian CAM: t(36)= –5.6, p<0.001; cervical CAM: t(38)= –3.7, p=0.001], and volunteers who were randomised to read a cancer leaflet scored higher than those who received a control leaflet [ovarian CAM: t(49)=7.5, p<0.001; cervical CAM: t(48)= –5.5, p<0.001]. Conclusions This study demonstrates the psychometric properties of the ovarian and cervical CAMs and supports their utility in assessing ovarian and cervical cancer awareness in the general population. PMID:21933805

Breast lesion shape and margin evaluation: BI-RADS based metrics understate radiologists' actual levels of agreement.

PubMed

Rawashdeh, Mohammad; Lewis, Sarah; Zaitoun, Maha; Brennan, Patrick

2018-05-01

While there is much literature describing the radiologic detection of breast cancer, there are limited data available on the agreement between experts when delineating and classifying breast lesions. The aim of this work is to measure the level of agreement between expert radiologists when delineating and classifying breast lesions as demonstrated through Breast Imaging Reporting and Data System (BI-RADS) and quantitative shape metrics. Forty mammographic images, each containing a single lesion, were presented to nine expert breast radiologists using a high specification interactive digital drawing tablet with stylus. Each reader was asked to manually delineate the breast masses using the tablet and stylus and then visually classify the lesion according to the American College of Radiology (ACR) BI-RADS lexicon. The delineated lesion compactness and elongation were computed using Matlab software. Intraclass Correlation Coefficient (ICC) and Cohen's kappa were used to assess inter-observer agreement for delineation and classification outcomes, respectively. Inter-observer agreement was fair for BI-RADS shape (kappa = 0.37) and moderate for margin (kappa = 0.58) assessments. Agreement for quantitative shape metrics was good for lesion elongation (ICC = 0.82) and excellent for compactness (ICC = 0.93). Fair to moderate levels of agreement was shown by radiologists for shape and margin classifications of cancers using the BI-RADS lexicon. When quantitative shape metrics were used to evaluate radiologists' delineation of lesions, good to excellent inter-observer agreement was found. The results suggest that qualitative descriptors such as BI-RADS lesion shape and margin understate the actual level of expert radiologist agreement. Copyright © 2018 Elsevier Ltd. All rights reserved.

Perceptual uncertainty supports design reasoning

NASA Astrophysics Data System (ADS)

Tseng, Winger S. W.

2018-06-01

The unstructured, ambiguous figures used as design cues in the experiment were classified as being at high, moderate, and low ambiguity. Participants were required to use the ideas suggested by the visual cues to design a novel table. Results showed that different levels of ambiguity within the cues significantly influenced the quantity of idea development of expert designers, but not novice designers, whose idea generation remained relatively low across all levels of ambiguity. For experts, as the level of ambiguity in the cue increased so did the number of design ideas that were generated. Most design interpretations created by both experts and novices were affected by geometric contours within the figures. In addition, when viewing cues of high ambiguity, experts produced more interpretative transformations than when viewing cues of moderate or low ambiguity. Furthermore, experts produced significantly more new functions or meanings than novices. We claim that increased ambiguity within presented visual cues engenders uncertainty in designers that facilitates flexible transformations and interpretations that prevent premature commitment to uncreative solutions. Such results could be applied in design learning and education, focused on differences between experts and novices, to generalize the principles and strategies of interpretations by experts during concept sketching to train novices when face design problems, and the development of CACD tools to support designers.

Echographic examination in isolated sites controlled from an expert center using a 2-D echograph guided by a teleoperated robotic arm.

PubMed

Arbeille, Philippe; Poisson, Gerard; Vieyres, Pierre; Ayoub, Jean; Porcher, Maryannick; Boulay, Jean Louis

2003-07-01

The objective of the present project was to design and validate a method for teleoperating (from an expert site) an echographic examination in an isolated site. A dedicated robotic arm holding a real ultrasound (US) probe is remotely controlled from the expert site with a fictive probe, and reproduces on the real probe all the movements of the expert hand. The isolated places, defined as areas with reduced medical facilities, could be secondary hospitals 20 to 50 km from the university hospital, or dispensaries in Africa or Amazonia, or a moving structure like a rescue vehicle or the International Space Station (ISS). These sites are linked to the expert one by ISDN (numeric) telephone or satellite lines. At the expert center, the US medical expert moves a fictive probe, connected to a computer (no. 1) that sends the coordinate changes of this probe via an ISDN or satellite line to a second computer (no. 2), located at the isolated site, that applies them to the robotic arm holding the real echographic probe. The system was tested on 20 patients. In all cases, the expert was able to perform the main views (longitudinal, transverse) of the liver, gallbladder, kidneys, aorta, pancreas, bladder, prostate and uterus as during direct examination on the patient. The heart and spleen were not visualized in 2 and 4 of the 20 cases, respectively. The mean duration of the robotized echography (27 +/- 7 min for three to four organs) was approximately 50% longer than direct echography of the patient.

Judging Acting Ability: The Transition from Novice to Expert.

ERIC Educational Resources Information Center

Myford, Carol M.

The aesthetic judgments of experts (casting directors and high school drama teachers), theater buffs, and novices were compared as they rated high school students' videotaped performances of Shakespearean monologues. It was hypothesized that theater buffs would represent an intermediate stage on the path to developing expertise in judging acting…

Expert system for computer-assisted annotation of MS/MS spectra.

PubMed

Neuhauser, Nadin; Michalski, Annette; Cox, Jürgen; Mann, Matthias

2012-11-01

An important step in mass spectrometry (MS)-based proteomics is the identification of peptides by their fragment spectra. Regardless of the identification score achieved, almost all tandem-MS (MS/MS) spectra contain remaining peaks that are not assigned by the search engine. These peaks may be explainable by human experts but the scale of modern proteomics experiments makes this impractical. In computer science, Expert Systems are a mature technology to implement a list of rules generated by interviews with practitioners. We here develop such an Expert System, making use of literature knowledge as well as a large body of high mass accuracy and pure fragmentation spectra. Interestingly, we find that even with high mass accuracy data, rule sets can quickly become too complex, leading to over-annotation. Therefore we establish a rigorous false discovery rate, calculated by random insertion of peaks from a large collection of other MS/MS spectra, and use it to develop an optimized knowledge base. This rule set correctly annotates almost all peaks of medium or high abundance. For high resolution HCD data, median intensity coverage of fragment peaks in MS/MS spectra increases from 58% by search engine annotation alone to 86%. The resulting annotation performance surpasses a human expert, especially on complex spectra such as those of larger phosphorylated peptides. Our system is also applicable to high resolution collision-induced dissociation data. It is available both as a part of MaxQuant and via a webserver that only requires an MS/MS spectrum and the corresponding peptides sequence, and which outputs publication quality, annotated MS/MS spectra (www.biochem.mpg.de/mann/tools/). It provides expert knowledge to beginners in the field of MS-based proteomics and helps advanced users to focus on unusual and possibly novel types of fragment ions.

Expert System for Computer-assisted Annotation of MS/MS Spectra*

PubMed Central

Neuhauser, Nadin; Michalski, Annette; Cox, Jürgen; Mann, Matthias

2012-01-01

An important step in mass spectrometry (MS)-based proteomics is the identification of peptides by their fragment spectra. Regardless of the identification score achieved, almost all tandem-MS (MS/MS) spectra contain remaining peaks that are not assigned by the search engine. These peaks may be explainable by human experts but the scale of modern proteomics experiments makes this impractical. In computer science, Expert Systems are a mature technology to implement a list of rules generated by interviews with practitioners. We here develop such an Expert System, making use of literature knowledge as well as a large body of high mass accuracy and pure fragmentation spectra. Interestingly, we find that even with high mass accuracy data, rule sets can quickly become too complex, leading to over-annotation. Therefore we establish a rigorous false discovery rate, calculated by random insertion of peaks from a large collection of other MS/MS spectra, and use it to develop an optimized knowledge base. This rule set correctly annotates almost all peaks of medium or high abundance. For high resolution HCD data, median intensity coverage of fragment peaks in MS/MS spectra increases from 58% by search engine annotation alone to 86%. The resulting annotation performance surpasses a human expert, especially on complex spectra such as those of larger phosphorylated peptides. Our system is also applicable to high resolution collision-induced dissociation data. It is available both as a part of MaxQuant and via a webserver that only requires an MS/MS spectrum and the corresponding peptides sequence, and which outputs publication quality, annotated MS/MS spectra (www.biochem.mpg.de/mann/tools/). It provides expert knowledge to beginners in the field of MS-based proteomics and helps advanced users to focus on unusual and possibly novel types of fragment ions. PMID:22888147

Can We Encourage Girls' Mobility towards Science-Related Careers? Disconfirming Stereotype Belief through Expert Influence

ERIC Educational Resources Information Center

Selimbegovic, Leila; Chatard, Armand; Mugny, Gabriel

2007-01-01

A study was conducted to explore expert influence as a possible way to encourage girls' mobility towards math- and science-related careers. High school students were exposed to an expert source presenting "scientific evidence" that contrary to stereotype, girls are better than boys in all subject domains. Beliefs related to stereotype…

What Matters Most: A Comparison of Expert and Novice Teachers' Noticing of Mathematics Classroom Events

ERIC Educational Resources Information Center

Huang, Rongjin; Li, Yeping

2012-01-01

In this study, we examined 10 expert and 10 novice teachers' noticing of classroom events in China. It was found that both expert and novice teachers, who were selected from two cities in China, highly attended to developing students' mathematics knowledge coherently and developing students' mathematical thinking and ability; they also paid…

Update of an occupational asthma-specific job exposure matrix to assess exposure to 30 specific agents.

PubMed

Le Moual, Nicole; Zock, Jan-Paul; Dumas, Orianne; Lytras, Theodore; Andersson, Eva; Lillienberg, Linnéa; Schlünssen, Vivi; Benke, Geza; Kromhout, Hans

2018-07-01

We aimed to update an asthmagen job exposure matrix (JEM) developed in the late 1990s. Main reasons were: the number of suspected and recognised asthmagens has since tripled; understanding of the aetiological role of irritants in asthma and methodological insights in application of JEMs have emerged in the period. For each agent of the new occupational asthma-specific JEM (OAsJEM), a working group of three experts out of eight evaluated exposure for each International Standard Classification of Occupations, 1988 (ISCO-88) job code into three categories: 'high' (high probability of exposure and moderate-to-high intensity), 'medium' (low-to-moderate probability or low intensity) and 'unexposed'. Within a working group, experts evaluated exposures independently from each other. If expert assessments were inconsistent the final decision was taken by consensus. Specificity was favoured over sensitivity, that is, jobs were classified with high exposure only if the probability of exposure was high and the intensity moderate-to-high. In the final review, all experts checked assigned exposures and proposed/improved recommendations for expert re-evaluation after default application of the JEM. The OAsJEM covers exposures to 30 sensitisers/irritants, including 12 newly recognised, classified into seven broad groups. Initial agreement between the three experts was mostly fair to moderate (κ values 0.2-0.5). Out of 506 ISCO-88 codes, the majority was classified as unexposed (from 82.6% (organic solvents) to 99.8% (persulfates)) and a minority as 'high-exposed' (0.2% (persulfates) to 2.6% (organic solvents)). The OAsJEM developed to improve occupational exposure assessment may improve evaluations of associations with asthma in epidemiological studies and contribute to assessment of the burden of work-related asthma. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Molecular signature of complex regional pain syndrome (CRPS) and its analysis.

PubMed

König, Simone; Schlereth, Tanja; Birklein, Frank

2017-10-01

Complex Regional Pain Syndrome (CRPS) is a rare, but often disabling pain disease. Biomarkers are lacking, but several inflammatory substances have been associated with the pathophysiology. This review outlines the current knowledge with respect to target biomolecules and the analytical tools available to measure them. Areas covered: Targets include cytokines, neuropeptides and resolvins; analysis strategies are thus needed for different classes of substances such as proteins, peptides, lipids and small molecules. Traditional methods like immunoassays are of importance next to state-of-the art high-resolution mass spectrometry techniques and 'omics' approaches. Expert commentary: Future biomarker studies need larger cohorts, which improve subgrouping of patients due to their presumed pathophysiology, and highly standardized workflows from sampling to analysis.

Ultrasound detection of simulated intra-ocular foreign bodies by minimally trained personnel.

PubMed

Sargsyan, Ashot E; Dulchavsky, Alexandria G; Adams, James; Melton, Shannon; Hamilton, Douglas R; Dulchavsky, Scott A

2008-01-01

To test the ability of non-expert ultrasound operators of divergent backgrounds to detect the presence, size, location, and composition of foreign bodies in an ocular model. High school students (N = 10) and NASA astronauts (N = 4) completed a brief ultrasound training session which focused on basic ultrasound principles and the detection of foreign bodies. The operators used portable ultrasound devices to detect foreign objects of varying location, size (0.5-2 mm), and material (glass, plastic, metal) in a gelatinous ocular model. Operator findings were compared to known foreign object parameters and ultrasound experts (N = 2) to determine accuracy across and between groups. Ultrasound had high sensitivity (astronauts 85%, students 87%, and experts 100%) and specificity (astronauts 81%, students 83%, and experts 95%) for the detection of foreign bodies. All user groups were able to accurately detect the presence of foreign bodies in this model (astronauts 84%, students 81%, and experts 97%). Astronaut and student sensitivity results for material (64% vs. 48%), size (60% vs. 46%), and position (77% vs. 64%) were not statistically different. Experts' results for material (85%), size (90%), and position (98%) were higher; however, the small sample size precluded statistical conclusions. Ultrasound can be used by operators with varying training to detect the presence, location, and composition of intraocular foreign bodies with high sensitivity, specificity, and accuracy.

Exploring Self-regulation of More or Less Expert College-Age Video Game Players: A Sequential Explanatory Design.

PubMed

Yilmaz Soylu, Meryem; Bruning, Roger H

2016-01-01

This study examined differences in self-regulation among college-age expert, moderately expert, and non-expert video game players in playing video games for fun. Winne's model of self-regulation (Winne, 2001) guided the study. The main assumption of this study was that expert video game players used more processes of self-regulation than the less-expert players. We surveyed 143 college students about their game playing frequency, habits, and use of self-regulation. Data analysis indicated that while playing recreational video games, expert gamers self-regulated more than moderately expert and non-expert players and moderately expert players used more processes of self-regulation than non-experts. Semi-structured interviews also were conducted with selected participants at each of the expertise levels. Qualitative follow-up analyses revealed five themes: (1) characteristics of expert video gamers, (2) conditions for playing a video game, (3) figuring out a game, (4) how gamers act and, (5) game context. Overall, findings indicated that playing a video game is a highly self-regulated activity and that becoming an expert video game player mobilizes multiple sets of self-regulation related skills and processes. These findings are seen as promising for educators desiring to encourage student self-regulation, because they indicate the possibility of supporting students via recreational video games by recognizing that their play includes processes of self-regulation.

Exploring Self-regulation of More or Less Expert College-Age Video Game Players: A Sequential Explanatory Design

PubMed Central

Yilmaz Soylu, Meryem; Bruning, Roger H.

2016-01-01

This study examined differences in self-regulation among college-age expert, moderately expert, and non-expert video game players in playing video games for fun. Winne's model of self-regulation (Winne, 2001) guided the study. The main assumption of this study was that expert video game players used more processes of self-regulation than the less-expert players. We surveyed 143 college students about their game playing frequency, habits, and use of self-regulation. Data analysis indicated that while playing recreational video games, expert gamers self-regulated more than moderately expert and non-expert players and moderately expert players used more processes of self-regulation than non-experts. Semi-structured interviews also were conducted with selected participants at each of the expertise levels. Qualitative follow-up analyses revealed five themes: (1) characteristics of expert video gamers, (2) conditions for playing a video game, (3) figuring out a game, (4) how gamers act and, (5) game context. Overall, findings indicated that playing a video game is a highly self-regulated activity and that becoming an expert video game player mobilizes multiple sets of self-regulation related skills and processes. These findings are seen as promising for educators desiring to encourage student self-regulation, because they indicate the possibility of supporting students via recreational video games by recognizing that their play includes processes of self-regulation. PMID:27729881

Communicable Diseases Prioritized for Surveillance and Epidemiological Research: Results of a Standardized Prioritization Procedure in Germany, 2011

PubMed Central

Balabanova, Yanina; Gilsdorf, Andreas; Buda, Silke; Burger, Reinhard; Eckmanns, Tim; Gärtner, Barbara; Groß, Uwe; Haas, Walter; Hamouda, Osamah; Hübner, Johannes; Jänisch, Thomas; Kist, Manfred; Kramer, Michael H.; Ledig, Thomas; Mielke, Martin; Pulz, Matthias; Stark, Klaus; Suttorp, Norbert; Ulbrich, Uta; Wichmann, Ole; Krause, Gérard

2011-01-01

Introduction To establish strategic priorities for the German national public health institute (RKI) and guide the institute's mid-term strategic decisions, we prioritized infectious pathogens in accordance with their importance for national surveillance and epidemiological research. Methods We used the Delphi process with internal (RKI) and external experts and a metric-consensus approach to score pathogens according to ten three-tiered criteria. Additional experts were invited to weight each criterion, leading to the calculation of a median weight by which each score was multiplied. We ranked the pathogens according to the total weighted score and divided them into four priority groups. Results 127 pathogens were scored. Eighty-six experts participated in the weighting; “Case fatality rate” was rated as the most important criterion. Twenty-six pathogens were ranked in the highest priority group; among those were pathogens with internationally recognised importance (e.g., Human Immunodeficiency Virus, Mycobacterium tuberculosis, Influenza virus, Hepatitis C virus, Neisseria meningitides), pathogens frequently causing large outbreaks (e.g., Campylobacter spp.), and nosocomial pathogens associated with antimicrobial resistance. Other pathogens in the highest priority group included Helicobacter pylori, Respiratory Syncytial Virus, Varicella zoster virus and Hantavirus. Discussion While several pathogens from the highest priority group already have a high profile in national and international health policy documents, high scores for other pathogens (e.g., Helicobacter pylori, Respiratory syncytial virus or Hantavirus) indicate a possible under-recognised importance within the current German public health framework. A process to strengthen respective surveillance systems and research has been started. The prioritization methodology has worked well; its modular structure makes it potentially useful for other settings. PMID:21991334

Psychomotor skills assessment by motion analysis in minimally invasive surgery on an animal organ.

PubMed

Hofstad, Erlend Fagertun; Våpenstad, Cecilie; Bø, Lars Eirik; Langø, Thomas; Kuhry, Esther; Mårvik, Ronald

2017-08-01

A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ. Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model. The motions of the surgical tools were acquired and analyzed by 11 different motion-related metrics, i.e., a total of 19 metrics as eight of them were measured separately for each hand. We identified for which of the metrics the experts outperformed the novices. In total, two experts and 28 novices were included. The experts achieved significantly better results for 13 of the 19 instrument motion metrics. Expert performance is characterized by a low time to complete the cholecystectomy, high bimanual dexterity (instrument coordination), a limited amount of movement and low measurement of motion smoothness of the dissection instrument, and relatively high usage of the grasper to optimize tissue positioning for dissection.

Can journalistic "false balance" distort public perception of consensus in expert opinion?

PubMed

Koehler, Derek J

2016-03-01

Media critics have expressed concern that journalistic "false balance" can distort the public's perceptions of what ought to be noncontroversial subjects (e.g., climate change). I report several experiments testing the influence of presenting conflicting comments from 2 experts who disagree on an issue (balance condition) in addition to a complete count of the number of experts on a panel who favor either side. Compared with a control condition, who received only the complete count, participants in the balance condition gave ratings of the perceived agreement among the experts that did not discriminate as clearly between issues with and without strong expert consensus. Participants in the balance condition also perceived less agreement among the experts in general, and were less likely to think that there was enough agreement among experts on the high-consensus issues to guide government policy. Evidently, "false balance" can distort perceptions of expert opinion even when participants would seem to have all the information needed to correct for its influence. (c) 2016 APA, all rights reserved).

Effects of Badminton Expertise on Representational Momentum: A Combination of Cross-Sectional and Longitudinal Studies

PubMed Central

Jin, Hua; Wang, Pin; Fang, Zhuo; Di, Xin; Ye, Zhuo’er; Xu, Guiping; Lin, Huiyan; Cheng, Yongmin; Li, Yongjie; Xu, Yong; Rao, Hengyi

2017-01-01

Representational momentum (RM) has been found to be magnified in experts (e.g., sport players) with respect to both real and implied motion in expert-familiar domains. However, it remains unclear whether similar effects can be achieved in expert-unfamiliar domains, especially within the context of implied motion. To answer this question, we conducted two independent experiments using an implied motion paradigm and examined the expert effects of badminton training on RM in both adult and child players. In Experiment 1, we used a cross-sectional design and compared RM between adult professional badminton players and matched controls. The results revealed significantly enhanced RM for adult players, supporting the expert effect in expert-unfamiliar domains for implied motion. However, cross-sectional studies could not ascertain whether the observed expert effect was due to innate factors or expertise acquirement. Therefore, in Experiment 2, we used a longitudinal design and compared RM between two groups of child participants, naming child players who had enrolled professional badminton training program at a sports school and age-matched peer non-players who attended an ordinary primary school without sports training. Before training, there were no differences in RM among child players, their non-player peers, and adult non-players. However, after 4 years of badminton training, child players demonstrated significantly enhanced RM compared to themselves prior to training. The increased RM observed in both adult and child players suggests that badminton expertise modulates implied motion RM. PMID:28970810

Comparison of manual and automatic segmentation methods for brain structures in the presence of space-occupying lesions: a multi-expert study

PubMed Central

Deeley, M A; Chen, A; Datteri, R; Noble, J; Cmelak, A; Donnelly, E; Malcolm, A; Moretti, L; Jaboin, J; Niermann, K; Yang, Eddy S; Yu, David S; Yei, F; Koyama, T; Ding, G X; Dawant, B M

2011-01-01

The purpose of this work was to characterize expert variation in segmentation of intracranial structures pertinent to radiation therapy, and to assess a registration-driven atlas-based segmentation algorithm in that context. Eight experts were recruited to segment the brainstem, optic chiasm, optic nerves, and eyes, of 20 patients who underwent therapy for large space-occupying tumors. Performance variability was assessed through three geometric measures: volume, Dice similarity coefficient, and Euclidean distance. In addition, two simulated ground truth segmentations were calculated via the simultaneous truth and performance level estimation (STAPLE) algorithm and a novel application of probability maps. The experts and automatic system were found to generate structures of similar volume, though the experts exhibited higher variation with respect to tubular structures. No difference was found between the mean Dice coefficient (DSC) of the automatic and expert delineations as a group at a 5% significance level over all cases and organs. The larger structures of the brainstem and eyes exhibited mean DSC of approximately 0.8–0.9, whereas the tubular chiasm and nerves were lower, approximately 0.4–0.5. Similarly low DSC have been reported previously without the context of several experts and patient volumes. This study, however, provides evidence that experts are similarly challenged. The average maximum distances (maximum inside, maximum outside) from a simulated ground truth ranged from (−4.3, +5.4) mm for the automatic system to (−3.9, +7.5) mm for the experts considered as a group. Over all the structures in a rank of true positive rates at a 2 mm threshold from the simulated ground truth, the automatic system ranked second of the nine raters. This work underscores the need for large scale studies utilizing statistically robust numbers of patients and experts in evaluating quality of automatic algorithms. PMID:21725140

Comparison of manual and automatic segmentation methods for brain structures in the presence of space-occupying lesions: a multi-expert study

NASA Astrophysics Data System (ADS)

Deeley, M. A.; Chen, A.; Datteri, R.; Noble, J. H.; Cmelak, A. J.; Donnelly, E. F.; Malcolm, A. W.; Moretti, L.; Jaboin, J.; Niermann, K.; Yang, Eddy S.; Yu, David S.; Yei, F.; Koyama, T.; Ding, G. X.; Dawant, B. M.

2011-07-01

The purpose of this work was to characterize expert variation in segmentation of intracranial structures pertinent to radiation therapy, and to assess a registration-driven atlas-based segmentation algorithm in that context. Eight experts were recruited to segment the brainstem, optic chiasm, optic nerves, and eyes, of 20 patients who underwent therapy for large space-occupying tumors. Performance variability was assessed through three geometric measures: volume, Dice similarity coefficient, and Euclidean distance. In addition, two simulated ground truth segmentations were calculated via the simultaneous truth and performance level estimation algorithm and a novel application of probability maps. The experts and automatic system were found to generate structures of similar volume, though the experts exhibited higher variation with respect to tubular structures. No difference was found between the mean Dice similarity coefficient (DSC) of the automatic and expert delineations as a group at a 5% significance level over all cases and organs. The larger structures of the brainstem and eyes exhibited mean DSC of approximately 0.8-0.9, whereas the tubular chiasm and nerves were lower, approximately 0.4-0.5. Similarly low DSCs have been reported previously without the context of several experts and patient volumes. This study, however, provides evidence that experts are similarly challenged. The average maximum distances (maximum inside, maximum outside) from a simulated ground truth ranged from (-4.3, +5.4) mm for the automatic system to (-3.9, +7.5) mm for the experts considered as a group. Over all the structures in a rank of true positive rates at a 2 mm threshold from the simulated ground truth, the automatic system ranked second of the nine raters. This work underscores the need for large scale studies utilizing statistically robust numbers of patients and experts in evaluating quality of automatic algorithms.

MOAB: a spatially explicit, individual-based expert system for creating animal foraging models

USGS Publications Warehouse

Carter, J.; Finn, John T.

1999-01-01

We describe the development, structure, and corroboration process of a simulation model of animal behavior (MOAB). MOAB can create spatially explicit, individual-based animal foraging models. Users can create or replicate heterogeneous landscape patterns, and place resources and individual animals of a goven species on that landscape to simultaneously simulate the foraging behavior of multiple species. The heuristic rules for animal behavior are maintained in a user-modifiable expert system. MOAB can be used to explore hypotheses concerning the influence of landscape patttern on animal movement and foraging behavior. A red fox (Vulpes vulpes L.) foraging and nest predation model was created to test MOAB's capabilities. Foxes were simulated for 30-day periods using both expert system and random movement rules. Home range size, territory formation and other available simulation studies. A striped skunk (Mephitis mephitis L.) model also was developed. The expert system model proved superior to stochastic in respect to territory formation, general movement patterns and home range size.

Mobile cosmetics advisor: an imaging based mobile service

NASA Astrophysics Data System (ADS)

Bhatti, Nina; Baker, Harlyn; Chao, Hui; Clearwater, Scott; Harville, Mike; Jain, Jhilmil; Lyons, Nic; Marguier, Joanna; Schettino, John; Süsstrunk, Sabine

2010-01-01

Selecting cosmetics requires visual information and often benefits from the assessments of a cosmetics expert. In this paper we present a unique mobile imaging application that enables women to use their cell phones to get immediate expert advice when selecting personal cosmetic products. We derive the visual information from analysis of camera phone images, and provide the judgment of the cosmetics specialist through use of an expert system. The result is a new paradigm for mobile interactions-image-based information services exploiting the ubiquity of camera phones. The application is designed to work with any handset over any cellular carrier using commonly available MMS and SMS features. Targeted at the unsophisticated consumer, it must be quick and easy to use, not requiring download capabilities or preplanning. Thus, all application processing occurs in the back-end system and not on the handset itself. We present the imaging pipeline technology and a comparison of the services' accuracy with respect to human experts.

Movement evaluation of front crawl swimming: Technical skill versus aesthetic quality

PubMed Central

2017-01-01

The study aim was to compare expert with non-expert swimmers’ rating of the aesthetic and technical qualities of front crawl in video-taped recordings of swimmers with low, middle, and high level proficiency. The results suggest that: i) observers’ experience affects their judgment: only the expert observers correctly rated the swimmers’ proficiency level; ii) evaluation of movement (technical and aesthetic scores) is correlated with the level of skill as expressed in the kinematics of the observed action (swimming speed, stroke frequency, and stroke length); iii) expert and non-expert observers use different strategies to rate the aesthetic and technical qualities of movement: equating the technical skill with the aesthetic quality is a general rule non-expert observers follow in the evaluation of human movement. PMID:28886063

Process consistency in models: The importance of system signatures, expert knowledge, and process complexity

NASA Astrophysics Data System (ADS)

Hrachowitz, M.; Fovet, O.; Ruiz, L.; Euser, T.; Gharari, S.; Nijzink, R.; Freer, J.; Savenije, H. H. G.; Gascuel-Odoux, C.

2014-09-01

Hydrological models frequently suffer from limited predictive power despite adequate calibration performances. This can indicate insufficient representations of the underlying processes. Thus, ways are sought to increase model consistency while satisfying the contrasting priorities of increased model complexity and limited equifinality. In this study, the value of a systematic use of hydrological signatures and expert knowledge for increasing model consistency was tested. It was found that a simple conceptual model, constrained by four calibration objective functions, was able to adequately reproduce the hydrograph in the calibration period. The model, however, could not reproduce a suite of hydrological signatures, indicating a lack of model consistency. Subsequently, testing 11 models, model complexity was increased in a stepwise way and counter-balanced by "prior constraints," inferred from expert knowledge to ensure a model which behaves well with respect to the modeler's perception of the system. We showed that, in spite of unchanged calibration performance, the most complex model setup exhibited increased performance in the independent test period and skill to better reproduce all tested signatures, indicating a better system representation. The results suggest that a model may be inadequate despite good performance with respect to multiple calibration objectives and that increasing model complexity, if counter-balanced by prior constraints, can significantly increase predictive performance of a model and its skill to reproduce hydrological signatures. The results strongly illustrate the need to balance automated model calibration with a more expert-knowledge-driven strategy of constraining models.

Acute effects of two different tennis sessions on dorsal and lumbar spine of adult players.

PubMed

Gallotta, Maria Chiara; Bonavolontà, Valerio; Emerenziani, Gian Pietro; Franciosi, Emanuele; Tito, Alessandro; Guidetti, Laura; Baldari, Carlo

2015-01-01

The aim of the study was to evaluate the dorsal and lumbar spine of expert and recreational tennis players before (pre) and after (post) two different training sessions. The sample consisted of 17 male tennis players, nine expert and eight recreational males (age 21.2 ± 1.6 years). We assessed the back surface by rasterstereography pre and post two different training sessions both lasting 1.5 h: a standard training and a specific over-shoulder shots training session, respectively. Lordotic and kyphotic angle, length, imbalance, inclination for trunk, pelvic torsion, left and right lateral deviation and surface rotation were measured. Tennis expertise (expert versus recreational) significantly affected the surface rotation and right lateral deviation (P < 0.05). Trunk length was affected by intervention (pre versus post) (P < 0.05). Left lateral deviation differed both for type of session (session 1 versus session 2) and intervention (P < 0.001, P < 0.05). Expert tennis players had higher values on surface rotation and right lateral deviation, around or just above physiological values (0-5° and 0-5 mm, respectively). Type of session significantly affected left lateral deviation, indicating that over-shoulder shots lead to a higher stress for the spine; the workload produced by both single sessions led to a shortening effect on trunk length. A single training session can induce acute modifications in some parameters of dorsal and lumbar spine of players.

What Geoscience Experts and Novices Look At, and What They See, When Viewing Data Visualizations

ERIC Educational Resources Information Center

Kastens, Kim A.; Shipley, Thomas F.; Boone, Alexander P.; Straccia, Frances

2016-01-01

This study examines how geoscience experts and novices make meaning from an iconic type of data visualization: shaded relief images of bathymetry and topography. Participants examined, described, and interpreted a global image, two high-resolution seafloor images, and 2 high-resolution continental images, while having their gaze direction…

Prevalence and proposal for cost-effective management of the ciguatera risk in the Noumea fish market, New Caledonia (South Pacific).

PubMed

Clua, Eric; Brena, Pierpaolo F; Lecasble, Côme; Ghnassia, Reine; Chauvet, Claude

2011-11-01

Ciguatera fish poisoning (CFP) is a common intoxication associated with the consumption of reef fish, which constitutes a critical issue for public health in many countries. The complexity of its epidemiology is responsible for the poor management of the risk in tropical fish markets. We used the example of the Noumea fish market in New Caledonia to develop a cost-effective methodology of assessing the CFP risk. We first used published reports and the knowledge of local experts to define a list of potentially poisonous local species, ranked by their ciguatoxic potential. Based on two 1-month surveys in the market, conducted in winters 2008 and 2009, we then calculated the consolidated ratio of biomass of potentially poisonous species vs. total biomass of fish sold on the market. The prevalence of high CFP-risk species in the market was 16.1% and 18.9% in 2008 and 2009, respectively. The most common high CFP risk species were groupers (serranids), king mackerels (scombrids), snappers (lutjanids), barracudas (sphyaraenids), emperors (lethrinids) and wrasses (labrids). The size (age) of the fish also plays a critical role in the potential ciguatoxic risk. According to proposals of average size thresholds provided by experts for high-risk species, we were also able to assess the additional risk induced by the sale of some large fish on the market. The data collected both from experts and from the market allowed us to develop a cost-effective proposal for improving the management of the CFP risk in this market. However, the successful implementation of any regulation aiming to ban some specific species and sizes from the market, with an acceptable economical impact, will require the improvement of the expertise in fish identification by public health officers and, ideally, the commitment of retailers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prompt comprehension in UNIX command production.

PubMed

Doane, S M; McNamara, D S; Kintsch, W; Polson, P G; Clawson, D M

1992-07-01

We hypothesize that a cognitive analysis based on the construction-integration theory of comprehension (Kintsch, 1988) can predict what is difficult about generating complex composite commands in the UNIX operating system. We provide empirical support for assumptions of the Doane, Kintsch, and Polson (1989, 1990) construction-integration model for generating complex commands in UNIX. We asked users whose UNIX experience varied to produce complex UNIX commands, and then provided help prompts whenever the commands that they produced were erroneous. The help prompts were designed to assist subjects with respect to both the knowledge and the memory processes that our UNIX modeling efforts have suggested are lacking in less expert users. It appears that experts respond to different prompts than do novices. Expert performance is helped by the presentation of abstract information, whereas novice and intermediate performance is modified by presentation of concrete information. Second, while presentation of specific prompts helps less expert subjects, they do not provide sufficient information to obtain correct performance. Our analyses suggest that information about the ordering of commands is required to help the less expert with both knowledge and memory load problems in a manner consistent with skill acquisition theories.

Integrated Data Capturing Requirements for 3d Semantic Modelling of Cultural Heritage: the Inception Protocol

NASA Astrophysics Data System (ADS)

Di Giulio, R.; Maietti, F.; Piaia, E.; Medici, M.; Ferrari, F.; Turillazzi, B.

2017-02-01

The generation of high quality 3D models can be still very time-consuming and expensive, and the outcome of digital reconstructions is frequently provided in formats that are not interoperable, and therefore cannot be easily accessed. This challenge is even more crucial for complex architectures and large heritage sites, which involve a large amount of data to be acquired, managed and enriched by metadata. In this framework, the ongoing EU funded project INCEPTION - Inclusive Cultural Heritage in Europe through 3D semantic modelling proposes a workflow aimed at the achievements of efficient 3D digitization methods, post-processing tools for an enriched semantic modelling, web-based solutions and applications to ensure a wide access to experts and non-experts. In order to face these challenges and to start solving the issue of the large amount of captured data and time-consuming processes in the production of 3D digital models, an Optimized Data Acquisition Protocol (DAP) has been set up. The purpose is to guide the processes of digitization of cultural heritage, respecting needs, requirements and specificities of cultural assets.

Field-based generation and social validation managers and staff competencies for small community residences.

PubMed

Thousand, J S; Burchard, S N; Hasazi, J E

1986-01-01

Characteristics and competencies for four staff positions in community residences for individuals with mental retardation were identified utilizing multiple empirical and deductive methods with field-based practitioners and field-based experts. The more commonly used competency generation methods of expert opinion and job performance analysis generated a high degree of knowledge and skill-based competencies similar to course curricula. Competencies generated by incumbent practitioners through open-ended methods of personal structured interview and critical incident analysis were ones which related to personal style, interpersonal interaction, and humanistic orientation. Although seldom included in staff, paraprofessional, or professional training curricula, these latter competencies include those identified by Carl Rogers as essential for developing an effective helping relationship in a therapeutic situation (i.e., showing liking, interest, and respect for the clients; being able to communicate positive regard to the client). Of 21 core competency statements selected as prerequisites to employment for all four staff positions, the majority (17 of 21) represented interpersonal skills important to working with others, including responsiveness to resident needs, personal valuation of persons with mental retardation, and normalization principles.

An analysis of key environmental and social risks in the development of concentrated solar power projects

NASA Astrophysics Data System (ADS)

Otieno, George A.; Loosen, Alexander E.

2016-05-01

Concentrated Solar Power projects have impacts on local environment and social conditions. This research set out to investigate the environmental and social risks in the development of such projects and rank these risks from highest to lowest. The risks were analysed for parabolic trough and tower technologies only. A literature review was undertaken, identifying seventeen risks that were then proposed to six CSP experts for scoring. The risks were scored based of five factors on a five tier scale. The scores from the experts were compiled to develop an overall rank of the identified risks. The risk of disruption of local water resources was found to represent the highest risk before and after mitigation with a score of moderate-high and moderate respectively. This score is linked to the importance of water in water scarce regions typified by the best regions for CSP. The risks to avian species, to worker health and safety, due to noise on the environment, to visual and recreational resources completed the top five risks after mitigation.

[A clinical audit on the use of medications for pressure sores, after the implementation of guidelines].

PubMed

Chiari, Paolo; Fontana, Mirella; Bianchi, Tommaso; Bonzagni, Cristina; Galetti, Caterina

2006-01-01

Although guidelines for the management of pressure sores are widely available, their implementation is not always easy and sometimes does not produce the desired changes. To describe the results of a clinical audit aiming at assessing the appropriate use of medications for pressure sores, after the implementation of guidelines. The audit group, with an expert in assessment, a nurse expert in pressure sores, a microbiologist, a dermatologist and a chemist analysed the clinical and nursing records of all the patients with a pressure sore, discharged during the first trimester of 2005 and 2006, after the implementation of the guidelines, from wards with higher prevalence of pressure sores: geriatric, medical, intensive care, rehabilitation and post acute wards. Each documented treatment was classified as appropriate, not appropriate or "grey area", treatments inappropriate according to guidelines but not according to expert or current knowledge (e.g. poliurethane medications for heel pressure sores). After each stage, the results were returned and discussed with the involved wards. One hundred 74 patients were surveyed in 2005 and 199 in 2006, with a total of respectively 287 and 326 sores. The percentage of inappropriate treatments was 20% in 2005 and 12.8% in 2006 (OR 1.79 I.C. 95% 1.10- 2.91), while an increase of treatments considered grey area (from 7% to 13.5%) was observed. The medium number of medications used was 17.3 per lesion, in 2005 and 16.4 in 2006 with a cost respectively of 83.6 and 67.35 per lesion, but the two populations were not strictly comparable. Clinical audit is a strategy that involving doctors and nurses, may promote positive changes. The rate of inappropriate treatments (higher in areas with high turnover of nurses) can be improved with educational interventions. The identification of treatments of the grey area highlights the need of periodically revising guidelines to update their contents according to new knowledge and technologies.

Evaluation of a new imaging tool for use with major trauma cases in the emergency department.

PubMed

Crönlein, Moritz; Holzapfel, Konstantin; Beirer, Marc; Postl, Lukas; Kanz, Karl-Georg; Pförringer, Dominik; Huber-Wagner, Stefan; Biberthaler, Peter; Kirchhoff, Chlodwig

2016-11-17

The aim of this study was to evaluate potential benefits of a new diagnostic software prototype (Trauma Viewer, TV) automatically reformatting computed tomography (CT) data on diagnostic speed and quality, compared to CT-image data evaluation using a conventional CT console. Multiple trauma CT data sets were analysed by one expert radiology and one expert traumatology fellow independently twice, once using the TV and once using the secondary conventional CT console placed in the CT control room. Actual analysis time and precision of diagnoses assessment were evaluated. The TV and CT-console results were compared respectively, but also a comparison to the initial multiple trauma CT reports assessed by emergency radiology fellows considered as the gold standard was performed. Finally, design and function of the Trauma Viewer were evaluated in a descriptive manner. CT data sets of 30 multiple trauma patients were enrolled. Mean time needed for analysis of one CT dataset was 2.43 min using the CT console and 3.58 min using the TV respectively. Thus, secondary conventional CT console analysis was on average 1.15 min shorter compared to the TV analysis. Both readers missed a total of 11 diagnoses using the secondary conventional CT console compared to 12 missed diagnoses using the TV. However, none of these overlooked diagnoses resulted in an Abbreviated Injury Scale (AIS) > 2 corresponding to life threatening injuries. Even though it took the two expert fellows a little longer to analyse the CT scans on the prototype TV compared to the CT console, which can be explained by the new user interface of the TV, our preliminary results demonstrate that, after further development, the TV might serve as a new diagnostic feature in the trauma room management. Its high potential to improve time and quality of CT-based diagnoses might help in fast decision making regarding treatment of severely injured patients.

[Construction of a physiological aging scale for healthy people based on a modified Delphi method].

PubMed

Long, Yao; Zhou, Xuan; Deng, Pengfei; Liao, Xiong; Wu, Lei; Zhou, Jianming; Huang, Helang

2016-04-01

To build a physiological aging scale for healthy people.
 We collected age-related physiologic items through literature screening and expert interview. Two rounds of Delphi were implemented. The importance, feasibility and the degree of authority for the physiological index system were graded. Using analytic hierarchy process, we determined the weight of dimensions and items.
 Using Delphy mothod, 17 physiological and other professional experts offered the results as follow: coefficient of expert authorities Cr was 0.86±0.03, coordination coefficients for the first and second round were 0.264(χ2=229.691, P<0.001) and 0.293(χ2=228.474，P<0.001), respectively. The consistency was good. The aging scale for healthy people included 3 dimensions, namely physical form, feeling movement and functional status. Each dimension had 8 items. The weight coefficients for the 3 dimensions were 0.54, 0.16, and 0.30, respectively. The Cronbach's α coefficient of the scale was 0.893, the reliability was 0.796, and the variance of the common factor was 58.17%.
 The improved Delphi method or physiological aging scale is satisfied, which can provide reference for the evaluation of aging.

"More than Honey": Investigation on Volatiles from Monovarietal Honeys Using New Analytical and Sensory Approaches.

PubMed

Siegmund, Barbara; Urdl, Katharina; Jurek, Andrea; Leitner, Erich

2018-03-14

Eight monovarietal honeys from dandelion, fir tree, linden tree, chestnut tree, robinia, orange, lavender, and rape were investigated with respect to their volatile compounds and sensory properties. Analysis of the volatile compounds was performed by gas chromatographic techniques (one-dimensional GC-MS as well as comprehensive GC×GC-MS). For sensory evaluation Napping in combination with ultraflash profiling was applied using sensory experts. For dandelion honey, 34 volatile compounds are described for the first time to be present in dandelion honey. PCA and cluster analysis of the volatile compounds, respectively, show high correlation with the PCA obtained from sensory evaluation. Lavender and linden honey showed sensory characteristics that were not expected from these honey types. Analysis of the volatile compounds resulted in the identification of odor-active compounds that are very likely derived from sources other than the respective honeyflow. Contamination with essential oils used in apiculture is very likely to be the reason for the occurrence of these compounds in the investigated honeys.

Mutually Augmented Cognition

NASA Astrophysics Data System (ADS)

Friesdorf, Florian; Pangercic, Dejan; Bubb, Heiner; Beetz, Michael

In mac, an ergonomic dialog-system and algorithms will be developed that enable human experts and companions to be integrated into knowledge gathering and decision making processes of highly complex cognitive systems (e.g. Assistive Household as manifested further in the paper). In this event we propose to join algorithms and methodologies coming from Ergonomics and Artificial Intelligence that: a) make cognitive systems more congenial for non-expert humans, b) facilitate their comprehension by utilizing a high-level expandable control code for human experts and c) augment representation of such cognitive system into “deep representation” obtained through an interaction with human companions.

[The application and development of artificial intelligence in medical diagnosis systems].

PubMed

Chen, Zhencheng; Jiang, Yong; Xu, Mingyu; Wang, Hongyan; Jiang, Dazong

2002-09-01

This paper has reviewed the development of artificial intelligence in medical practice and medical diagnostic expert systems, and has summarized the application of artificial neural network. It explains that a source of difficulty in medical diagnostic system is the co-existence of multiple diseases--the potentially inter-related diseases. However, the difficulty of image expert systems is inherent in high-level vision. And it increases the complexity of expert system in medical image. At last, the prospect for the development of artificial intelligence in medical image expert systems is made.

Fluorescein angiography-based diagnosis for retinopathy of prematurity: expert-non expert comparison.

PubMed

Guagliano, Rosanna; Barillà, Donatella; Bertone, Chiara; Maffia, Anna; Periti, Francesca; Spallone, Laura; Anselmetti, Giovanni; Giacosa, Elisabetta; Stronati, Mauro; Tinelli, Carmine; Bianchi, Paolo Emilio

2013-01-01

To evaluate accuracy and inter-rater reliability of RetCam fundus images and digital camera fluorangioscopic images in acute retinopathy of prematurity (ROP) by comparing diagnoses given by trainee ophthalmologists with those provided by expert ophthalmologists. 
 This is a multicenter retrospective observational study of diagnostic data from 48 eyes of 24 premature infants with classical ROP, stage II, as evaluated by RetCam 3 and fluorescein angiography (FA). Average gestational age was 25.4 weeks, average weight 804.7 g. A staging grid (with ocular fundus divided into 3 concentric zones) and 24 15° sectors centered around the optic papilla were superimposed on 360° retina photomontages (Photoshop) made from RetCam and FA images. Non expert vs expert diagnosis agreement was measured for each sector by means of Cohen kappa (Fleiss, 1981).
 A high degree of concordance was found. Inter-rater agreement between expert and non expert interpretations of retinal photomontages was greater for fluorangiographic images than for RetCam images, with κ = 0.61-1 for 120/152 (78.9%) sectors examined on the RetCam images and 
κ = 0.61-1 for 168/198 (84.8%) sectors examined on the FA images.
 The FA images appear to be easier to interpret than RetCam images, both by expert and non expert ophthalmologists. The results confirm that FA is a good examination technique with a high degree of reliability, even where trainee practitioners are involved. This suggests that retinopathy management can be improved by entrusting diagnostic responsibilities to trainee ophthalmologists, in order to extend access to correct diagnosis, recognition of threshold lesions, and prompt treatment.

Global priorities for research and the relative importance of different research outcomes: an international Delphi survey of malaria research experts.

PubMed

Mulligan, Jo-Ann; Conteh, Lesong

2016-12-06

As global research investment increases, attention inevitably turns to assessing and measuring the outcomes and impact from research programmes. Research can have many different outcomes such as producing advances in scientific knowledge, building research capacity and, ultimately, health and broader societal benefits. The aim of this study was to test the use of a Delphi methodology as a way of gathering views from malaria research experts on research priorities and eliciting relative valuations of the different types of health research impact. An international Delphi survey of 60 malaria research experts was used to understand views on research outcomes and priorities within malaria and across global health more widely. The study demonstrated the application of the Delphi technique to eliciting views on malaria specific research priorities, wider global health research priorities and the values assigned to different types of research impact. In terms of the most important past research successes, the development of new anti-malarial drugs and insecticide-treated bed nets were rated as the most important. When asked about research priorities for future funding, respondents ranked tackling emerging drug and insecticide resistance the highest. With respect to research impact, the panel valued research that focuses on health and health sector benefits and informing policy and product development. Contributions to scientific knowledge, although highly valued, came lower down the ranking, suggesting that efforts to move research discoveries to health products and services are valued more highly than pure advances in scientific knowledge. Although the Delphi technique has been used to elicit views on research questions in global health this was the first time it has been used to assess how a group of research experts value or rank different types of research impact. The results suggest it is feasible to inject the views of a key stakeholder group into the research prioritization process and the Delphi approach is a useful tool for eliciting views on the value or importance of research impact. Future work will explore other methods for assessing and valuing research impact and test the feasibility of developing a composite tool for measuring research outcomes weighted by the values of different stakeholders.

Development of an objective assessment tool for total laparoscopic hysterectomy: A Delphi method among experts and evaluation on a virtual reality simulator

PubMed Central

Knight, Sophie; Aggarwal, Rajesh; Agostini, Aubert; Loundou, Anderson; Berdah, Stéphane

2018-01-01

Introduction Total Laparoscopic hysterectomy (LH) requires an advanced level of operative skills and training. The aim of this study was to develop an objective scale specific for the assessment of technical skills for LH (H-OSATS) and to demonstrate feasibility of use and validity in a virtual reality setting. Material and methods The scale was developed using a hierarchical task analysis and a panel of international experts. A Delphi method obtained consensus among experts on relevant steps that should be included into the H-OSATS scale for assessment of operative performances. Feasibility of use and validity of the scale were evaluated by reviewing video recordings of LH performed on a virtual reality laparoscopic simulator. Three groups of operators of different levels of experience were assessed in a Marseille teaching hospital (10 novices, 8 intermediates and 8 experienced surgeons). Correlations with scores obtained using a recognised generic global rating tool (OSATS) were calculated. Results A total of 76 discrete steps were identified by the hierarchical task analysis. 14 experts completed the two rounds of the Delphi questionnaire. 64 steps reached consensus and were integrated in the scale. During the validation process, median time to rate each video recording was 25 minutes. There was a significant difference between the novice, intermediate and experienced group for total H-OSATS scores (133, 155.9 and 178.25 respectively; p = 0.002). H-OSATS scale demonstrated high inter-rater reliability (intraclass correlation coefficient [ICC] = 0.930; p<0.001) and test retest reliability (ICC = 0.877; p<0.001). High correlations were found between total H-OSATS scores and OSATS scores (rho = 0.928; p<0.001). Conclusion The H-OSATS scale displayed evidence of validity for assessment of technical performances for LH performed on a virtual reality simulator. The implementation of this scale is expected to facilitate deliberate practice. Next steps should focus on evaluating the validity of the scale in the operating room. PMID:29293635

Upper arm elevation and repetitive shoulder movements: a general population job exposure matrix based on expert ratings and technical measurements.

PubMed

Dalbøge, Annett; Hansson, Gert-Åke; Frost, Poul; Andersen, Johan Hviid; Heilskov-Hansen, Thomas; Svendsen, Susanne Wulff

2016-08-01

We recently constructed a general population job exposure matrix (JEM), The Shoulder JEM, based on expert ratings. The overall aim of this study was to convert expert-rated job exposures for upper arm elevation and repetitive shoulder movements to measurement scales. The Shoulder JEM covers all Danish occupational titles, divided into 172 job groups. For 36 of these job groups, we obtained technical measurements (inclinometry) of upper arm elevation and repetitive shoulder movements. To validate the expert-rated job exposures against the measured job exposures, we used Spearman rank correlations and the explained variance[Formula: see text] according to linear regression analyses (36 job groups). We used the linear regression equations to convert the expert-rated job exposures for all 172 job groups into predicted measured job exposures. Bland-Altman analyses were used to assess the agreement between the predicted and measured job exposures. The Spearman rank correlations were 0.63 for upper arm elevation and 0.64 for repetitive shoulder movements. The expert-rated job exposures explained 64% and 41% of the variance of the measured job exposures, respectively. The corresponding calibration equations were y=0.5%time+0.16×expert rating and y=27°/s+0.47×expert rating. The mean differences between predicted and measured job exposures were zero due to calibration; the 95% limits of agreement were ±2.9% time for upper arm elevation >90° and ±33°/s for repetitive shoulder movements. The updated Shoulder JEM can be used to present exposure-response relationships on measurement scales. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Essential aspects of ophthalmological expert assessment in private accident insurance].

PubMed

Tost, F

2014-06-01

Commissions for an expert assessment place basically high demands on commissioned eye specialists because this activity differs from the normal routine field of work. In addition to assessing objective symptoms and subjective symptomatics in a special analytical manner, eye specialists are expected to have knowledge of basic legal terminology, such as proximate cause, evidence and evidential value. Only under these prerequisites can an ophthalmologist fulfill the function of an expert with a high level of quality and adequately adjust the special medical ophthalmological expertise to the requirements of the predominantly legally based clients commissioning the report and oriented to the appropriate valid legal norms. Particularly common difficulties associated with making an ophthalmological expert report for private accident insurance, e.g. determination of the reduction in functional quality, consideration of partial causality and assessment of diplopia are discussed.

The role of communication in breast cancer screening: a qualitative study with Australian experts.

PubMed

Parker, Lisa M; Rychetnik, Lucie; Carter, Stacy M

2015-10-19

One well-accepted strategy for optimising outcomes in mammographic breast cancer screening is to improve communication with women about screening. It is not always clear, however, what it is that communication should be expected to achieve, and why or how this is so. We investigated Australian experts' opinions on breast screening communication. Our research questions were: 1 What are the views of Australian experts about communicating with consumers on breast screening? 2 How do experts reason about this topic? We used a qualitative methodology, interviewing 33 breast screening experts across Australia with recognisable influence in the Australian mammographic breast cancer screening setting. We used purposive and theoretical sampling to identify experts from different professional roles (including clinicians, program managers, policy makers, advocates and researchers) with a range of opinions about communication in breast screening. Experts discussed the topic of communication with consumers by focusing on two main questions: how strongly to guide consumers' breast cancer screening choices, and what to communicate about overdiagnosis. Each expert adopted one of three approaches to consumer communication depending on their views about these topics. We labelled these approaches: Be screened; Be screened and here's why; Screening is available please consider whether it's right for you. There was a similar level of support for all three approaches. Experts' reasoning was grounded in how they conceived of and prioritised their underlying values including: delivering benefits, avoiding harms, delivering more benefits than harms, respecting autonomy and transparency. There is disagreement between experts regarding communication with breast screening consumers. Our study provides some insights into this persisting lack of consensus, highlighting the different meanings that experts give to values, and different ways that values are prioritised. We suggest that explicit discussion about ethical values might help to focus thinking, clarify concepts and promote consensus in policy around communication with consumers. More specifically, we suggest that decision-makers who are considering policy on screening communication should begin with identifying and agreeing on the specific values to be prioritised and use this to guide them in establishing what the communication aims will be and which communication strategy will achieve those aims.

Third CLIPS Conference Proceedings, volume 1

NASA Technical Reports Server (NTRS)

Riley, Gary (Editor)

1994-01-01

Expert systems are computed programs which emulate human expertise in well defined problem domains. The potential payoff from expert systems is high: valuable expertise can be captured and preserved, repetitive and/or mundane tasks requiring human expertise can be automated, and uniformity can be applied in decision making processes. The C Language Integrated Production Systems (CLIPS) is an expert system building tool, developed at the Johnson Space Center, which provides a complete environment for the development and delivery of rule and/or object based expert systems. CLIPS was specifically designed to provide a low cost option for developing and deploying expert system applications across a wide range of hardware platforms. The development of CLIPS has helped to improve the ability to deliver expert systems technology throughout the public and private sectors for a wide range of applications and diverse computing environments.

Experience of High School Cooperation with Manufacturing Enterprise While Training Rocket and Space Industry Experts

NASA Astrophysics Data System (ADS)

Novykov, O.; Dzhur, Y.; Perlyk, V.

2002-01-01

Cooperation between Yuzhnoye SDO and Dniepropetrovsk National University (Physical and Engineering Institute) constitutes an example for the efficient practical realization of the idea of integration of science, industry and education, i.e. scientists and industrial experts take an active part in educational process while teachers and students participate in resolution of vital scientific and technical problems. The report is devoted to a summary analysis of such cooperation, which during the creation of Dniepropetrovsk Rocket Center, the largest in the former USSR, helped solving the relevant employment issues and contributed to foundation of Dniepropetrovsk scientific rocket school in the shortest possible time. Later, the cooperation was of avail in adequate reinforcement of the rocket and space industry with highly skilled experts (more than 20 thousand experts have graduated during 50 years). The University department branches representative of principal schools, i.e. rocket and spacecraft design and manufacture, engine design, automated control systems, production practice etc. established at the company's premises resolve vital issues related to improvement of expert training reliability. The department branches successfully resolve the tasks associated with prompt adaptation of the experts by comprehensively accounting both for the needs of the industry and the company's development outlook as well as by involving up-to-date manufacturing equipment in educational process, during researches, etc. Recently a new entity has been established playing an important role in building a continuous aerospace education system. This entity is called the National Center for aerospace education of Ukrainian youth, which unites high and higher school students, young scientists, and allows resolving different tasks ranging from searching and selecting gifted youth to training of highly skilled scientists.

48 CFR 970.3102-05-22 - Lobbying and political activity costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... or expert advice of a factual, technical, or scientific nature, with respect to topics directly... topics directly related to the performance of the contract or proposed legislation. In providing this...

Examining Harry Thaw's "brain-storm" defense: APA and ANA presidents as expert witnesses in a 1907 trial.

PubMed

Pinta, Emil R

2008-06-01

In 1907, Harry K. Thaw, son of a railroad multi-millionaire, stood trial for shooting and killing architect Stanford White during the performance of a Broadway musical. The defense claimed that Thaw had experienced a "brain storm" causing temporary insanity. The brain-storm defense was ridiculed by professional groups, the public and the press. However, the defense experts were all respected leaders in their fields. They included five past or future presidents of the American Psychiatric Association and American Neurological Association. With no standard terminology in 1907, the much-maligned brain-storm diagnosis was in many respects an appropriate term for a sudden, drastic and temporary defect of reasoning having a physical cause. In spite of a strict test for mental nonresponsibility, the jury did not return a murder verdict.

Evaluation and revision of checklists for screening facilities and municipal governmental programs for gastric cancer and colorectal cancer screening in Japan.

PubMed

Higashi, Takahiro; Machii, Ryoko; Aoki, Ayako; Hamashima, Chisato; Saito, Hiroshi

2010-11-01

To evaluate the appropriateness of current checklists created by a governmental committee to assess screening programs run by municipal governments and service provider facilities for gastric and colorectal cancer, and to accumulate expert opinions to provide insights aimed at the next revision. We convened an expert panel that consisted of physicians nominated by regional offices of the Japanese Society for Gastrointestinal Cancer Screening and radiology technicians nominated by the technician chapter of the society. The panel rated the appropriateness of each checklist item on a scale of 1-9 (1, extremely inappropriate; 9, extremely appropriate) twice, between which they had a face-to-face discussion meeting. During the process they were allowed to propose modifications and additions to the items. In the first round of rating, the panelists rated all 57 and 56 checklists items for gastric and colorectal cancer, respectively, as appropriate based on an acceptance rule determined a priori. During the process of the face-to-face discussion, however, the panel proposed modifications to 23 (40%) and 22 (39%) items, respectively, and the addition of 27 new items each. After integrating overlapping items and rating again for appropriateness, 66 and 64 items, respectively, were accepted as the revised checklist set. The expert panel considered current checklists for colorectal and gastric cancer-screening programs and facilities to be suitable. Their proposals for a new set of checklist items will help further improve the checklists.

Correspondence between training load executed by volleyball players and the one observed by coaches.

PubMed

Rodríguez-Marroyo, Jose A; Medina, Javier; García-López, Juan; García-Tormo, José V; Foster, Carl

2014-06-01

The main aim of this study was to compare the training load (TL) executed by volleyball players with that observed by coaches. Second, we analyzed the influence of the coaches' experience in the estimated TL. Twelve female volleyball players and 4 male coaches participated in this study. During a period of 15 weeks, physical (PT) and technical-tactical training sessions and matches were monitored. In each session, the session rating of perceived exertion (sRPE) was recorded to analyze the players' exercise intensity and TL(RP)E. Coaches were present in all sessions and rated their estimate of sRPE at the same time as the players to calculate the coaches' TL(RPE). Both players' and coaches' mean sRPE (4.0 ± 1.1, 3.7 ± 1.1, and 3.8 ± 1.0 in players and expert and beginning coaches, respectively) and TLRPE (380.1 ± 106.8, 358.3 ± 110.5, and 359.7 ± 108.0 in players and expert and beginning coaches, respectively) were similar. However, a higher (p < 0.01) sRPE and TL(RPE) were observed in the players during PT. In general, the weekly TL(RPE) variation over the course of this study was similar in players and coaches. The players' sRPE and TL(RPE) were correlated (p < 0.01) with expert and beginner coaches' RPE (r = 0.70 and 0.72, respectively) and TL(RPE) (r = 0.75 and 0.76, respectively). In conclusion, the present findings show the correspondence between players' and coaches' sRPE and TL(RPE) regardless of their experience. Hence, coaches' TL(RPE) could be a useful and practical method to monitor and control the TL and other derived parameters in an easy way during volleyball.

Validity Evidence for the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT).

PubMed

Breimer, Gerben E; Haji, Faizal A; Cinalli, Giuseppe; Hoving, Eelco W; Drake, James M

2017-02-01

Growing demand for transparent and standardized methods for evaluating surgical competence prompted the construction of the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT). To provide validity evidence of the NEVAT by reporting on the tool's internal structure and its relationship with surgical expertise during simulation-based training. The NEVAT was used to assess performance of trainees and faculty at an international neuroendoscopy workshop. All participants performed an endoscopic third ventriculostomy (ETV) on a synthetic simulator. Participants were simultaneously scored by 2 raters using the NEVAT procedural checklist and global rating scale (GRS). Evidence of internal structure was collected by calculating interrater reliability and internal consistency of raters' scores. Evidence of relationships with other variables was collected by comparing the ETV performance of experts, experienced trainees, and novices using Jonckheere's test (evidence of construct validity). Thirteen experts, 11 experienced trainees, and 10 novices participated. The interrater reliability by the intraclass correlation coefficient for the checklist and GRS was 0.82 and 0.94, respectively. Internal consistency (Cronbach's α) for the checklist and the GRS was 0.74 and 0.97, respectively. Median scores with interquartile range on the checklist and GRS for novices, experienced trainees, and experts were 0.69 (0.58-0.86), 0.85 (0.63-0.89), and 0.85 (0.81-0.91) and 3.1 (2.5-3.8), 3.7 (2.2-4.3) and 4.6 (4.4-4.9), respectively. Jonckheere's test showed that the median checklist and GRS score increased with performer expertise ( P = .04 and .002, respectively). This study provides validity evidence for the NEVAT to support its use as a standardized method of evaluating neuroendoscopic competence during simulation-based training. Copyright © 2016 by the Congress of Neurological Surgeons

A new metric for detecting change in slowly evolving brain tumors: validation in meningioma patients.

PubMed

Pohl, Kilian M; Konukoglu, Ender; Novellas, Sebastian; Ayache, Nicholas; Fedorov, Andriy; Talos, Ion-Florin; Golby, Alexandra; Wells, William M; Kikinis, Ron; Black, Peter M

2011-03-01

Change detection is a critical component in the diagnosis and monitoring of many slowly evolving pathologies. This article describes a semiautomatic monitoring approach using longitudinal medical images. We test the method on brain scans of patients with meningioma, which experts have found difficult to monitor because the tumor evolution is very slow and may be obscured by artifacts related to image acquisition. We describe a semiautomatic procedure targeted toward identifying difficult-to-detect changes in brain tumor imaging. The tool combines input from a medical expert with state-of-the-art technology. The software is easy to calibrate and, in less than 5 minutes, returns the total volume of tumor change in mm. We test the method on postgadolinium, T1-weighted magnetic resonance images of 10 patients with meningioma and compare our results with experts' findings. We also perform benchmark testing with synthetic data. Our experiments indicated that experts' visual inspections are not sensitive enough to detect subtle growth. Measurements based on experts' manual segmentations were highly accurate but also labor intensive. The accuracy of our approach was comparable to the experts' results. However, our approach required far less user input and generated more consistent measurements. The sensitivity of experts' visual inspection is often too low to detect subtle growth of meningiomas from longitudinal scans. Measurements based on experts' segmentation are highly accurate but generally too labor intensive for standard clinical settings. We described an alternative metric that provides accurate and robust measurements of subtle tumor changes while requiring a minimal amount of user input.

Three CLIPS-based expert systems for solving engineering problems

NASA Technical Reports Server (NTRS)

Parkinson, W. J.; Luger, G. F.; Bretz, R. E.

1990-01-01

We have written three expert systems, using the CLIPS PC-based expert system shell. These three expert systems are rule based and are relatively small, with the largest containing slightly less than 200 rules. The first expert system is an expert assistant that was written to help users of the ASPEN computer code choose the proper thermodynamic package to use with their particular vapor-liquid equilibrium problem. The second expert system was designed to help petroleum engineers choose the proper enhanced oil recovery method to be used with a given reservoir. The effectiveness of each technique is highly dependent upon the reservoir conditions. The third expert system is a combination consultant and control system. This system was designed specifically for silicon carbide whisker growth. Silicon carbide whiskers are an extremely strong product used to make ceramic and metal composites. The manufacture of whiskers is a very complicated process. which to date. has defied a good mathematical model. The process was run by experts who had gained their expertise by trial and error. A system of rules was devised by these experts both for procedure setup and for the process control. In this paper we discuss the three problem areas of the design, development and evaluation of the CLIPS-based programs.

Similarity and accuracy of mental models formed during nursing handovers: A concept mapping approach.

PubMed

Drach-Zahavy, Anat; Broyer, Chaya; Dagan, Efrat

2017-09-01

Shared mental models are crucial for constructing mutual understanding of the patient's condition during a clinical handover. Yet, scant research, if any, has empirically explored mental models of the parties involved in a clinical handover. This study aimed to examine the similarities among mental models of incoming and outgoing nurses, and to test their accuracy by comparing them with mental models of expert nurses. A cross-sectional study, exploring nurses' mental models via the concept mapping technique. 40 clinical handovers. Data were collected via concept mapping of the incoming, outgoing, and expert nurses' mental models (total of 120 concept maps). Similarity and accuracy for concepts and associations indexes were calculated to compare the different maps. About one fifth of the concepts emerged in both outgoing and incoming nurses' concept maps (concept similarity=23%±10.6). Concept accuracy indexes were 35%±18.8 for incoming and 62%±19.6 for outgoing nurses' maps. Although incoming nurses absorbed fewer number of concepts and associations (23% and 12%, respectively), they partially closed the gap (35% and 22%, respectively) relative to expert nurses' maps. The correlations between concept similarities, and incoming as well as outgoing nurses' concept accuracy, were significant (r=0.43, p<0.01; r=0.68 p<0.01, respectively). Finally, in 90% of the maps, outgoing nurses added information concerning the processes enacted during the shift, beyond the expert nurses' gold standard. Two seemingly contradicting processes in the handover were identified. "Information loss", captured by the low similarity indexes among the mental models of incoming and outgoing nurses; and "information restoration", based on accuracy measures indexes among the mental models of the incoming nurses. Based on mental model theory, we propose possible explanations for these processes and derive implications for how to improve a clinical handover. Copyright © 2017 Elsevier Ltd. All rights reserved.

An evaluation of computer assisted clinical classification algorithms.

PubMed

Chute, C G; Yang, Y; Buntrock, J

1994-01-01

The Mayo Clinic has a long tradition of indexing patient records in high resolution and volume. Several algorithms have been developed which promise to help human coders in the classification process. We evaluate variations on code browsers and free text indexing systems with respect to their speed and error rates in our production environment. The more sophisticated indexing systems save measurable time in the coding process, but suffer from incompleteness which requires a back-up system or human verification. Expert Network does the best job of rank ordering clinical text, potentially enabling the creation of thresholds for the pass through of computer coded data without human review.

Quality assessment of structure and language elements of written responses given by seven Scandinavian drug information centres.

PubMed

Reppe, Linda Amundstuen; Spigset, Olav; Kampmann, Jens Peter; Damkier, Per; Christensen, Hanne Rolighed; Böttiger, Ylva; Schjøtt, Jan

2017-05-01

The aim of this study was to identify structure and language elements affecting the quality of responses from Scandinavian drug information centres (DICs). Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The centres were blinded for which queries were part of the study. The responses were assessed qualitatively by six clinical pharmacologists (internal experts) and six general practitioners (GPs, external experts). In addition, linguistic aspects of the responses were evaluated by a plain language expert. The quality of responses was generally judged as satisfactory to good. Presenting specific advice and conclusions were considered to improve the quality of the responses. However, small nuances in language formulations could affect the individual judgments of the experts, e.g. on whether or not advice was given. Some experts preferred the use of primary sources to the use of secondary and tertiary sources. Both internal and external experts criticised the use of abbreviations, professional terminology and study findings that was left unexplained. The plain language expert emphasised the importance of defining and explaining pharmacological terms to ensure that enquirers understand the response as intended. In addition, more use of active voice and less compressed text structure would be desirable. This evaluation of responses to DIC queries may give some indications on how to improve written responses on drug-related queries with respect to language and text structure. Giving specific advice and precise conclusions and avoiding too compressed language and non-standard abbreviations may aid to reach this goal.

Short-term Forecasting of the Prevalence of Trachoma: Expert Opinion, Statistical Regression, versus Transmission Models.

PubMed

Liu, Fengchen; Porco, Travis C; Amza, Abdou; Kadri, Boubacar; Nassirou, Baido; West, Sheila K; Bailey, Robin L; Keenan, Jeremy D; Solomon, Anthony W; Emerson, Paul M; Gambhir, Manoj; Lietman, Thomas M

2015-08-01

Trachoma programs rely on guidelines made in large part using expert opinion of what will happen with and without intervention. Large community-randomized trials offer an opportunity to actually compare forecasting methods in a masked fashion. The Program for the Rapid Elimination of Trachoma trials estimated longitudinal prevalence of ocular chlamydial infection from 24 communities treated annually with mass azithromycin. Given antibiotic coverage and biannual assessments from baseline through 30 months, forecasts of the prevalence of infection in each of the 24 communities at 36 months were made by three methods: the sum of 15 experts' opinion, statistical regression of the square-root-transformed prevalence, and a stochastic hidden Markov model of infection transmission (Susceptible-Infectious-Susceptible, or SIS model). All forecasters were masked to the 36-month results and to the other forecasts. Forecasts of the 24 communities were scored by the likelihood of the observed results and compared using Wilcoxon's signed-rank statistic. Regression and SIS hidden Markov models had significantly better likelihood than community expert opinion (p = 0.004 and p = 0.01, respectively). All forecasts scored better when perturbed to decrease Fisher's information. Each individual expert's forecast was poorer than the sum of experts. Regression and SIS models performed significantly better than expert opinion, although all forecasts were overly confident. Further model refinements may score better, although would need to be tested and compared in new masked studies. Construction of guidelines that rely on forecasting future prevalence could consider use of mathematical and statistical models. Clinicaltrials.gov NCT00792922.

Practice of One Health approaches: bridges and barriers in Tanzania.

PubMed

Kayunze, Kim A; Kiwara, Angwara; Lyamuya, Eligius; Kambarage, Dominic M; Rushton, Jonathan; Coker, Richard; Kock, Richard

2014-04-23

The practice of one health approaches in human and animal health programmes is influenced by type and scope of bridges and barriers for partnerships. It was thus essential to evaluate the nature and scope of collaborative arrangements among human, animal, and wildlife health experts in dealing with health challenges which demand inter-sectoral partnership. The nature of collaborative arrangement was assessed, and the respective bridges and barriers over a period of 12 months (July 20011 to June 2012) were identified. The specific objectives were to: (1) determine the proportion of health experts who had collaborated with other experts of disciplines different from theirs, (2) rank the general bridges for and barriers against collaboration according to the views of the health experts, and (3) find the actual bridges for and barriers against collaboration among the health experts interviewed. It was found that 27.0% of animal health officers interviewed had collaborated with medical officers while 12.4% of the medical officers interviewed had collaborated with animal health experts. Only 6.7% of the wildlife officers had collaborated with animal health experts. The main bridges for collaboration were instruction by upper level leaders, zoonotic diseases of serious impacts, and availability of funding. The main barriers for collaboration were lack of knowledge about animal/human health issues, lack of networks for collaboration, and lack of plans to collaborate. This thus calls for the need to curb barriers in order to enhance inter-sectoral collaboration for more effective management of risks attributable to infectious diseases of humans and animals.

[The Senior Expert Service in West Germany].

PubMed

Fritz, G

1983-01-01

A Senior Expert Service (SES) has been established by the Government of the Federal Republic of Germany by the end of January 1983. Experts from the economy, public administration, agricultural and educational fields etc. are being sent by the SES as short-term advisors unremunerated into Third World countries. Their tasks are mainly to strengthen the economies there and to further industrial development, especially small and medium enterprise, but their activities will cover all areas of development aid. Head of the Senior Expert Service of the Federal Republic of Germany is Dr. Gerhard Fritz. 600 Senior Experts have been put on file by the end of July 1983 out of 2000 who initially showed interest in the Service Required are not only their skills and qualifications, but adequate abilities in foreign languages as well. the experts may guide positively social attitudes towards those retired from active professional life and encourage seniors in our own society. The projects concern clearly defined tasks. The activities of the Senior Experts are safeguarded by being taken into the circle of German representatives in the respective countries. board and lodging, as well as a modest pocket money are being provided by the foreign partner. 11 honorary missions have been completed successfully by August 1983. At present, ca. 90 possibilities for projects are being envisaged. Out of those, 20 are planned for 1983, about 50 for 1984 and possibly 100 for 1985. As a rule, a mission may last between two weeks and three months; in case of longer duration, it may be possible for wives to accompany their husbands.

Genotoxicity Expert Panel review: weight of evidence evaluation of the genotoxicity of glyphosate, glyphosate-based formulations, and aminomethylphosphonic acid.

PubMed

Brusick, David; Aardema, Marilyn; Kier, Larry; Kirkland, David; Williams, Gary

2016-09-01

In 2015, the International Agency for Research on Cancer (IARC) published a monograph concluding there was strong evidence for genotoxicity of glyphosate and glyphosate formulations and moderate evidence for genotoxicity of the metabolite aminomethylphosphonic acid (AMPA). These conclusions contradicted earlier extensive reviews supporting the lack of genotoxicity of glyphosate and glyphosate formulations. The IARC Monograph concluded there was strong evidence of induction of oxidative stress by glyphosate, glyphosate formulations, and AMPA. The Expert Panel reviewed the genotoxicity and oxidative stress data considered in the IARC Monograph, together with other available data not considered by IARC. The Expert Panel defined and used a weight of evidence (WoE) approach that included ranking of studies and endpoints by the strength of their linkage to events associated with carcinogenic mechanisms. Importantly, the Expert Panel concluded that there was sufficient information available from a very large number of regulatory genotoxicity studies that should have been considered by IARC. The WoE approach, the inclusion of all relevant regulatory studies, and some differences in interpretation of individual studies led to significantly different conclusions by the Expert Panel compared with the IARC Monograph. The Expert Panel concluded that glyphosate, glyphosate formulations, and AMPA do not pose a genotoxic hazard and the data do not support the IARC Monograph genotoxicity evaluation. With respect to carcinogenicity classification and mechanism, the Expert Panel concluded that evidence relating to an oxidative stress mechanism of carcinogenicity was largely unconvincing and that the data profiles were not consistent with the characteristics of genotoxic carcinogens.

A Delphi Consensus of the Crucial Steps in Gastric Bypass and Sleeve Gastrectomy Procedures in the Netherlands.

PubMed

Kaijser, Mirjam A; van Ramshorst, Gabrielle H; Emous, Marloes; Veeger, Nic J G M; van Wagensveld, Bart A; Pierie, Jean-Pierre E N

2018-04-09

Bariatric procedures are technically complex and skill demanding. In order to standardize the procedures for research and training, a Delphi analysis was performed to reach consensus on the practice of the laparoscopic gastric bypass and sleeve gastrectomy in the Netherlands. After a pre-round identifying all possible steps from literature and expert opinion within our study group, questionnaires were send to 68 registered Dutch bariatric surgeons, with 73 steps for bypass surgery and 51 steps for sleeve gastrectomy. Statistical analysis was performed to identify steps with and without consensus. This process was repeated to reach consensus of all necessary steps. Thirty-eight participants (56%) responded in the first round and 32 participants (47%) in the second round. After the first Delphi round, 19 steps for gastric bypass (26%) and 14 for sleeve gastrectomy (27%) gained full consensus. After the second round, an additional amount of 10 and 12 sub-steps was confirmed as key steps, respectively. Thirteen steps in the gastric bypass and seven in the gastric sleeve were deemed advisable. Our expert panel showed a high level of consensus expressed in a Cronbach's alpha of 0.82 for the gastric bypass and 0.87 for the sleeve gastrectomy. The Delphi consensus defined 29 steps for gastric bypass and 26 for sleeve gastrectomy as being crucial for correct performance of these procedures to the standards of our expert panel. These results offer a clear framework for the technical execution of these procedures.

Confirming, Classifying, and Prioritizing Needed Over-the-Bed Table Improvements via Methodological Triangulation.

PubMed

Manganelli, Joe; Threatt, Anthony; Brooks, Johnell O; Healy, Stan; Merino, Jessica; Yanik, Paul; Walker, Ian; Green, Keith

2014-01-01

This article presents the results of a qualitative study that confirmed, classified, and prioritized user needs for the design of a more useful, usable, and actively assistive over-the-bed table. Manganelli et al. (2014) generated a list of 74 needs for use in developing an actively assistive over-the-bed table. This present study assesses the value and importance of those needs. Fourteen healthcare subject matter experts and eight research and design subject matter experts engaged in a participatory and iterative research and design process. A mixed methods qualitative approach used methodological triangulation to confirm the value of the findings and ratings to establish importance. Open and closed card sorts and a Delphi study were used. Data analysis methods included frequency analysis, content analysis, and a modified Kano analysis. A table demonstrating the needs that are of high importance to both groups of subject matter experts and classification of the design challenges each represents was produced. Through this process, the list of 74 needs was refined to the 37 most important need statements for both groups. Designing a more useful, usable, and actively assistive over-the-bed table is primarily about the ability to position it optimally with respect to the user for any task, as well as improving ease of use and usability. It is also important to make explicit and discuss the differences in priorities and perspectives demonstrated between research and design teams and their clients. © 2014 Vendome Group, LLC.

Expert systems for superalloy studies

NASA Technical Reports Server (NTRS)

Workman, Gary L.; Kaukler, William F.

1990-01-01

There are many areas in science and engineering which require knowledge of an extremely complex foundation of experimental results in order to design methodologies for developing new materials or products. Superalloys are an area which fit well into this discussion in the sense that they are complex combinations of elements which exhibit certain characteristics. Obviously the use of superalloys in high performance, high temperature systems such as the Space Shuttle Main Engine is of interest to NASA. The superalloy manufacturing process is complex and the implementation of an expert system within the design process requires some thought as to how and where it should be implemented. A major motivation is to develop a methodology to assist metallurgists in the design of superalloy materials using current expert systems technology. Hydrogen embrittlement is disasterous to rocket engines and the heuristics can be very complex. Attacking this problem as one module in the overall design process represents a significant step forward. In order to describe the objectives of the first phase implementation, the expert system was designated Hydrogen Environment Embrittlement Expert System (HEEES).

The effect on surgical skills of expert surgeons using 3D/HD and 2D/4K resolution monitors in laparoscopic phantom tasks.

PubMed

Harada, Hitoshi; Kanaji, Shingo; Hasegawa, Hiroshi; Yamamoto, Masashi; Matsuda, Yoshiko; Yamashita, Kimihiro; Matsuda, Takeru; Oshikiri, Taro; Sumi, Yasuo; Nakamura, Tetsu; Suzuki, Satoshi; Kakeji, Yoshihiro

2018-03-30

Recently, several new imaging technologies, such as three-dimensional (3D)/high-definition (HD) stereovision and high-resolution two-dimensional (2D)/4K monitors, have been introduced in laparoscopic surgery. However, it is still unclear whether these technologies actually improve surgical performance. Participants were 11 expert laparoscopic surgeons. We designed three laparoscopic suturing tasks (task 1: simple suturing, task 2: knotting thread in a small box, and task 3: suturing in a narrow space) in training boxes. Performances were recorded by an optical position tracker. All participants first performed each task five times consecutively using a conventional 2D/HD monitor. Then they were randomly divided into two groups: six participants performed the tasks using 3D/HD before using 2D/4K; the other five participants performed the tasks using a 2D/4K monitor before the 3D/HD monitor. After the trials, we evaluated the performance scores (operative time, path length of forceps, and technical errors) and compared performance scores across all monitors. Surgical performances of participants were ranked in decreasing order: 3D/HD, 2D/4K, and 2D/HD using the total scores for each task. In task 1 (simple suturing), some surgical performances using 3D/HD were significantly better than those using 2D/4K (P = 0.017, P = 0.033, P = 0.492 for operative time, path length, and technical errors, respectively). On the other hand, with operation in narrow spaces such as in tasks 2 and 3, performances using 2D/4K were not inferior to 3D/HD performances. The high-resolution images from the 2D/4K monitor may enhance depth perception in narrow spaces and may complement stereoscopic vision almost as well as using 3D/HD. Compared to a 2D/HD monitor, a 3D/HD monitor improved the laparoscopic surgical technique of expert surgeons more than a 2D/4K monitor. However, the advantage of 2D/4K high-resolution images may be comparable to a 3D/HD monitor especially in narrow spaces.

[Development of expert diagnostic system for common respiratory diseases].

PubMed

Xu, Wei-hua; Chen, You-ling; Yan, Zheng

2014-03-01

To develop an internet-based expert diagnostic system for common respiratory diseases. SaaS system was used to build architecture; pattern of forward reasoning was applied for inference engine design; ASP.NET with C# from the tool pack of Microsoft Visual Studio 2005 was used for website-interview medical expert system.The database of the system was constructed with Microsoft SQL Server 2005. The developed expert system contained large data memory and high efficient function of data interview and data analysis for diagnosis of various diseases.The users were able to perform this system to obtain diagnosis for common respiratory diseases via internet. The developed expert system may be used for internet-based diagnosis of various respiratory diseases,particularly in telemedicine setting.

Can jurors recognize missing control groups, confounds, and experimenter bias in psychological science?

PubMed

McAuliff, Bradley D; Kovera, Margaret Bull; Nunez, Gabriel

2009-06-01

This study examined the ability of jury-eligible community members (N = 248) to detect internal validity threats in psychological science presented during a trial. Participants read a case summary in which an expert testified about a study that varied in internal validity (valid, missing control group, confound, and experimenter bias) and ecological validity (high, low). Ratings of expert evidence quality and expert credibility were higher for the valid versus missing control group versions only. Internal validity did not influence verdict or ratings of plaintiff credibility and no differences emerged as a function of ecological validity. Expert evidence quality, expert credibility, and plaintiff credibility were positively correlated with verdict. Implications for the scientific reasoning literature and for trials containing psychological science are discussed.

The double crush syndrome revisited--a Delphi study to reveal current expert views on mechanisms underlying dual nerve disorders.

PubMed

Schmid, Annina B; Coppieters, Michel W

2011-12-01

A high prevalence of dual nerve disorders is frequently reported. How a secondary nerve disorder may develop following a primary nerve disorder remains largely unknown. Although still frequently cited, most explanatory theories were formulated many years ago. Considering recent advances in neuroscience, it is uncertain whether these theories still reflect current expert opinion. A Delphi study was conducted to update views on potential mechanisms underlying dual nerve disorders. In three rounds, seventeen international experts in the field of peripheral nerve disorders were asked to list possible mechanisms and rate their plausibility. Mechanisms with a median plausibility rating of ≥7 out of 10 were considered highly plausible. The experts identified fourteen mechanisms associated with a first nerve disorder that may predispose to the development of another nerve disorder. Of these fourteen mechanisms, nine have not previously been linked to double crush. Four mechanisms were considered highly plausible (impaired axonal transport, ion channel up or downregulation, inflammation in the dorsal root ganglia and neuroma-in-continuity). Eight additional mechanisms were listed which are not triggered by a primary nerve disorder, but may render the nervous system more vulnerable to multiple nerve disorders, such as systemic diseases and neurotoxic medication. Even though many mechanisms were classified as plausible or highly plausible, overall plausibility ratings varied widely. Experts indicated that a wide range of mechanisms has to be considered to better understand dual nerve disorders. Previously listed theories cannot be discarded, but may be insufficient to explain the high prevalence of dual nerve disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

Research and development for Onboard Navigation (ONAV) ground based expert/trainer system: Preliminary ascent knowledge requirements

NASA Technical Reports Server (NTRS)

Bochsler, Daniel C.

1988-01-01

The preliminary version of expert knowledge for the Onboard Navigation (ONAV) Ground Based Expert Trainer Ascent system for the space shuttle is presented. Included is some brief background information along with the information describing the knowledge the system will contain. Information is given on rules and heuristics, telemetry status, landing sites, inertial measurement units, and a high speed trajectory determinator (HSTD) state vector.

Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider's Choice.

PubMed

Quan-Hoang, Vuong

2016-10-01

Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. To investigate the effects that medical/health services information on perceived expensiveness of patients' labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. There is evidence for established relations among the variables "Convexp" and "Convrel" (all p's < 0.01), indicating that both information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of perceived expensiveness. a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as "expensive"; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system.

Android-assisted physics mobile learning to improve senior high school students' divergent thinking skills and physics HOTS

NASA Astrophysics Data System (ADS)

Mardiana, Nana; Kuswanto, Heru

2017-08-01

The aims of the research concerned here were to reveal (1) the characteristics of Android-assisted PML (physics mobile learning) to improve SMA (sekolah menengah atas, Indonesian senior high school) students' divergent thinking skills and physics HOTS (higher order thinking skills); (2) the feasibility of the Android-assisted PML; and (3) the influence of using the Android-assisted PML on improvement in SMA students' divergent thinking skills and physics HOTS. The7 research was of the R&D (research and development) type, adapted from theBorg-&-Gall development model. The research data were analyzed by means of MANOVA with the significance level of 5%. The results are as follows. (1) The product of the development, a learning media in software form with the android package(apk) format, is named PML (to refer to Physics Mobile Learning), which has such characterictics as being operable with use of Android devicesand being very good in quality in the aspect oflearning, material, software technology, and audiovisual appearance. 2) The developed learning media referred to as PML is appropriate for learning activity according to evaluation by a material expert, a media expert, peer reviewers, and physics teachers as well as according to results of students' tryouts. (3) The use of the Android-assisted PML media product could improve SMA students' divergent thinking skillsand physics HOTS with the respective high-category gain scores of 0.701 and 0.759.

Where Low and High Inference Data Converge: Validation of CLASS Assessment of Mathematics Instruction Using Mobile Eye Tracking with Expert and Novice Teachers

ERIC Educational Resources Information Center

Cortina, Kai S.; Miller, Kevin F.; McKenzie, Ryan; Epstein, Alanna

2015-01-01

Classroom observation research and research on teacher expertise are similar in their reliance on observational data with high-inference procedure to assess the quality of instruction. Expertise research usually uses low-inference measures like eye tracking to identify qualitative difference between expert and novice behaviors and cognition. In…

Modelling a Complex System: Using Novice-Expert Analysis for Developing an Effective Technology-Enhanced Learning Environment

ERIC Educational Resources Information Center

Wu, Hsin-Kai

2010-01-01

The purposes of this article are to present the design of a technology-enhanced learning environment (Air Pollution Modeling Environment [APoME]) that was informed by a novice-expert analysis and to discuss high school students' development of modelling practices in the learning environment. APoME was designed to help high school students…

Ask an Expert.

ERIC Educational Resources Information Center

Trautman, Steve; Klein, Kate

1993-01-01

Offers guidelines for determining when and how to recruit subject matter experts (SMEs) and for ensuring that they deliver high quality training. Considers common problems of SMEs, such as giving too much information, conflicts with their job commitments, and stage fright. (JOW)

Adaptation and fallibility in experts' judgments of novice performers.

PubMed

Larson, Jeffrey S; Billeter, Darron M

2017-02-01

Competition judges are often selected for their expertise, under the belief that a high level of performance expertise should enable accurate judgments of the competitors. Contrary to this assumption, we find evidence that expertise can reduce judgment accuracy. Adaptation level theory proposes that discriminatory capacity decreases with greater distance from one's adaptation level. Because experts' learning has produced an adaptation level close to ideal performance standards, they may be less able to discriminate among lower-level competitors. As a result, expertise increases judgment accuracy of high-level competitions but decreases judgment accuracy of low-level competitions. Additionally, we demonstrate that, consistent with an adaptation level theory account of expert judgment, experts systematically give more critical ratings than intermediates or novices. In summary, this work demonstrates a systematic change in human perception that occurs as task learning increases. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Threat expert system technology advisor

NASA Technical Reports Server (NTRS)

Kurrasch, E. R.; Tripp, L. R.

1987-01-01

A prototype expert system was developed to determine the feasibility of using expert system technology to enhance the performance and survivability of helicopter pilots in a combat threat environment while flying NOE (Nap of the Earth) missions. The basis for the concept is the potential of using an Expert System Advisor to reduce the extreme overloading of the pilot who flies NOE mission below treetop level at approximately 40 knots while performing several other functions. The ultimate goal is to develop a Threat Expert System Advisor which provides threat information and advice that are better than even a highly experienced copilot. The results clearly show that the NOE pilot needs all the help in decision aiding and threat situation awareness that he can get. It clearly shows that heuristics are important and that an expert system for combat NOE helicopter missions can be of great help to the pilot in complex threat situations and in making decisions.

Short report: the effect of expertise in hiking on recognition memory for mountain scenes.

PubMed

Kawamura, Satoru; Suzuki, Sae; Morikawa, Kazunori

2007-10-01

The nature of an expert memory advantage that does not depend on stimulus structure or chunking was examined, using more ecologically valid stimuli in the context of a more natural activity than previously studied domains. Do expert hikers and novice hikers see and remember mountain scenes differently? In the present experiment, 18 novice hikers and 17 expert hikers were presented with 60 photographs of scenes from hiking trails. These scenes differed in the degree of functional aspects that implied some action possibilities or dangers. The recognition test revealed that the memory performance of experts was significantly superior to that of novices for scenes with highly functional aspects. The memory performance for the scenes with few functional aspects did not differ between novices and experts. These results suggest that experts pay more attention to, and thus remember better, scenes with functional meanings than do novices.

Effects of interprofessional education for medical and nursing students: enablers, barriers and expectations for optimizing future interprofessional collaboration - a qualitative study.

PubMed

Homeyer, Sabine; Hoffmann, Wolfgang; Hingst, Peter; Oppermann, Roman F; Dreier-Wolfgramm, Adina

2018-01-01

To ensure high quality patient care an effective interprofessional collaboration between healthcare professionals is required. Interprofessional education (IPE) has a positive impact on team work in daily health care practice. Nevertheless, there are various challenges for sustainable implementation of IPE. To identify enablers and barriers of IPE for medical and nursing students as well as to specify impacts of IPE for both professions, the 'Cooperative academical regional evidence-based Nursing Study in Mecklenburg-Western Pomerania' (Care-N Study M-V) was conducted. The aim is to explore, how IPE has to be designed and implemented in medical and nursing training programs to optimize students' impact for IPC. A qualitative study was conducted using the Delphi method and included 25 experts. Experts were selected by following inclusion criteria: (a) ability to answer every research question, one question particularly competent, (b) interdisciplinarity, (c) sustainability and (d) status. They were purposely sampled. Recruitment was based on existing collaborations and a web based search. The experts find more enablers than barriers for IPE between medical and nursing students. Four primary arguments for IPE were mentioned: (1) development and promotion of interprofessional thinking and acting, (2) acquirement of shared knowledge, (3) promotion of beneficial information and knowledge exchange, and (4) promotion of mutual understanding. Major barriers of IPE are the coordination and harmonization of the curricula of the two professions. With respect to the effects of IPE for IPC, experts mentioned possible improvements on (a) patient level and (b) professional level. Experts expect an improved patient-centered care based on better mutual understanding and coordinated cooperation in interprofessional health care teams. To sustainably implement IPE for medical and nursing students, IPE needs endorsement by both, medical and nursing faculties. In conclusion, IPE promotes interprofessional cooperation between the medical and the nursing profession. Skills in interprofessional communication and roles understanding will be primary preconditions to improve collaborative patient-centered care. The impact of IPE for patients and caregivers as well as for both professions now needs to be more specifically analysed in prospective intervention studies.

[Virtual teaching (e-learning) in Pediatric Urology. Master and expert course programme].

PubMed

Miguélez-Lago, Carlos; López-Pereira, Pedro; de la Fuente-Madero, José Luis; Caparrós-Cayuela, Aurora

2015-01-01

Currently there is a need for specific training and special dedication to pediatric urology (PU). Nevertheless, we lack of a continuous education program, which must be specific and multidisciplinary. To create a complementary training program in PU with the following differential characteristics: 1) University postgraduate, 2) internationally accredited, 3) multidisciplinary, 4) theoretical and practical, 5) through virtual teaching, 6) with on-site support, 7) academically directed and mentored, 8) based on individual and group self learning, 9) with international faculty and alumni 10) objectively evaluable. We developed two original projects of virtual training courses with practices in PU, Master and Expert following the International University of Andalucía (UNIA) regulations and with the support of the Medical College of Malaga. The Master has a general content one year duration and will be repeated yearly. The Expert course has monographic character, half-year duration and will be repeated yearly with different topics. They are credited 60 and 30 ECTS credits respectively. The course has 3 parts well differentiated in objectives and development: 1. Virtual training 2. On-site hospital practices and, 3. Final work. The alumni answered a questionnaire to evaluate the master at the midpoint. The UNIA has considered viable and approved all 3 projects presented: I PU MASTER (2014-2015), II PU MASTER (2015-2016) and Expert Course on pediatric incontinence (2015-2016)First PU MASTER data.- Registration applications: 60 alumni. Admitted alumni 40; mean age 37 years; 8 nationalities, 57% Spanish, 43% Foreigners. Specialities: Urology 14(35%), Pediatric Surgery 24 (60%), Pediatrics (Pediatric nephrology 1), General Medicine 1. Mid term Master evaluation by the alumni (0-100). Difficulty 60. Quality of the topics 92; complementary materials 90; faculty 90; UNIA virtual Campus 89. The demand of registrations demonstrates the need and interest of a pediatric Urology training program, through Master and Expert Courses. Virtual Training, e-learning, within the Virtual Campus of the UNIA is viable. This self-learning model is being highly valued by the international alumni. We offer an interesting supplement for continuous education in PU.

mHealth to Train Community Health Nurses in Visual Inspection With Acetic Acid for Cervical Cancer Screening in Ghana.

PubMed

Asgary, Ramin; Adongo, Philip Baba; Nwameme, Adanna; Cole, Helen V S; Maya, Ernest; Liu, Mengling; Yeates, Karen; Adanu, Richard; Ogedegbe, Olugbenga

2016-07-01

There is a shortage of trained health care personnel for cervical cancer screening in low-/middle-income countries. We evaluated the feasibility and limited efficacy of a smartphone-based training of community health nurses in visual inspection of the cervix under acetic acid (VIA). During April to July 2015 in urban Ghana, we designed and developed a study to determine the feasibility and efficacy of an mHealth-supported training of community health nurses (CHNs, n = 15) to perform VIA and to use smartphone images to obtain expert feedback on their diagnoses within 24 hours and to improve VIA skills retention. The CHNs completed a 2-week on-site introductory training in VIA performance and interpretation, followed by an ongoing 3-month text messaging-supported VIA training by an expert VIA reviewer. Community health nurses screened 169 women at their respective community health centers while receiving real-time feedback from the reviewer. The total agreement rate between all VIA diagnoses made by all CHNs and the expert reviewer was 95%. The mean (SD) rate of agreement between each CHN and the expert reviewer was 89.6% (12.8%). The agreement rates for positive and negative cases were 61.5% and 98.0%, respectively. Cohen κ statistic was 0.67 (95% CI = 0.45-0.88). Around 7.7% of women tested VIA positive and received cryotherapy or further services. Our findings demonstrate the feasibility and efficacy of mHealth-supported VIA training of CHNs and have the potential to improve cervical cancer screening coverage in Ghana.

The Concept of Noise Annoyance: how International Experts See it

NASA Astrophysics Data System (ADS)

Guski, R.; Felscher-Suhr, U.; Schuemer, R.

1999-06-01

The first part of this paper is a review of some definitions of noise annoyance which have been used explicitly or implicitly in major files and laboratory studies in different countries. This analysis shows wide differences. For instance, in some cases annoyance is seen as an outcome of disturbances, in other cases it is seen as an indication of the degree of helplessness with respect to the noise source. The second part is a report of an empirical study in which 68 noise research experts from seven different nations were asked (1) to indicate the main effect of noise, and (2) to rate the similarity between the concept “noise annoyance” and several related concepts. It turned out that (1) noise annoyance is seen as the major effect of noise, (2) that noise annoyance is a multi-faceted psychological concept, including behavioral, and evaluative aspects. Also, (3) the two aspects rated highest in similarity to annoyance are “nuisance” and “disturbance”, (4) although noise annoyance must be related to acoustic variables, acoustic characteristics do not play an overwhelming role in the concept of annoyance and (5) although experts from different languages agree upon the main components of the annoyance concept (e.g., nuisance, disturbance, and unpleasantness), there are some significant differences in the weights English, German, and Japanese speaking experts assign to several components (e.g., to nuisance, interference, irritation, and vexation). Whether these different weights are due to different concepts of annoyance, or due to different connotations of the related words in the respective languages, could not be analyzed with the data at hand.

Physicians' Self-Conceptions of Their Expertise in Statutory Health Insurance and Social Security Systems.

PubMed

Seger, Wolfgang; Nüchtern, Elisabeth

2015-07-01

Medical experts who practice social medicine have a strong ethical approach for their professional positions. Their reports must reflect an objective, independent, high-quality assessment of interactions between health status and the disability of individuals. However, they must simultaneously consider the societal involvement of these individuals when determining the framework of the Statutory Health Insurance and Social Security Systems. Their task is to recommend sociomedical benefits that are tailored to suit personal needs and that respect the individual life situations of the persons involved, thus complementing the efforts of healthcare professionals in clinical settings. The editorial describes the self-conception of this medical specialty on behalf of the German Society of Social Medicine and Prevention (DGSMP). Policy makers in social insurances and social security systems generally must respect independent sociomedical recommendations as a crucial point for further realistic development activities.

Diagnostic accuracy of semi-automatic quantitative metrics as an alternative to expert reading of CT myocardial perfusion in the CORE320 study.

PubMed

Ostovaneh, Mohammad R; Vavere, Andrea L; Mehra, Vishal C; Kofoed, Klaus F; Matheson, Matthew B; Arbab-Zadeh, Armin; Fujisawa, Yasuko; Schuijf, Joanne D; Rochitte, Carlos E; Scholte, Arthur J; Kitagawa, Kakuya; Dewey, Marc; Cox, Christopher; DiCarli, Marcelo F; George, Richard T; Lima, Joao A C

To determine the diagnostic accuracy of semi-automatic quantitative metrics compared to expert reading for interpretation of computed tomography perfusion (CTP) imaging. The CORE320 multicenter diagnostic accuracy clinical study enrolled patients between 45 and 85 years of age who were clinically referred for invasive coronary angiography (ICA). Computed tomography angiography (CTA), CTP, single photon emission computed tomography (SPECT), and ICA images were interpreted manually in blinded core laboratories by two experienced readers. Additionally, eight quantitative CTP metrics as continuous values were computed semi-automatically from myocardial and blood attenuation and were combined using logistic regression to derive a final quantitative CTP metric score. For the reference standard, hemodynamically significant coronary artery disease (CAD) was defined as a quantitative ICA stenosis of 50% or greater and a corresponding perfusion defect by SPECT. Diagnostic accuracy was determined by area under the receiver operating characteristic curve (AUC). Of the total 377 included patients, 66% were male, median age was 62 (IQR: 56, 68) years, and 27% had prior myocardial infarction. In patient based analysis, the AUC (95% CI) for combined CTA-CTP expert reading and combined CTA-CTP semi-automatic quantitative metrics was 0.87(0.84-0.91) and 0.86 (0.83-0.9), respectively. In vessel based analyses the AUC's were 0.85 (0.82-0.88) and 0.84 (0.81-0.87), respectively. No significant difference in AUC was found between combined CTA-CTP expert reading and CTA-CTP semi-automatic quantitative metrics in patient based or vessel based analyses(p > 0.05 for all). Combined CTA-CTP semi-automatic quantitative metrics is as accurate as CTA-CTP expert reading to detect hemodynamically significant CAD. Copyright © 2018 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Analysing pseudoephedrine/methamphetamine policy options in Australia using multi-criteria decision modelling.

PubMed

Manning, Matthew; Wong, Gabriel T W; Ransley, Janet; Smith, Christine

2016-06-01

In this paper we capture and synthesize the unique knowledge of experts so that choices regarding policy measures to address methamphetamine consumption and dependency in Australia can be strengthened. We examine perceptions of the: (1) influence of underlying factors that impact on the methamphetamine problem; (2) importance of various models of intervention that have the potential to affect the success of policies; and (3) efficacy of alternative pseudoephedrine policy options. We adopt a multi-criteria decision model to unpack factors that affect decisions made by experts and examine potential variations on weight/preference among groups. Seventy experts from five groups (i.e. academia (18.6%), government and policy (27.1%), health (18.6%), pharmaceutical (17.1%) and police (18.6%)) in Australia participated in the survey. Social characteristics are considered the most important underlying factor, prevention the most effective strategy and Project STOP the most preferred policy option with respect to reducing methamphetamine consumption and dependency in Australia. One-way repeated ANOVAs indicate a statistically significant difference with regards to the influence of underlying factors (F(2.3, 144.5)=11.256, p<.001), effectiveness of interventions (F(2.4, 153.1)=28.738, p<.001) and policy options (F(2.8, 175.5)=70.854, p<.001). A majority of respondents believed that genetic, biological, emotional, cognitive and social factors are the most influential explanatory variables in terms of methamphetamine consumption and dependency. Most experts support the use of preventative mechanisms to inhibit drug initiation and delayed drug uptake. Compared to other policies, Project STOP (which aims to disrupt the initial diversion of pseudoephedrine) appears to be a more preferable preventative mechanism to control the production and subsequent sale and use of methamphetamine. This regulatory civil law lever engages third parties in controlling drug-related crime. The literature supports third-party partnerships as it engages experts who have knowledge and expertise with respect to prevention and harm minimization. Copyright © 2016 Elsevier B.V. All rights reserved.

A Comparison of Defense and Plaintiff Expert Witnesses in Orthopaedic Surgery Malpractice Litigation.

PubMed

Park, Howard Y; Zoller, Stephen D; Sheppard, William L; Hegde, Vishal; Smith, Ryan A; Borthwell, Rachel M; Clarkson, Samuel J; Hamad, Christopher D; Proal, Joshua D; Bernthal, Nicholas M

2018-06-06

According to the American Academy of Orthopaedic Surgeons (AAOS) Standards of Professionalism, the responsible testimony of expert witnesses in orthopaedic surgery malpractice lawsuits is important to the public interest. However, these expert witnesses are recruited and compensated without established standards, and their testimony can potentially sway court opinion, with substantial consequences. The objective of this study was to characterize defense and plaintiff expert orthopaedic surgeon witnesses in orthopaedic surgery malpractice litigation. Utilizing the WestlawNext legal database, defense and plaintiff expert witnesses involved in orthopaedic surgery malpractice lawsuits from 2013 to 2017 were identified. Each witness's subspecialty, mean years of experience, involvement in academic or private practice, fellowship training, and scholarly impact, as measured by the Hirsch index (h-index), were determined through a query of professional profiles, the Scopus database, and a PubMed search. Statistical comparisons were made for each parameter among defense and plaintiff expert witnesses. Between 2013 and 2017, 306 expert medical witnesses for orthopaedic cases were identified; 174 (56.9%) testified on behalf of the plaintiff, and 132 (43.1%) testified on behalf of the defense. Orthopaedic surgeons who identified themselves as general orthopaedists comprised the largest share of expert witnesses on both the plaintiff (n = 61) and defense (n = 25) sides. The plaintiff witnesses averaged 36 years of experience versus 31 years for the defense witnesses (p < 0.001); 26% of the plaintiff witnesses held an academic position versus 43% of the defense witnesses (p = 0.013). Defense witnesses exhibited a higher proportion of fellowship training in comparison to plaintiff expert witnesses (80.5% versus 64.5%, respectively, p = 0.003). The h-index for the plaintiff group was 6.6 versus 9.1 for the defense group (p = 0.04). Two witnesses testified for both the plaintiff and defense sides. Defense expert witnesses held higher rates of academic appointments and exhibited greater scholarly impact than their plaintiff counterparts, with both sides averaging >30 years of experience. These data collectively show that there are differences in characteristics between plaintiff and defense witnesses. Additional study is needed to illuminate the etiology of these differences.

Expert panel on practice patterns in the management of cow's milk protein allergy and associated economic burden of disease on health service in Turkey.

PubMed

Sekerel, Bulent Enis; Seyhun, Oznur

2017-09-01

To evaluate practice patterns in the management of cow's milk protein allergy (CMPA) and associated economic burden of disease on health service in Turkey. This study was based on experts' views on the practice patterns in management of CMPA manifesting with either proctocolitis or eczema symptoms and, thereby, aimed to estimate economic burden of CMPA. Practice patterns were determined via patient flow charts developed by experts using the modified Delphi method for CMPA presented with proctocolitis and eczema. Per patient total 2-year direct medical costs were calculated, including cost items of physician visits, laboratory tests, and treatment. According to the consensus opinion of experts, 2-year total direct medical cost from a payer perspective and societal perspective was calculated to be $US2,116.05 and $US2,435.84, respectively, in an infant with CMPA presenting with proctocolitis symptoms, and $US4,001.65 and $US4,828.90, respectively, in an infant with CMPA presenting with eczema symptoms. Clinical nutrition was the primary cost driver that accounted for 89-92% of 2-year total direct medical costs, while the highest total direct medical cost estimated from a payer perspective and societal perspective was noted for the management of an exclusively formula-fed infant presenting either with proctocolitis ($US3,743.85 and $US4,025.63, respectively) or eczema ($US6,854.10 and $US7,917.30, respectively). The first line use of amino acid based formula (AAF) was associated with total direct cost increment $US1,848.08 and $US3,444.52 in the case of proctocolitis and eczema, respectively. Certain limitations to this study should be considered. First, being focused only on direct costs, the lack of data on indirect costs or intangible costs of illness seems to be a major limitation of the present study, which likely results in a downward bias in the estimates of the economic cost of CMPA. Second, given the limited number of studies concerning epidemiology and practice patterns in CMPA in Turkey, use of expert clinical opinion of the panel members rather than real-life data on practice patterns that were used to identify direct medical costs might raise a concern with the validity and reliability of the data. Also, while this was a three-step study with six experts included in the first stage (developing local guidelines for diagnosis, treatment, and follow-up of infants with CMPA in Turkey) and 410 pediatricians included in the second stage (a cross-sectional questionnaire-survey to determine pediatricians' awareness and practice of CMPA in infants and children), only four members were included in the present Delphi panel, which allows a limited discussion. Third, lack of sensitivity analyses and exclusion of indirect costs and costs related to alterations in quality of life, behavior of infants, and general well-being of infants and their parents from the cost-analysis seems to be another limitation that may have caused under-estimation of relative cost-effectiveness of the formulae. Fourth, calculation of costs per local guidelines rather than real-life practice patterns is another limitation that, otherwise, would extend the knowledge achieved in the current study. Notwithstanding these limitations, the present expert panel provided practice patterns in the management of CMPA and an estimate of the associated costs, depending on the symptom profile at initial admission for the first time in Turkey. In conclusion, in providing the first health economic data on CMPA in Turkey, the findings revealed that CMPA imposes a substantial burden on the Turkish healthcare system from both a payer perspective and societal perspective, and indicated clinical nutrition as a primary cost driver. Management of infants presenting with eczema, exclusively formula-fed infants, and first line use of AAF were associated with higher estimates for 2-year direct medical costs.

Assessing nutrient flows in septic tanks by eliciting expert judgement: a promising method in the context of developing countries.

PubMed

Montangero, Agnes; Belevi, Hasan

2007-03-01

Simple models based on the physical and biochemical processes occurring in septic tanks, pit and urine diversion latrines were developed to determine the nutrient flows in these systems. Nitrogen and phosphorus separation in different output materials from these on-site sanitation installations were thus determined. Moreover, nutrient separation in septic tanks was also assessed through literature values and by eliciting expert judgement. Use of formal expert elicitation technique proved to be effective, particularly in the context of developing countries where data is often scarce but expert judgement readily available. In Vietnam, only 5-14% and 11-27% of the nitrogen and phosphorus input, respectively, are removed from septic tanks with the faecal sludge. The remaining fraction leaves the tank via the liquid effluent. Unlike septic tanks, urine diversion latrines allow to immobilize most of the nutrients either in form of stored urine or dehydrated faecal matter. These latrines thus contribute to reducing the nutrient load in the environment and lowering consumption of energy and non-renewable resources for fertiliser production.

On Consistency Test Method of Expert Opinion in Ecological Security Assessment.

PubMed

Gong, Zaiwu; Wang, Lihong

2017-09-04

To reflect the initiative design and initiative of human security management and safety warning, ecological safety assessment is of great value. In the comprehensive evaluation of regional ecological security with the participation of experts, the expert's individual judgment level, ability and the consistency of the expert's overall opinion will have a very important influence on the evaluation result. This paper studies the consistency measure and consensus measure based on the multiplicative and additive consistency property of fuzzy preference relation (FPR). We firstly propose the optimization methods to obtain the optimal multiplicative consistent and additively consistent FPRs of individual and group judgments, respectively. Then, we put forward a consistency measure by computing the distance between the original individual judgment and the optimal individual estimation, along with a consensus measure by computing the distance between the original collective judgment and the optimal collective estimation. In the end, we make a case study on ecological security for five cities. Result shows that the optimal FPRs are helpful in measuring the consistency degree of individual judgment and the consensus degree of collective judgment.

The development of expertise in pediatric rehabilitation therapists: changes in approach, self-knowledge, and use of enabling and customizing strategies.

PubMed

King, Gillian; Currie, Melissa; Bartlett, Doreen J; Gilpin, Michelle; Willoughby, Colleen; Tucker, Mary Ann; Strachan, Deborah; Baxter, Donna

2007-01-01

To examine the clinical decision making of novice, intermediate, and expert pediatric rehabilitation therapists from various disciplines. Two qualitative studies were conducted. Thirteen therapists took part in a study using the critical incident interview technique and 11 therapists took part in a study using the 'think aloud' technique. Therapists were classified as novice, intermediate, or expert in developmental level based on a cluster analysis of data collected using a multifaceted battery of assessment tools. Data were analyzed using a grounded theory approach. Expert and intermediate therapists differed from novices with respect to content, self-, and procedural knowledge. With increasing expertise, therapists use a supportive, educational, holistic, functional, and strengths-based approach; have heightened humility yet increased self-confidence; and understand how to facilitate and support client change and adaptation by using principles of engagement, coherence, and manageability. Expert therapists use enabling and customizing strategies to ensure a successful therapeutic session, optimize the child's functioning in the mid-term, and ensure child and family adaptation and accommodation over the longer-term.

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

PubMed

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

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

Breakfast barriers and opportunities for children living in a Dutch disadvantaged neighbourhood.

PubMed

van Kleef, Ellen; Vingerhoeds, Monique H; Vrijhof, Milou; van Trijp, Hans C M

2016-12-01

The objective of this study was to explore parents', children's, and experts' beliefs and experiences about breakfast motivation, opportunity, and ability and elicit their thoughts on effective interventions to encourage healthy breakfast consumption. The setting was a disadvantaged neighbourhood in Rotterdam, the Netherlands. Focus groups with mothers and children and semi-structured individual interviews with experts were conducted. Interview guides were developed based on the motivation, opportunity, and ability consumer psychology model. Thirty-two mothers of primary school children participated in five group discussions, eight focus groups were conducted with 44 children, and nine experts participated in interviews. Data from expert interviews and group discussions were coded and thematically analysed. The following themes emerged from the focus groups: (1) generally high motivation to have breakfast, (2) improved performance at school is key motivator, (3) limited time hinders breakfast, and (4) lack of nutritional knowledge about high quality breakfast. Experts mentioned lack of effort, knowledge, and time; financial constraints; and environmental issues (food availability) as barriers to breakfasting healthily. Several ways to encourage healthy breakfasting habits were identified: (1) involvement of both children and parents, (2) role models inspiring change, and (3) interactive educational approaches. Experts perceived more problems and challenges in achieving healthy breakfast habits than did mothers and children. Lack of opportunity (according to the children and experts) and ability (according to the experts) were identified, although the motivation to eat a healthy breakfast was present. Predominant barriers are lack of time and nutritional knowledge. Overall, findings suggest educational and social marketing approaches as interventions to encourage healthy breakfast consumption. Copyright © 2016 Elsevier Ltd. All rights reserved.

An expert system for the esthetic rating of bridges.

DOT National Transportation Integrated Search

1990-01-01

The expert system presented should facilitate the in-depth analysis of bridge esthetics and encourage high standards for the appearance of bridges. The procedure described systematically evaluates features of a target bridge in relation to a similar ...

Expert systems for C3I. Volume 1. A user's introduction

NASA Astrophysics Data System (ADS)

Clapp, J. A.; Hockett, S. M.; Prelle, M. J.; Tallant, A. M.; Triant, D. D.

1985-10-01

There has been a tremendous burgeoning of interest in artificial intelligence (AI) over the last few years. Investments of commercial and government sponsors reflect a widespread belief that AI is now ready for practical applications. The area of AI currently receiving the greatest attention and investment is expert system technology. Most major high tech corporations have begun to develop expert systems, and many software houses specializing in expert system tools and applications have recently appeared. The defense community is one of the heaviest investors in expert system technology, and within this community one of the application areas receiving greatest attention is C3I. Many ESD programs are now beginning to ask whether expert system applications for C3I are ready for incorporation into ESD-developed systems, and, if so, what are the potential benefits and risks of doing so. This report was prepared to help ESD and MITRE personnel working on acquisition programs to address these issues and to gain a better understanding of what expert systems are all about. The primary intention of this report is to investigate what expert systems are and the advances that are being made in expert system technology for C3I applications. The report begins with a brief tutorial on expert systems, emphasizing how they differ from conventional software systems and what they are best at doing.

A reconnaissance method for delineation of tracts for regional-scale mineral-resource assessment based on geologic-map data

USGS Publications Warehouse

Raines, G.L.; Mihalasky, M.J.

2002-01-01

The U.S. Geological Survey (USGS) is proposing to conduct a global mineral-resource assessment using geologic maps, significant deposits, and exploration history as minimal data requirements. Using a geologic map and locations of significant pluton-related deposits, the pluton-related-deposit tract maps from the USGS national mineral-resource assessment have been reproduced with GIS-based analysis and modeling techniques. Agreement, kappa, and Jaccard's C correlation statistics between the expert USGS and calculated tract maps of 87%, 40%, and 28%, respectively, have been achieved using a combination of weights-of-evidence and weighted logistic regression methods. Between the experts' and calculated maps, the ranking of states measured by total permissive area correlates at 84%. The disagreement between the experts and calculated results can be explained primarily by tracts defined by geophysical evidence not considered in the calculations, generalization of tracts by the experts, differences in map scales, and the experts' inclusion of large tracts that are arguably not permissive. This analysis shows that tracts for regional mineral-resource assessment approximating those delineated by USGS experts can be calculated using weights of evidence and weighted logistic regression, a geologic map, and the location of significant deposits. Weights of evidence and weighted logistic regression applied to a global geologic map could provide quickly a useful reconnaissance definition of tracts for mineral assessment that is tied to the data and is reproducible. ?? 2002 International Association for Mathematical Geology.

Best practice strategies to safeguard drug prescribing and drug administration: an anthology of expert views and opinions.

PubMed

Seidling, Hanna M; Stützle, Marion; Hoppe-Tichy, Torsten; Allenet, Benoît; Bedouch, Pierrick; Bonnabry, Pascal; Coleman, Jamie J; Fernandez-Llimos, Fernando; Lovis, Christian; Rei, Maria Jose; Störzinger, Dominic; Taylor, Lenka A; Pontefract, Sarah K; van den Bemt, Patricia M L A; van der Sijs, Heleen; Haefeli, Walter E

2016-04-01

While evidence on implementation of medication safety strategies is increasing, reasons for selecting and relinquishing distinct strategies and details on implementation are typically not shared in published literature. We aimed to collect and structure expert information resulting from implementing medication safety strategies to provide advice for decision-makers. Medication safety experts with clinical expertise from thirteen hospitals throughout twelve European and North American countries shared their experience in workshop meetings, on-site-visits and remote structured interviews. We performed an expert-based, in-depth assessment of implementation of best-practice strategies to improve drug prescribing and drug administration. Workflow, variability and recommended medication safety strategies in drug prescribing and drug administration processes. According to the experts, institutions chose strategies that targeted process steps known to be particularly error-prone in the respective setting. Often, the selection was channeled by local constraints such as the e-health equipment and critically modulated by national context factors. In our study, the experts favored electronic prescribing with clinical decision support and medication reconciliation as most promising interventions. They agreed that self-assessment and introduction of medication safety boards were crucial to satisfy the setting-specific differences and foster successful implementation. While general evidence for implementation of strategies to improve medication safety exists, successful selection and adaptation of a distinct strategy requires a thorough knowledge of the institute-specific constraints and an ongoing monitoring and adjustment of the implemented measures.

Content Validity of National Post Marriage Educational Program Using Mixed Methods

PubMed Central

MOHAJER RAHBARI, Masoumeh; SHARIATI, Mohammad; KERAMAT, Afsaneh; YUNESIAN, Masoud; ESLAMI, Mohammad; MOUSAVI, Seyed Abbas; MONTAZERI, Ali

2015-01-01

Background: Although the validity of content of program is mostly conducted with qualitative methods, this study used both qualitative and quantitative methods for the validation of content of post marriage training program provided for newly married couples. Content validity is a preliminary step of obtaining authorization required to install the program in country's health care system. Methods: This mixed methodological content validation study carried out in four steps with forming three expert panels. Altogether 24 expert panelists were involved in 3 qualitative and quantitative panels; 6 in the first item development one; 12 in the reduction kind, 4 of them were common with the first panel, and 10 executive experts in the last one organized to evaluate psychometric properties of CVR and CVI and Face validity of 57 educational objectives. Results: The raw data of post marriage program had been written by professional experts of Ministry of Health, using qualitative expert panel, the content was more developed by generating 3 topics and refining one topic and its respective content. In the second panel, totally six other objectives were deleted, three for being out of agreement cut of point and three on experts' consensus. The validity of all items was above 0.8 and their content validity indices (0.8–1) were completely appropriate in quantitative assessment. Conclusion: This study provided a good evidence for validation and accreditation of national post marriage program planned for newly married couples in health centers of the country in the near future. PMID:26056672

Performance of an HRP-2 Rapid Diagnostic Test in Nigerian Children Less Than 5 Years of Age

PubMed Central

Ajumobi, Olufemi; Sabitu, Kabir; Nguku, Patrick; Kwaga, Jacob; Ntadom, Godwin; Gitta, Sheba; Elizeus, Rutebemberwa; Oyibo, Wellington; Nsubuga, Peter; Maire, Mark; Poggensee, Gabriele

2015-01-01

The diagnostic performance of histidine-rich protein 2 (HRP-2)–based malaria rapid diagnostic test (RDT) was evaluated in a mesoendemic area for malaria, Kaduna, Nigeria. We compared RDT results with expert microscopy results of blood samples from 295 febrile children under 5 years. Overall, 11.9% (35/295) tested positive with RDT compared with 10.5% (31/295) by microscopy: sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100%, 98.5%, 88.6%, and 100%, respectively. The RDT sensitivity was not affected by transmission season, parasite density, and age. Specificity and positive PV decreased slightly during the high-transmission season (97.5% and 83.3%). The RDT test positivity rates in the low- and high-transmission seasons were 9.4% and 13.5%, respectively. Overall, the test performance of this RDT was satisfactory. The findings of a low proportion of RDT false positives, no invalid and no false-negative results should validate the performance of RDTs in this context. PMID:25711608

Accuracy of Two Malaria Rapid Diagnostic Tests (RDTS) for Initial Diagnosis and Treatment Monitoring in a High Transmission Setting in Uganda

PubMed Central

Mbabazi, Phoebe; Hopkins, Heidi; Osilo, Emmanuel; Kalungu, Michael; Byakika-Kibwika, Pauline; Kamya, Moses R.

2015-01-01

Malaria rapid diagnostic tests (RDTs) may improve fever management in areas without microscopy. We compared the accuracy of histidine-rich protein 2 (HRP2) and Plasmodium lactate dehydrogenase (pLDH)-based RDTs, using expert microscopy as a gold standard, for initial diagnosis, treatment monitoring, and diagnosis of recurrent malaria in a cohort of children followed longitudinally in a high-transmission area in Uganda. For 305 initial fever episodes, sensitivity was 98% for HRP2 and 87% for pLDH, whereas specificity was 55% and 96%, respectively. The HRP2 gave 51% false-positive results on Day 28, whereas pLDH gave no false positives after Day 7. For 59 recurrent fever episodes during follow-up, sensitivity was 100% for HRP2 and 91% for pLDH, whereas specificity was 33% and 100%, respectively. The HRP2-based RDTs are useful for initial diagnosis of malaria caused by superior sensitivity; however, as a result of superior specificity, pLDH-based RDTs are more appropriate to monitor treatment and diagnose recurrent malaria. PMID:25624399

Dietary exposure of Hong Kong adults to fatty acid esters of 3-monochloropropane-1,2-diol.

PubMed

Chung, H Y; Chung, Stephen W C; Chan, B T P; Ho, Yuk Yin; Xiao, Ying

2013-01-01

A total of 290 individual food samples were collected in Hong Kong, China, for 3-monochloropropane-1,2-diol (3-MCPD) fatty acid esters analysis. Most samples were processed food and in ready-to-eat form. The results show that the levels of 3-MCPD fatty acid esters were high in biscuits, fats and oils, snacks and Chinese pastry with mean bound 3-MCPD levels of 440, 390, 270 and 270 μg kg⁻¹, respectively. The dietary exposures to bound 3-MCPD of average and high adult consumers were estimated to be 0.20 and 0.53 μg kg bw⁻¹ day⁻¹, respectively. The primary toxicological concern of 3-MCPD fatty acid esters is its potential to release 3-MCPD in vivo during digestion in the gastrointestinal tract. 3-MCPD would affect the kidney, the central nervous system and the male reproductive system of rats. Assuming that 100% of the 3-MCPD was released from 3-MCPD fatty acid esters by hydrolysis in the digestive system, the dietary exposures to 3-MCPD for average and high adult consumers were only 10% and 26% of the provisional maximum tolerable daily intake (PMTDI) of 3-MCPD established by the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives (JECFA) (2 μg kg bw⁻¹ day⁻¹), respectively. The results suggest that both average and high adult consumers are unlikely to experience major toxicological effects of 3-MCPD.

[Application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment].

PubMed

Pang, Yan-Xia; Zhang, Jian; Yang, Cheng-Long; Cang, Yong; Wang, Xue-Ling

2011-06-01

Study on the application of WAIS-RC short forms and adult intelligence disability scale in mental impairment assessment. Mental impairment assessment cases between July 2009 and March 2011 in judicial appraisal institute of Taizhou University were collected. Assessment results obtained with the WAIS-RC short forms and adult intelligence disability scale were compared with the experts assessing conclusions and analyzed using SPSS 11.5 software. Assessment results with the two scales did not fully comply with the expert's conclusions, with reliability coefficient were 0.785 and 0.940 respectively, correlation coefficient were 0.850 and 0.922 respectively. The intelligence assessment was influenced by many factors. When the appraised individuals had nerve dysfunction and mild intelligence disability or mental disorders, the two scales should be used together. When the appraised individuals had moderate intelligence disability or mental disorders, adult intelligence disability scale had advantage.

Retinopathy of Prematurity-assist: Novel Software for Detecting Plus Disease

PubMed Central

Pour, Elias Khalili; Pourreza, Hamidreza; Zamani, Kambiz Ameli; Mahmoudi, Alireza; Sadeghi, Arash Mir Mohammad; Shadravan, Mahla; Karkhaneh, Reza; Pour, Ramak Rouhi

2017-01-01

Purpose To design software with a novel algorithm, which analyzes the tortuosity and vascular dilatation in fundal images of retinopathy of prematurity (ROP) patients with an acceptable accuracy for detecting plus disease. Methods Eighty-seven well-focused fundal images taken with RetCam were classified to three groups of plus, non-plus, and pre-plus by agreement between three ROP experts. Automated algorithms in this study were designed based on two methods: the curvature measure and distance transform for assessment of tortuosity and vascular dilatation, respectively as two major parameters of plus disease detection. Results Thirty-eight plus, 12 pre-plus, and 37 non-plus images, which were classified by three experts, were tested by an automated algorithm and software evaluated the correct grouping of images in comparison to expert voting with three different classifiers, k-nearest neighbor, support vector machine and multilayer perceptron network. The plus, pre-plus, and non-plus images were analyzed with 72.3%, 83.7%, and 84.4% accuracy, respectively. Conclusions The new automated algorithm used in this pilot scheme for diagnosis and screening of patients with plus ROP has acceptable accuracy. With more improvements, it may become particularly useful, especially in centers without a skilled person in the ROP field. PMID:29022295

Impact of Expert Teaching Quality on Novice Academic Performance in the Jigsaw Cooperative Learning Method

NASA Astrophysics Data System (ADS)

Berger, Roland; Hänze, Martin

2015-01-01

We assessed the impact of expert students' instructional quality on the academic performance of novice students in 12th-grade physics classes organized in an expert model of cooperative learning ('jigsaw classroom'). The instructional quality of 129 expert students was measured by a newly developed rating system. As expected, when aggregating across all four subtopics taught, regression analysis revealed that academic performance of novice students increases with the quality of expert students' instruction. The difficulty of subtopics, however, moderates this effect: higher instructional quality of more difficult subtopics did not lead to better academic performance of novice students. We interpret this finding in the light of Cognitive Load Theory. Demanding tasks cause high intrinsic cognitive load and hindered the novice students' learning.

Dramatically Polarized Opinion on the Role of Brachytherapy Boost in Management of High-risk Prostate Cancer: A Survey of North American Genitourinary Expert Radiation Oncologists.

PubMed

McClelland, Shearwood; Sandler, Kiri A; Degnin, Catherine; Chen, Yiyi; Mitin, Timur

2018-06-01

Three randomized clinical trials have established brachytherapy (BT) boost in combination with external beam radiation therapy (EBRT) and androgen deprivation therapy (ADT) as superior to definitive EBRT and ADT alone in terms of biochemical control (but not overall survival) at the expense of increased toxicity in men with high-risk (HR) prostate cancer (PCa). The current view regarding these 2 treatment algorithms among North American genitourinary (GU) experts is not known. A survey was distributed to 88 practicing North American GU physicians serving on decision-making committees of cooperative group research organizations. Questions pertained to opinions regarding BT as monotherapy for low-risk PCa and BT boost for HR PCa. Responders were asked to self-identify as BT experts versus non-experts. Treatment recommendations were correlated with practice patterns using the Fisher exact test. Forty-two radiation oncologists completed the survey, of whom 23 (55%) recommend EBRT and ADT alone and 19 (45%) recommend addition of BT boost. Twenty-five participants (60%) identified themselves as BT experts. Nearly 90% of those recommending BT boost were BT experts versus approximately 10% of non-BT experts (P < .001). Responders who recommended BT monotherapy as first-choice treatment for low-risk PCa were more likely to recommend BT boost for HR PCa (P < .0001). There is a dramatic polarization in opinions regarding incorporation of BT boost into EBRT + ADT therapy for patients with HR PCa among North American GU radiation oncology experts, who serve on decision-making committees and influence the national treatment guidelines and future clinical trials. Those who identify themselves as BT experts are significantly more likely to recommend BT boost. These findings are likely to influence the national guidelines and implementation of BT boost in current and future North American PCa clinical studies. Copyright © 2018 Elsevier Inc. All rights reserved.

ISTAR: Intelligent System for Telemetry Analysis in Real-time

NASA Technical Reports Server (NTRS)

Simmons, Charles

1994-01-01

The intelligent system for telemetry analysis in real-time (ISTAR) is an advanced vehicle monitoring environment incorporating expert systems, analysis tools, and on-line hypermedia documentation. The system was developed for the Air Force Space and Missile Systems Center (SMC) in Los Angeles, California, in support of the inertial upper stage (IUS) booster vehicle. Over a five year period the system progressed from rapid prototype to operational system. ISTAR has been used to support five IUS missions and countless mission simulations. There were a significant number of lessons learned with respect to integrating an expert system capability into an existing ground system.

Quantifying catchment water balances and their uncertainties by expert elicitation

NASA Astrophysics Data System (ADS)

Sebok, Eva; Refsgaard, Jens Christian; Warmink, Jord J.; Stisen, Simon; Høgh Jensen, Karsten

2017-04-01

The increasing demand on water resources necessitates a more responsible and sustainable water management requiring a thorough understanding of hydrological processes both on small scale and on catchment scale. On catchment scale, the characterization of hydrological processes is often carried out by calculating a water balance based on the principle of mass conservation in hydrological fluxes. Assuming a perfect water balance closure and estimating one of these fluxes as a residual of the water balance is a common practice although this estimate will contain uncertainties related to uncertainties in the other components. Water balance closure on the catchment scale is also an issue in Denmark, thus, it was one of the research objectives of the HOBE hydrological observatory, that has been collecting data in the Skjern river catchment since 2008. Water balance components in the 1050 km2 Ahlergaarde catchment and the nested 120 km2 Holtum catchment, located in the glacial outwash plan of the Skjern catchment, were estimated using a multitude of methods. As the collected data enables the complex assessment of uncertainty of both the individual water balance components and catchment-scale water balances, the expert elicitation approach was chosen to integrate the results of the hydrological observatory. This approach relies on the subjective opinion of experts whose available knowledge and experience about the subject allows to integrate complex information from multiple sources. In this study 35 experts were involved in a multi-step elicitation process with the aim of (1) eliciting average annual values of water balance components for two nested catchments and quantifying the contribution of different sources of uncertainties to the total uncertainty in these average annual estimates; (2) calculating water balances for two catchments by reaching consensus among experts interacting in form of group discussions. To address the complex problem of water balance closure, the water balance was separated into five components: precipitation, evapotranspiration, surface runoff, recharge and subsurface outflow. During the study, experts first participated in individual interviews where they gave their opinion on the probability distribution of their water balance component of interest. The average annual values and uncertainty of water balance components and catchment-scale water balances were obtained at a later stage by reaching consensus during group discussions. The obtained water balance errors for the Ahlergaarde catchment and the Holtum catchment were -5 and -62 mm/yr, respectively, with an uncertainty of 66 and 86 mm/yr, respectively. As an advantage of the expert elicitation, drawing on the intuitive experience and capabilities of experts to assess complex, site-specific problems, not only the uncertainty of the water balance error was quantified, but the uncertainty of individual water balance components as well.

The Evonik-Mainz Eye Care-Study (EMECS): Development of an Expert System for Glaucoma Risk Detection in a Working Population

PubMed Central

Wahl, Jochen; Barleon, Lorenz; Morfeld, Peter; Lichtmeß, Andrea; Haas-Brähler, Sibylle; Pfeiffer, Norbert

2016-01-01

Purpose To develop an expert system for glaucoma screening in a working population based on a human expert procedure using images of optic nerve head (ONH), visual field (frequency doubling technology, FDT) and intraocular pressure (IOP). Methods 4167 of 13037 (32%) employees between 40 and 65 years of Evonik Industries were screened. An experienced glaucoma expert (JW) assessed papilla parameters and evaluated all individual screening results. His classification into “no glaucoma”, “possible glaucoma” and “probable glaucoma” was defined as “gold standard”. A screening model was developed which was tested versus the gold-standard. This model took into account the assessment of the ONH. Values and relationships of CDR and IOP and the FDT were considered additionally and a glaucoma score was generated. The structure of the screening model was specified a priori whereas values of the parameters were chosen post-hoc to optimize sensitivity and specificity of the algorithm. Simple screening models based on IOP and / or FDT were investigated for comparison. Results 111 persons (2.66%) were classified as glaucoma suspects, thereof 13 (0.31%) as probable and 98 (2.35%) as possible glaucoma suspects by the expert. Re-evaluation by the screening model revealed a sensitivity of 83.8% and a specificity of 99.6% for all glaucoma suspects. The positive predictive value of the model was 80.2%, the negative predictive value 99.6%. Simple screening models showed insufficient diagnostic accuracy. Conclusion Adjustment of ONH and symmetry parameters with respect to excavation and IOP in an expert system produced sufficiently satisfying diagnostic accuracy. This screening model seems to be applicable in such a working population with relatively low age and low glaucoma prevalence. Different experts should validate the model in different populations. PMID:27479301

An exploration of partnership through interactions between young 'expert' patients with cystic fibrosis and healthcare professionals.

PubMed

MacDonald, Kath; Irvine, Lindesay; Smith, Margaret Coulter

2015-12-01

To explore how young 'expert patients' living with Cystic Fibrosis and the healthcare professionals with whom they interact perceive partnership and negotiate care. Modern healthcare policy encourages partnership, engagement and self-management of long-term conditions. This philosophy is congruent with the model adopted in the care of those with Cystic Fibrosis, where self-management, trust and mutual respect are perceived to be integral to the development of the ongoing patient/professional relationship. Self-management is associated with the term; 'expert patient'; an individual with a long-term condition whose knowledge and skills are valued and used in partnership with healthcare professionals. However, the term 'expert patient' is debated in the literature as are the motivation for its use and the assumptions implicit in the term. A qualitative exploratory design informed by Interpretivism and Symbolic Interactionism was conducted. Thirty-four consultations were observed and 23 semi-structured interviews conducted between 10 patients, 2 carers and 12 healthcare professionals. Data were analysed thematically using the five stages of 'Framework' a matrix-based qualitative data analysis approach and were subject to peer review and respondent validation. The study received full ethical approval. Three main themes emerged; experiences of partnership, attributes of the expert patient and constructions of illness. Sub-themes of the 'ceremonial order of the clinic', negotiation and trust in relationships and perceptions of the expert patient are presented. The model of consultation may be a barrier to person-centred care. Healthcare professionals show leniency in negotiations, but do not always trust patients' accounts. The term 'expert patient' is unpopular and remains contested. Gaining insight into structures and processes that enable or inhibit partnership can lead to a collaborative approach to service redesign and a revision of the consultation model. © 2015 John Wiley & Sons Ltd.

Assessment of using digital manipulation tools for diagnosing mandibular radiolucent lesions

PubMed Central

Raitz, R; Assunção Junior, JNR; Fenyo-Pereira, M; Correa, L; de Lima, LP

2012-01-01

Objective The purpose of this study was to analyse the use of digital tools for image enhancement of mandibular radiolucent lesions and the effects of this manipulation on the percentage of correct radiographic diagnoses. Methods 24 panoramic radiographs exhibiting radiolucent lesions were selected, digitized and evaluated by non-experts (undergraduate and newly graduated practitioners) and by professional experts in oral diagnosis. The percentages of correct and incorrect diagnoses, according to the use of brightness/contrast, sharpness, inversion, highlight and zoom tools, were compared. All dental professionals made their evaluations without (T1) and with (T2) a list of radiographic diagnostic parameters. Results Digital tools were used with low frequency mainly in T2. The most preferred tool was sharpness (45.2%). In the expert group, the percentage of correct diagnoses did not change when any of the digital tools were used. For the non-expert group, there was an increase in the frequency of correct diagnoses when brightness/contrast was used in T2 (p=0.008) and when brightness/contrast and sharpness were not used in T1 (p=0.027). The use or non-use of brightness/contrast, zoom and sharpness showed moderate agreement in the group of experts [kappa agreement coefficient (κ)=0.514, 0.425 and 0.335, respectively]. For the non-expert group there was slight agreement for all the tools used (κ≤0.237). Conclusions Consulting the list of radiographic parameters before image manipulation reduced the frequency of tool use in both groups of examiners. Consulting the radiographic parameters with the use of some digital tools was important for improving correct diagnosis only in the group of non-expert examiners. PMID:22116126

Assessment of using digital manipulation tools for diagnosing mandibular radiolucent lesions.

PubMed

Raitz, R; Assunção Junior, J N R; Fenyo-Pereira, M; Correa, L; de Lima, L P

2012-03-01

The purpose of this study was to analyse the use of digital tools for image enhancement of mandibular radiolucent lesions and the effects of this manipulation on the percentage of correct radiographic diagnoses. 24 panoramic radiographs exhibiting radiolucent lesions were selected, digitized and evaluated by non-experts (undergraduate and newly graduated practitioners) and by professional experts in oral diagnosis. The percentages of correct and incorrect diagnoses, according to the use of brightness/contrast, sharpness, inversion, highlight and zoom tools, were compared. All dental professionals made their evaluations without (T₁) and with (T₂) a list of radiographic diagnostic parameters. Digital tools were used with low frequency mainly in T₂. The most preferred tool was sharpness (45.2%). In the expert group, the percentage of correct diagnoses did not change when any of the digital tools were used. For the non-expert group, there was an increase in the frequency of correct diagnoses when brightness/contrast was used in T₂ (p=0.008) and when brightness/contrast and sharpness were not used in T₁ (p=0.027). The use or non-use of brightness/contrast, zoom and sharpness showed moderate agreement in the group of experts [kappa agreement coefficient (κ) = 0.514, 0.425 and 0.335, respectively]. For the non-expert group there was slight agreement for all the tools used (κ ≤ 0.237). Consulting the list of radiographic parameters before image manipulation reduced the frequency of tool use in both groups of examiners. Consulting the radiographic parameters with the use of some digital tools was important for improving correct diagnosis only in the group of non-expert examiners.

New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS).

PubMed

Sieper, J; van der Heijde, D; Landewé, R; Brandt, J; Burgos-Vagas, R; Collantes-Estevez, E; Dijkmans, B; Dougados, M; Khan, M A; Leirisalo-Repo, M; van der Linden, S; Maksymowych, W P; Mielants, H; Olivieri, I; Rudwaleit, M

2009-06-01

Inflammatory back pain (IBP) is an important clinical symptom in patients with axial spondyloarthritis (SpA), and relevant for classification and diagnosis. In the present report, a new approach for the development of IBP classification criteria is discussed. Rheumatologists (n = 13) who are experts in SpA took part in a 2-day international workshop to investigate 20 patients with back pain and possible SpA. Each expert documented the presence/absence of clinical parameters typical for IBP, and judged whether IBP was considered present or absent based on the received information. This expert judgement was used as the dependent variable in a logistic regression analysis in order to identify those individual IBP parameters that contributed best to a diagnosis of IBP. The new set of IBP criteria was validated in a separate cohort of patients (n = 648). Five parameters best explained IBP according to the experts. These were: (1) improvement with exercise (odds ratio (OR) 23.1); (2) pain at night (OR 20.4); (3) insidious onset (OR 12.7); (4) age at onset <40 years (OR 9.9); and (5) no improvement with rest (OR 7.7). If at least four out of these five parameters were fulfilled, the criteria had a sensitivity of 77.0% and specificity of 91.7% in the patients participating in the workshop, and 79.6% and 72.4%, respectively, in the validation cohort. This new approach with real patients defines a set of IBP definition criteria using overall expert judgement on IBP as the gold standard. The IBP experts' criteria are robust, easy to apply and have good face validity.

The Evonik-Mainz Eye Care-Study (EMECS): Development of an Expert System for Glaucoma Risk Detection in a Working Population.

PubMed

Wahl, Jochen; Barleon, Lorenz; Morfeld, Peter; Lichtmeß, Andrea; Haas-Brähler, Sibylle; Pfeiffer, Norbert

2016-01-01

To develop an expert system for glaucoma screening in a working population based on a human expert procedure using images of optic nerve head (ONH), visual field (frequency doubling technology, FDT) and intraocular pressure (IOP). 4167 of 13037 (32%) employees between 40 and 65 years of Evonik Industries were screened. An experienced glaucoma expert (JW) assessed papilla parameters and evaluated all individual screening results. His classification into "no glaucoma", "possible glaucoma" and "probable glaucoma" was defined as "gold standard". A screening model was developed which was tested versus the gold-standard. This model took into account the assessment of the ONH. Values and relationships of CDR and IOP and the FDT were considered additionally and a glaucoma score was generated. The structure of the screening model was specified a priori whereas values of the parameters were chosen post-hoc to optimize sensitivity and specificity of the algorithm. Simple screening models based on IOP and / or FDT were investigated for comparison. 111 persons (2.66%) were classified as glaucoma suspects, thereof 13 (0.31%) as probable and 98 (2.35%) as possible glaucoma suspects by the expert. Re-evaluation by the screening model revealed a sensitivity of 83.8% and a specificity of 99.6% for all glaucoma suspects. The positive predictive value of the model was 80.2%, the negative predictive value 99.6%. Simple screening models showed insufficient diagnostic accuracy. Adjustment of ONH and symmetry parameters with respect to excavation and IOP in an expert system produced sufficiently satisfying diagnostic accuracy. This screening model seems to be applicable in such a working population with relatively low age and low glaucoma prevalence. Different experts should validate the model in different populations.

Bothered by abstractness or engaged by cohesion? Experts' explanations enhance novices' deep-learning.

PubMed

Lachner, Andreas; Nückles, Matthias

2015-03-01

Experts' explanations have been shown to better enhance novices' transfer as compared with advanced students' explanations. Based on research on expertise and text comprehension, we investigated whether the abstractness or the cohesion of experts' and intermediates' explanations accounted for novices' learning. In Study 1, we showed that the superior cohesion of experts' explanations accounted for most of novices' transfer, whereas the degree of abstractness did not impact novices' transfer performance. In Study 2, we investigated novices' processing while learning with experts' and intermediates' explanations. We found that novices studying experts' explanations actively self-regulated their processing of the explanations, as they showed mainly deep-processing activities, whereas novices learning with intermediates' explanations were mainly engaged in shallow-processing activities by paraphrasing the explanations. Thus, we concluded that subject-matter expertise is a crucial prerequisite for instructors. Despite the abstract character of experts' explanations, their subject-matter expertise enables them to generate highly cohesive explanations that serve as a valuable scaffold for students' construction of flexible knowledge by engaging them in deep-level processing. PsycINFO Database Record (c) 2015 APA, all rights reserved.

An Intervention Based on Video Feedback and Questioning to Improve Tactical Knowledge in Expert Female Volleyball Players.

PubMed

Moreno, M Perla; Moreno, Alberto; García-González, Luis; Ureña, Aurelio; Hernández, César; Del Villar, Fernando

2016-06-01

This study applied an intervention program, based on video feedback and questioning, to expert female volleyball players to improve their tactical knowledge. The sample consisted of eight female attackers (26 ± 2.6 years old) from the Spanish National Volleyball Team, who were divided into an experimental group (n = 4) and a control group (n = 4). The video feedback and questioning program applied in the study was developed over eight reflective sessions and consisted of three phases: viewing of the selected actions, self-analysis and reflection by the attacker, and joint player-coach analysis. The attackers were videotaped in an actual game and four clips (situations) of each of the attackers were chosen for each reflective session. Two of the clips showed a correct action by the attacker, and two showed an incorrect decision. Tactical knowledge was measured by problem representation with a verbal protocol. The members of the experimental group showed adaptations in long-term memory, significantly improving their tactical knowledge. With respect to conceptual content, there was an increase in the total number of conditions verbalized by the players; with respect to conceptual sophistication, there was an increase in the indication of appropriate conditions with two or more details; and finally, with respect to conceptual structure, there was an increase in the use of double or triple conceptual structures. The intervention program, based on video feedback and questioning, in addition to on-court training sessions of expert volleyball players, appears to improve the athletes' tactical knowledge. © The Author(s) 2016.

Three approaches to define desired soil organic matter contents.

PubMed

Sparling, G; Parfitt, R L; Hewitt, A E; Schipper, L A

2003-01-01

Soil organic C is often suggested as an indicator of soil quality, but desirable targets are rarely specified. We tested three approaches to define maximum and lowest desirable soil C contents for four New Zealand soil orders. Approach 1 used the New Zealand National Soils Database (NSD). The maximum C content was defined as the median value of long-term pastures, and the lower quartile defined the lowest desirable soil C content. Approach 2 used the CENTURY model to predict maximum C contents of long-term pasture. Lowest desirable content was defined by the level that still allowed recovery to 80% of the maximum C content over 25 yr. Approach 3 used an expert panel to define desirable C contents based on production and environmental criteria. Median C contents (0-20 cm) for the Recent, Granular, Melanic, and Allophanic orders were 72, 88, 98, 132 Mg ha(-1), and similar to contents predicted by the CENTURY model (78, 93, 102, and 134 Mg ha(-1), respectively). Lower quartile values (54, 78, 73, and 103 Mg ha(-1), respectively) were similar to the lowest desirable C contents calculated by CENTURY (55, 54, 67, and 104 Mg ha(-1), respectively). Expert opinion was that C contents could be depleted below these values with tolerable effects on production but less so for the environment. The CENTURY model is our preferred approach for setting soil organic C targets, but the model needs calibrating for other soils and land uses. The statistical and expert opinion approaches are less defensible in setting lower limits for desirable C contents.

Classification of Cough as a Symptom in Adults and Management Algorithms: CHEST Guideline and Expert Panel Report.

PubMed

Irwin, Richard S; French, Cynthia L; Chang, Anne B; Altman, Kenneth W

2018-01-01

We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework. Data from the systematic reviews in conjunction with patient values and preferences and the clinical context were used to form recommendations or suggestions. Delphi methodology was used to obtain the final grading. With respect to acute cough (< 3 weeks), only three studies met our criteria for quality assessment, and all had a high risk of bias. As predicted by the 2006 CHEST Cough Guidelines, the most common causes were respiratory infections, most likely of viral cause, followed by exacerbations of underlying diseases such as asthma and COPD and pneumonia. The subjects resided on three continents: North America, Europe, and Asia. With respect to subacute cough (duration, 3-8 weeks), only two studies met our criteria for quality assessment, and both had a high risk of bias. As predicted by the 2006 guidelines, the most common causes were postinfectious cough and exacerbation of underlying diseases such as asthma, COPD, and upper airway cough syndrome (UACS). The subjects resided in countries in Asia. With respect to chronic cough (> 8 weeks), 11 studies met our criteria for quality assessment, and all had a high risk of bias. As predicted by the 2006 guidelines, the most common causes were UACS from rhinosinus conditions, asthma, gastroesophageal reflux disease, nonasthmatic eosinophilic bronchitis, combinations of these four conditions, and, less commonly, a variety of miscellaneous conditions and atopic cough in Asian countries. The subjects resided on four continents: North America, South America, Europe, and Asia. Although the quality of evidence was low, the published literature since 2006 suggests that CHEST's 2006 Cough Guidelines and management algorithms for acute, subacute, and chronic cough in adults appeared useful in diagnosing and treating patients with cough around the globe. These same algorithms have been updated to reflect the advances in cough management as of 2017. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Controlling Real-Time Processes On The Space Station With Expert Systems

NASA Astrophysics Data System (ADS)

Leinweber, David; Perry, John

1987-02-01

Many aspects of space station operations involve continuous control of real-time processes. These processes include electrical power system monitoring, propulsion system health and maintenance, environmental and life support systems, space suit checkout, on-board manufacturing, and servicing of attached vehicles such as satellites, shuttles, orbital maneuvering vehicles, orbital transfer vehicles and remote teleoperators. Traditionally, monitoring of these critical real-time processes has been done by trained human experts monitoring telemetry data. However, the long duration of space station missions and the high cost of crew time in space creates a powerful economic incentive for the development of highly autonomous knowledge-based expert control procedures for these space stations. In addition to controlling the normal operations of these processes, the expert systems must also be able to quickly respond to anomalous events, determine their cause and initiate corrective actions in a safe and timely manner. This must be accomplished without excessive diversion of system resources from ongoing control activities and any events beyond the scope of the expert control and diagnosis functions must be recognized and brought to the attention of human operators. Real-time sensor based expert systems (as opposed to off-line, consulting or planning systems receiving data via the keyboard) pose particular problems associated with sensor failures, sensor degradation and data consistency, which must be explicitly handled in an efficient manner. A set of these systems must also be able to work together in a cooperative manner. This paper describes the requirements for real-time expert systems in space station control, and presents prototype implementations of space station expert control procedures in PICON (process intelligent control). PICON is a real-time expert system shell which operates in parallel with distributed data acquisition systems. It incorporates a specialized inference engine with a specialized scheduling portion specifically designed to match the allocation of system resources with the operational requirements of real-time control systems. Innovative knowledge engineering techniques used in PICON to facilitate the development of real-time sensor-based expert systems which use the special features of the inference engine are illustrated in the prototype examples.

Causality Assessment in Drug-Induced Liver Injury Using a Structured Expert Opinion Process: Comparison to the Roussel-Uclaf Causality Assessment Method

PubMed Central

Rockey, Don C.; Seeff, Leonard B.; Rochon, James; Freston, James; Chalasani, Naga; Bonacini, Maurizio; Fontana, Robert J.; Hayashi, Paul H.

2011-01-01

Drug-induced liver injury (DILI) is largely a diagnosis of exclusion and is therefore challenging. The US Drug-Induced Liver Injury Network (DILIN) prospective study used two methods to assess DILI causality: a structured expert opinion process and the Roussel-Uclaf Causality Assessment Method (RUCAM). Causality assessment focused on detailed clinical and laboratory data from patients with suspected DILI. The adjudication process used standardized numerical and descriptive definitions and scored cases as definite, highly likely, probable, possible, or unlikely. Results of the structured expert opinion procedure were compared with those derived by the RUCAM approach. Among 250 patients with suspected DILI, the expert opinion adjudication process scored 78 patients (31%) as definite, 102 (41%) as highly likely, 37 (15%) as probable, 25 (10%) as possible, and 8 (3%) as unlikely. Among 187 enrollees who had received a single implicated drug, initial complete agreement was reached for 50 (27%) with the expert opinion process and for 34 (19%) with a five-category RUCAM scale (P = 0.08), and the two methods demonstrated a modest correlation with each other (Spearman's r = 0.42, P = 0.0001). Importantly, the RUCAM approach substantially shifted the causality likelihood toward lower probabilities in comparison with the DILIN expert opinion process. Conclusion The structured DILIN expert opinion process produced higher agreement rates and likelihood scores than RUCAM in assessing causality, but there was still considerable interobserver variability in both. Accordingly, a more objective, reliable, and reproducible means of assessing DILI causality is still needed. PMID:20512999

An evaluation of Ada for Al applications

NASA Technical Reports Server (NTRS)

Wallace, David R.

1986-01-01

Expert system technology seems to be the most promising type of Artificial Intelligence (AI) application for Ada. An expert system implemented with an expert system shell provides a highly structured approach that fits well with the structured approach found in Ada systems. The current commercial expert system shells use Lisp. In this highly structured situation a shell could be built that used Ada just as well. On the other hand, if it is necessary to deal with some AI problems that are not suited to expert systems, the use of Ada becomes more problematical. Ada was not designed as an AI development language, and is not suited to that. It is possible that an application developed in say, Common Lisp could be translated to Ada for actual use in a particular application, but this could be difficult. Some standard Ada packages could be developed to make such a translation easier. If the most general AI programs need to be dealt with, a Common Lisp system integrated with the Ada Environment is probably necessary. Aside from problems with language features, Ada, by itself, is not well suited to the prototyping and incremental development that is well supported by Lisp.

[Expert consensus on prescription comment of Chinese traditional patent medicine for promoting the rational use of drugs in Beijing].

PubMed

Jin, Rui; Zhao, Kui-Jun; Guo, Gui-Ming; Zhang, Bing; Wang, Yu-Guang; Xue, Chun-Miao; Yang, Yi-Heng; Wang, Li-Xia; Li, Guo-Hui; Tang, Jin-Fa; Nie, Li-Xing; Zhang, Xiang-Lin; Zhao, Ting-Ting; Zhang, Yi; Yan, Can; Yuan, Suo-Zhong; Sun, Lu-Lu; Feng, Xing-Zhong; Yan, Dan

2018-03-01

With the growth of number of Chinese patent medicines and clinical use, the rational use of Chinese medicine is becoming more and more serious. Due to the complexity of Chinese medicine theory and the uncertainty of clinical application, the prescription review of Chinese patent medicine always relied on experience in their respective, leading to the uncontrolled of clinical rational use. According to the traditional Chinese medicine (TCM) theory and characteristics of the unique clinical therapeutics, based on the practice experience and expertise comments, our paper formed the expert consensus on the prescription review of Chinese traditional patent medicine for promoting the rational use of drugs in Beijing. The objective, methods and key points of prescription review of Chinese patent medicine, were included in this expert consensus, in order to regulate the behavior of prescription and promote rational drug use. Copyright© by the Chinese Pharmaceutical Association.

[Progressive noise induced hearing loss caused by hearing AIDS, a dilemma for the worker and the expert alike].

PubMed

Feldmann, H

2001-12-01

Investigating cases of noise induced hearing loss the expert is often confronted with the situation that the hearing loss is progressive although the noise exposure has been reduced to almost non-damaging levels. Other causes such as age, hereditary deafness, head injuries, blasts, internal diseases can be excluded. Hearing aids as sources of damaging noise? By consulting the protocol of the hearing-aid acoustician and by own examinations the expert should obtain the following data: loudness level that yields best discrimination score of speech; level of discomfort for tones and speech, discrimination score that is achieved under free field condition with a speech level of 65 dB, using the hearing aids. Furthermore he should explore the circumstances under which the hearing aids are used: how many hours per day, at what occasions etc.? It is likely that in using the hearing aids they are adjusted to emit an intensity level identical to the one yielding the optimal discrimination score. If this e. g. is 100 dB and the hearing aids are used for 2 hours per day this would be equivalent to an exposure to industrial noise of 94 dB (A) for 8 hours daily without ear protection. Among all individuals working under industrial noise exposure today only about 1 - 2 % having unusually vulnerable inner ears will suffer a noise induced hearing loss. On the other hand workers in industrial noise are accustomed to loud noise levels, usually have a raised threshold of discomfort and therefore are likely to adjust their hearing aids to such high intensities. The expert will have to decide whether in an individual case the industrial noise exposure or the use of the hearing aids is the dominant risk for further damage. The consequences in respect to the regulations of the workers' health insurance are discussed.

The potential for intelligent decision support systems to improve the quality and consistency of medication reviews.

PubMed

Bindoff, I; Stafford, A; Peterson, G; Kang, B H; Tenni, P

2012-08-01

Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided. The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into improved medication usage if they were implemented into routine use. © 2011 Blackwell Publishing Ltd.

Analysis of free online physician advice services.

PubMed

Cohen, Raphael; Elhadad, Michael; Birk, Ohad

2013-01-01

Online Consumer Health websites are a major source of information for patients worldwide. We focus on another modality, online physician advice. We aim to evaluate and compare the freely available online expert physicians' advice in different countries, its scope and the type of content provided. Using automated methods for information retrieval and analysis, we compared consumer health portals from the US, Canada, the UK and Israel (WebMD,NetDoctor,AskTheDoctor and BeOK). The evaluated content was generated between 2002 and 2011. We analyzed the different sites, looking at the distribution of questions in the various health topics, answer lengths and content type. Answers could be categorized into longer broad-educational answers versus shorter patient-specific ones, with different physicians having personal preferences as to answer type. The Israeli website BeOK, providing 10 times the number of answers than in the other three health portals, supplied answers that are shorter on average than in the other websites. Response times in these sites may be rapid with 32% of the WebMD answers and 64% of the BeOK answers provided in less than 24 hours. The voluntary contribution model used by BeOK and WebMD enables generation of large numbers of physician expert answers at low cost, providing 50,000 and 3,500 answers per year, respectively. Unlike health information in online databases or advice and support in patient-forums, online physician advice provides qualified specialists' responses directly relevant to the questions asked. Our analysis showed that high numbers of expert answers could be generated in a timely fashion using a voluntary model. The length of answers varied significantly between the internet sites. Longer answers were associated with educational content while short answers were associated with patient-specific content. Standard site-specific guidelines for expert answers will allow for more desirable content (educational content) or better throughput (patient-specific content).

Validation of a Full-Immersion Simulation Platform for Percutaneous Nephrolithotomy Using Three-Dimensional Printing Technology.

PubMed

Ghazi, Ahmed; Campbell, Timothy; Melnyk, Rachel; Feng, Changyong; Andrusco, Alex; Stone, Jonathan; Erturk, Erdal

2017-12-01

The restriction of resident hours with an increasing focus on patient safety and a reduced caseload has impacted surgical training. A complex and complication prone procedure such as percutaneous nephrolithotomy (PCNL) with a steep learning curve may create an unsafe environment for hands-on resident training. In this study, we validate a high fidelity, inanimate PCNL model within a full-immersion simulation environment. Anatomically correct models of the human pelvicaliceal system, kidney, and relevant adjacent structures were created using polyvinyl alcohol hydrogels and three-dimensional-printed injection molds. All steps of a PCNL were simulated including percutaneous renal access, nephroscopy, and lithotripsy. Five experts (>100 caseload) and 10 novices (<20 caseload) from both urology (full procedure) and interventional radiology (access only) departments completed the simulation. Face and content validity were calculated using model ratings for similarity to the real procedure and usefulness as a training tool. Differences in performance among groups with various levels of experience using clinically relevant procedural metrics were used to calculate construct validity. The model was determined to have an excellent face and content validity with an average score of 4.5/5.0 and 4.6/5.0, respectively. There were significant differences between novice and expert operative metrics including mean fluoroscopy time, the number of percutaneous access attempts, and number of times the needle was repositioned. Experts achieved better stone clearance with fewer procedural complications. We demonstrated the face, content, and construct validity of an inanimate, full task trainer for PCNL. Construct validity between experts and novices was demonstrated using incorporated procedural metrics, which permitted the accurate assessment of performance. While hands-on training under supervision remains an integral part of any residency, this full-immersion simulation provides a comprehensive tool for surgical skills development and evaluation before hands-on exposure.

A comprehensive information technology system to support physician learning at the point of care.

PubMed

Cook, David A; Sorensen, Kristi J; Nishimura, Rick A; Ommen, Steve R; Lloyd, Farrell J

2015-01-01

MayoExpert is a multifaceted information system integrated with the electronic medical record (EMR) across Mayo Clinic's multisite health system. It was developed as a technology-based solution to manage information, standardize clinical practice, and promote and document learning in clinical contexts. Features include urgent test result notifications; models illustrating expert-approved care processes; concise, expert-approved answers to frequently asked questions (FAQs); a directory of topic-specific experts; and a portfolio for provider licensure and credentialing. The authors evaluate MayoExpert's reach, effectiveness, adoption, implementation, and maintenance. Evaluation data sources included usage statistics, user surveys, and pilot studies.As of October 2013, MayoExpert was available at 94 clinical sites in 12 states and contained 1,368 clinical topics, answers to 7,640 FAQs, and 92 care process models. In 2012, MayoExpert was accessed at least once by 2,578/3,643 (71%) staff physicians, 900/1,374 (66%) midlevel providers, and 1,728/2,291 (75%) residents and fellows. In a 2013 survey of MayoExpert users with 536 respondents, all features were highly rated (≥67% favorable). More providers reported using MayoExpert to answer questions before/after than during patient visits (68% versus 36%). During November 2012 to April 2013, MayoExpert sent 1,660 notifications of new-onset atrial fibrillation and 1,590 notifications of prolonged QT. MayoExpert has become part of routine clinical and educational operations, and its care process models now define Mayo Clinic best practices. MayoExpert's infrastructure and content will continue to expand with improved templates and content organization, new care process models, additional notifications, better EMR integration, and improved support for credentialing activities.

Essential Concepts of Nanoscale Science and Technology for High School Students Based on a Delphi Study by the Expert Community

ERIC Educational Resources Information Center

Sakhnini, Sohair; Blonder, Ron

2015-01-01

Nanoscale science and technology (NST) is an important new field in modern science. In the current study, we seek to answer the question: "What are the essential concepts of NST that should be taught in high school"? A 3-round Delphi study methodology was applied based on 2 communities of experts in nanotechnology research and science…

Knowledge-Acquisition Tool For Expert System

NASA Technical Reports Server (NTRS)

Disbrow, James D.; Duke, Eugene L.; Regenie, Victoria A.

1988-01-01

Digital flight-control systems monitored by computer program that evaluates and recommends. Flight-systems engineers for advanced, high-performance aircraft use knowlege-acquisition tool for expert-system flight-status monitor suppling interpretative data. Interpretative function especially important in time-critical, high-stress situations because it facilitates problem identification and corrective strategy. Conditions evaluated and recommendations made by ground-based engineers having essential knowledge for analysis and monitoring of performances of advanced aircraft systems.

Classifying dysmorphic syndromes by using artificial neural network based hierarchical decision tree.

PubMed

Özdemir, Merve Erkınay; Telatar, Ziya; Eroğul, Osman; Tunca, Yusuf

2018-05-01

Dysmorphic syndromes have different facial malformations. These malformations are significant to an early diagnosis of dysmorphic syndromes and contain distinctive information for face recognition. In this study we define the certain features of each syndrome by considering facial malformations and classify Fragile X, Hurler, Prader Willi, Down, Wolf Hirschhorn syndromes and healthy groups automatically. The reference points are marked on the face images and ratios between the points' distances are taken into consideration as features. We suggest a neural network based hierarchical decision tree structure in order to classify the syndrome types. We also implement k-nearest neighbor (k-NN) and artificial neural network (ANN) classifiers to compare classification accuracy with our hierarchical decision tree. The classification accuracy is 50, 73 and 86.7% with k-NN, ANN and hierarchical decision tree methods, respectively. Then, the same images are shown to a clinical expert who achieve a recognition rate of 46.7%. We develop an efficient system to recognize different syndrome types automatically in a simple, non-invasive imaging data, which is independent from the patient's age, sex and race at high accuracy. The promising results indicate that our method can be used for pre-diagnosis of the dysmorphic syndromes by clinical experts.

Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application.

PubMed

Valle, Xavier; Alentorn-Geli, Eduard; Tol, Johannes L; Hamilton, Bruce; Garrett, William E; Pruna, Ricard; Til, Lluís; Gutierrez, Josep Antoni; Alomar, Xavier; Balius, Ramón; Malliaropoulos, Nikos; Monllau, Joan Carles; Whiteley, Rodney; Witvrouw, Erik; Samuelsson, Kristian; Rodas, Gil

2017-07-01

Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is essential for a full understanding of the injury and to optimize its management and return-to-play process. The ongoing failure to establish a classification system with broad acceptance has resulted from factors such as limited clinical applicability, and the inclusion of subjective findings and ambiguous terminology. The purpose of this article was to describe a classification system for muscle injuries with easy clinical application, adequate grouping of injuries with similar functional impairment, and potential prognostic value. This evidence-informed and expert consensus-based classification system for muscle injuries is based on a four-letter initialism system: MLG-R, respectively referring to the mechanism of injury (M), location of injury (L), grading of severity (G), and number of muscle re-injuries (R). The goal of the classification is to enhance communication between healthcare and sports-related professionals and facilitate rehabilitation and return-to-play decision making.

The impact of new and emerging technologies in the commercial aviation maintenance, repair, and overhaul industry a Delphi study

NASA Astrophysics Data System (ADS)

Gray, Janet

Purpose. The purpose of this study was to identify new or emerging technological trends and events that are likely to occur between now and 2017 that will have an impact on the commercial aviation maintenance, repair, and overhaul (MRO) industry. Further, it was the purpose of this study to examine those technological trends and events believed to provide the greatest impact and, given the experts' analysis, identify the feasibility of implementation. Methodology. This descriptive study utilized the Delphi method with a panel of twenty-four experts comprised of practitioners, theorists, and futurists. A priority matrix was utilized to determine the impact and feasibility of trend and events. Findings. The experts identified fifty-three trends and events that will impact the commercial aviation maintenance, repair, and overhaul (MRO) industry. Analysis of the priority matrix revealed eighteen trends and events were of high priority and high feasibility. Conclusions. The responses from the expert panel were examined and the findings analyzed. The following are the conclusions constructed from the data provided by the Delphi panel of experts: (1) the need to respond to the demands of the maintenance, repair, and overhaul (MRO) industry such as down time, efficiency, cost, and environmental concerns by implementing new technology, (2) the demand to integrate and implement new technology as indicative of the priority matrix scoring high importance/high feasibility, (3) to proactively address the inadequate professional development in new technologies, and (4) the consensus reached by the panel of experts of importance and feasibility of implementation of new technologies encompass eighteen trends and events. Implications and recommendations for action. The implementation of new and emerging technological advances in the commercial aviation maintenance, repair, and overhaul (MRO) industry between now and 2017 will be dependent on the technologies' capacity to reduce downtime and increase efficiency. In order to maintain America's global leadership in aviation, integration of innovated technology is key.

Quality assessment of expert answers to lay questions about cystic fibrosis from various language zones in Europe: the ECORN-CF project.

PubMed

d'Alquen, Daniela; De Boeck, Kris; Bradley, Judy; Vávrová, Věra; Dembski, Birgit; Wagner, Thomas O F; Pfalz, Annette; Hebestreit, Helge

2012-02-06

The European Centres of Reference Network for Cystic Fibrosis (ECORN-CF) established an Internet forum which provides the opportunity for CF patients and other interested people to ask experts questions about CF in their mother language. The objectives of this study were to: 1) develop a detailed quality assessment tool to analyze quality of expert answers, 2) evaluate the intra- and inter-rater agreement of this tool, and 3) explore changes in the quality of expert answers over the time frame of the project. The quality assessment tool was developed by an expert panel. Five experts within the ECORN-CF project used the quality assessment tool to analyze the quality of 108 expert answers published on ECORN-CF from six language zones. 25 expert answers were scored at two time points, one year apart. Quality of answers was also assessed at an early and later period of the project. Individual rater scores and group mean scores were analyzed for each expert answer. A scoring system and training manual were developed analyzing two quality categories of answers: content and formal quality. For content quality, the grades based on group mean scores for all raters showed substantial agreement between two time points, however this was not the case for the grades based on individual rater scores. For formal quality the grades based on group mean scores showed only slight agreement between two time points and there was also poor agreement between time points for the individual grades. The inter-rater agreement for content quality was fair (mean kappa value 0.232 ± 0.036, p < 0.001) while only slight agreement was observed for the grades of the formal quality (mean kappa value 0.105 ± 0.024, p < 0.001). The quality of expert answers was rated high (four language zones) or satisfactory (two language zones) and did not change over time. The quality assessment tool described in this study was feasible and reliable when content quality was assessed by a group of raters. Within ECORN-CF, the tool will help ensure that CF patients all over Europe have equal possibility of access to high quality expert advice on their illness. © 2012 d’Alquen et al; licensee BioMed Central Ltd.

Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

PubMed

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

2014-09-01

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. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. 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. 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. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

Self-Regulation of Beer Advertising: A Comparative Analysis of Perceived Violations by Adolescents and Experts.

PubMed

Vendrame, Alan; Silva, Rebeca; Xuan, Ziming; Sparks, Robert; Noel, Jonathan; Pinsky, Ilana

2015-09-01

We assessed the impact of the 2010 revisions to Brazil's self-regulatory alcohol marketing code using expert and adolescent raters. Five popular TV beer ads were selected. Ads were rated based on the 2010 Brazilian self-regulatory marketing code. The expert group (N = 31) represented health-related professions; the adolescent group (N = 110) were public high school students. At least 1 ad violated 11 of 17 guidelines included in the study. Ratings by experts and adolescents were similar. Both found violations in all sections of the self-regulatory code, but significant group differences were seen in applying the section that prohibits the promotion of excessive alcohol consumption, with experts identifying more violations than adolescents. Beer ads in the sample systematically violated the self-regulatory standards for alcohol advertising in Brazil according to both experts and youth. Public policies for more effective restrictions and prohibitions in alcohol ads should be considered. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

GenSAA: A tool for advancing satellite monitoring with graphical expert systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M.; Luczak, Edward C.

1993-01-01

During numerous contacts with a satellite each day, spacecraft analysts must closely monitor real time data for combinations of telemetry parameter values, trends, and other indications that may signify a problem or failure. As satellites become more complex and the number of data items increases, this task is becoming increasingly difficult for humans to perform at acceptable performance levels. At the NASA Goddard Space Flight Center, fault-isolation expert systems have been developed to support data monitoring and fault detection tasks in satellite control centers. Based on the lessons learned during these initial efforts in expert system automation, a new domain-specific expert system development tool named the Generic Spacecraft Analyst Assistant (GenSAA) is being developed to facilitate the rapid development and reuse of real-time expert systems to serve as fault-isolation assistants for spacecraft analysts. Although initially domain-specific in nature, this powerful tool will support the development of highly graphical expert systems for data monitoring purposes throughout the space and commercial industry.

The Generic Spacecraft Analyst Assistant (gensaa): a Tool for Developing Graphical Expert Systems

NASA Technical Reports Server (NTRS)

Hughes, Peter M.

1993-01-01

During numerous contacts with a satellite each day, spacecraft analysts must closely monitor real-time data. The analysts must watch for combinations of telemetry parameter values, trends, and other indications that may signify a problem or failure. As the satellites become more complex and the number of data items increases, this task is becoming increasingly difficult for humans to perform at acceptable performance levels. At NASA GSFC, fault-isolation expert systems are in operation supporting this data monitoring task. Based on the lessons learned during these initial efforts in expert system automation, a new domain-specific expert system development tool named the Generic Spacecraft Analyst Assistant (GenSAA) is being developed to facilitate the rapid development and reuse of real-time expert systems to serve as fault-isolation assistants for spacecraft analysts. Although initially domain-specific in nature, this powerful tool will readily support the development of highly graphical expert systems for data monitoring purposes throughout the space and commercial industry.

TRACING THE DEVELOPMENT OF TYPEWRITING SKILLS IN AN ADAPTIVE E-LEARNING ENVIRONMENT.

PubMed

van den Bergh, Mattis; Hofman, Abe D; Schmittmann, Verena D; van der Maas, Han L J

2015-12-01

Typewriting studies which compare novice and expert typists have suggested that highly trained typing skills involve cognitive process with an inner and outer loop, which regulate keystrokes and words, respectively. The present study investigates these loops longitudinally, using multi-level modeling of 1,091,707 keystroke latencies from 62 children (M age=12.6 yr.) following an online typing course. Using finger movement repetition as indicator of the inner loop and words typed as indicator of the outer loop, practicing keystroke latencies resulted in different developmental curves for each loop. Moreover, based on plateaus in the developmental curves, the inner loop seemed to require less practice to develop than the outer loop.

"Beards, Sandals, and Other Signs of Rugged Individualism": Masculine Culture within the Computing Professions.

PubMed

Ensmenger, Nathan

2015-01-01

Over the course of the 1960s and 1970s, male computer experts were able to successfully transform the "routine and mechanical" (and therefore feminized) activity of computer programming into a highly valued, well-paying, and professionally respectable discipline. They did so by constructing for themselves a distinctively masculine identity in which individual artistic genius, personal eccentricity, anti-authoritarian behavior, and a characteristic "dislike of activities involving human interaction" were mobilized as sources of personal and professional authority. This article explores the history of masculine culture and practices in computer programming, with a particular focus on the role of university computer centers as key sites of cultural formation and dissemination.

MOORE: A prototype expert system for diagnosing spacecraft problems

NASA Technical Reports Server (NTRS)

Howlin, Katherine; Weissert, Jerry; Krantz, Kerry

1988-01-01

MOORE is a rule-based, prototype expert system that assists in diagnosing operational Tracking and Data Relay Satellite (TDRS) problems. It is intended to assist spacecraft engineers at the TDRS ground terminal in trouble shooting problems that are not readily solved with routine procedures, and without expert counsel. An additional goal of the prototype system is to develop in-house expert system and knowledge engineering skills. The prototype system diagnoses antenna pointing and earth pointing problems that may occur within the TDRS Attitude Control System (ACS). Plans include expansion to fault isolation of problems in the most critical subsystems of the TDRS spacecraft. Long term benefits are anticipated with use of an expert system during future TDRS programs with increased mission support time, reduced problem solving time, and retained expert knowledge and experience. Phase 2 of the project is intended to provide NASA the necessary expertise and capability to define requirements, evaluate proposals, and monitor the development progress of a highly competent expert system for NASA's Tracking Data Relay Satellite. Phase 2 also envisions addressing two unexplored applications for expert systems, spacecraft integration and tests (I and T) and support to launch activities. The concept, goals, domain, tools, knowledge acquisition, developmental approach, and design of the expert system. It will explain how NASA obtained the knowledge and capability to develop the system in-house without assistance from outside consultants. Future plans will also be presented.

The KIDROP model of combining strategies for providing retinopathy of prematurity screening in underserved areas in India using wide-field imaging, tele-medicine, non-physician graders and smart phone reporting

PubMed Central

Vinekar, Anand; Gilbert, Clare; Dogra, Mangat; Kurian, Mathew; Shainesh, Gangadharan; Shetty, Bhujang; Bauer, Noel

2014-01-01

Aim: To report the Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) program for retinopathy of prematurity (ROP) screening in underserved rural areas using an indigenously developed tele-ROP model. Materials and Methods: KIDROP currently provides ROP screening and treatment services in three zones and 81 neonatal units in Karnataka, India. Technicians were trained to use a portable Retcam Shuttle (Clarity, USA) and validated against ROP experts performing indirect ophthalmoscopy. An indigenously developed 20-point score (STAT score) graded their ability (Level I to III) to image and decide follow-up based on a three-way algorithm. Images were also uploaded on a secure tele-ROP platform and accessed and reported by remote experts on their smart phones (iPhone, Apple). Results: 6339 imaging sessions of 1601 infants were analyzed. A level III technician agreed with 94.3% of all expert decisions. The sensitivity, specificity, positive predictive value and negative predictive value for treatment grade disease were 95.7, 93.2, 81.5 and 98.6 respectively. The kappa for technicians to decide discharge of babies was 0.94 (P < 0.001). Only 0.4% of infants needing treatment were missed. The kappa agreement of experts reporting on the iPhone vs Retcam for treatment requiring and mild ROP were 0.96 and 0.94 (P < 0.001) respectively. Conclusions: This is the first and largest real-world program to employ accredited non-physicians to grade and report ROP. The KIDROP tele-ROP model demonstrates that ROP services can be delivered to the outreach despite lack of specialists and may be useful in other middle-income countries with similar demographics. PMID:24492500

Impact of hospital and surgeon case volume on morbidity in colorectal endometriosis management: a plea to define criteria for expert centers.

PubMed

Bendifallah, Sofiane; Roman, Horace; Rubod, Chrystel; Leguevaque, Pierre; Watrelot, Antoine; Bourdel, Nicolas; Ballester, Marcos; Darai, Emile

2018-04-01

National and international guidelines recommend referring patients with severe forms of endometriosis to expert centers. However, there is a lack of clear criteria to define an expert center. We examined the roles of surgeon and hospital procedure volumes as determinants of morbidity in deep infiltrating endometriosis of the rectum and sigmoid colon (DIERS). We conducted a French retrospective multicenter study of hospital facilities performing colorectal surgery for DIERS in 2015. The primary end point was to analyze the relation between case volume and the incidence of complications. We estimated the optimal cut-off (OCO) determined by a minimal p-value approach. The study included 56 hospital facilities and collected data of 1135 cases of surgical management of colorectal endometriosis. The mean and median number of procedures per year and per surgeon were 9.17 and 5.58, respectively. The overall rate of grade III-V complication was 7.6% (82/1135). One grade V complication occurred. The rates of rectovaginal fistula, anastomotic leakage, pelvic abscess, and ureteral fistula were: 2.7% (31/1135), 0.79% (9/1135), 3.4% (39/1135), and 0.70% (8/1135), respectively. An OCO of 20 procedures per center and per year (p < 0.001) was defined. The OCO per surgeon and per year varied between seven (p = 0.007) and 13 procedures (p = 0.03). In a multivariate analysis, we found that only the volume of activity was independently correlated to complication outcomes (p = 0.0013). Our results contribute to providing objective morbidity data to determine criteria for defining expert centers for colorectal surgery for endometriosis.

Report of the experts' meeting on maritime transport in the Caribbean

DOT National Transportation Integrated Search

2000-11-01

A meeting of high-level experts in the area of maritime transport took place on 14 and 15 September 2000 at the Economic Commission for Latin America and the Caribbean (ECLAC) Subregional Headquarters in Port-of-Spain, Trinidad and Tobago. The purpos...

Priorities for Research in Agricultural Education.

ERIC Educational Resources Information Center

Silva-Guerrero, Luis; Sutphin, H. Dean

1990-01-01

Twenty agricultural education experts identified research topics and categories, which were then rated by 34 research experts (92 percent) and 49 department heads (79 percent). Highest ratings went to biotechnology, high technology, and agribusiness; agricultural education curriculum; and long-term impact and cost effectiveness of agricultural…

Expert system applications for army vehicle diagnostics

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

Halle, R.F.

1987-01-01

Bulky manuals, limited training procedures, and complex Automatic Test Equipment are but a few of the problems a mechanic must face when trying to repair many of the military's new and highly complex vehicle systems. Recent technological advances in Expert Systms has given the mechanic the potential to solve many of these problems and to actually enhance his maintenance proficiency. This paper describes both the history of and the future potential of the Expert System and how it could impact on the present military maintenance system.

Optical Coherence Tomography (OCT) Device Independent Intraretinal Layer Segmentation

PubMed Central

Ehnes, Alexander; Wenner, Yaroslava; Friedburg, Christoph; Preising, Markus N.; Bowl, Wadim; Sekundo, Walter; zu Bexten, Erdmuthe Meyer; Stieger, Knut; Lorenz, Birgit

2014-01-01

Purpose To develop and test an algorithm to segment intraretinal layers irrespectively of the actual Optical Coherence Tomography (OCT) device used. Methods The developed algorithm is based on the graph theory optimization. The algorithm's performance was evaluated against that of three expert graders for unsigned boundary position difference and thickness measurement of a retinal layer group in 50 and 41 B-scans, respectively. Reproducibility of the algorithm was tested in 30 C-scans of 10 healthy subjects each with the Spectralis and the Stratus OCT. Comparability between different devices was evaluated in 84 C-scans (volume or radial scans) obtained from 21 healthy subjects, two scans per subject with the Spectralis OCT, and one scan per subject each with the Stratus OCT and the RTVue-100 OCT. Each C-scan was segmented and the mean thickness for each retinal layer in sections of the early treatment of diabetic retinopathy study (ETDRS) grid was measured. Results The algorithm was able to segment up to 11 intraretinal layers. Measurements with the algorithm were within the 95% confidence interval of a single grader and the difference was smaller than the interindividual difference between the expert graders themselves. The cross-device examination of ETDRS-grid related layer thicknesses highly agreed between the three OCT devices. The algorithm correctly segmented a C-scan of a patient with X-linked retinitis pigmentosa. Conclusions The segmentation software provides device-independent, reliable, and reproducible analysis of intraretinal layers, similar to what is obtained from expert graders. Translational Relevance Potential application of the software includes routine clinical practice and multicenter clinical trials. PMID:24820053

78 FR 15012 - Request for Nominations of Experts for a Science Advisory Board Panel To Review EPA's Draft...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... expertise in stream ecology or wetland ecology, particularly with respect to freshwater stream-wetland... address http://yosemite.epa.gov/sab/sabproduct.nsf/Web/ethics?OpenDocument . The approved policy under...

Ultrasound Fracture Diagnosis in Space

NASA Technical Reports Server (NTRS)

Dulchavsky, Scott A.; Amponsah, David; Sargsyan, Ashot E.; Garcia, Kathleen M.; Hamilton, Douglas R.; vanHolsbeeck, Marnix

2010-01-01

Introduction: This ground-based investigation accumulated high-level clinical evidence on the sensitivity and specificity of point of care ultrasound performed by expert and novice users for the rapid diagnosis of musculoskeletal (MSK) injuries. We developed preliminary educational methodologies to provide just-in-time training of novice users by creating multi-media training tools and imaging procedures for non expert operators and evaluated the sensitivity and specificity of non-expert performed musculoskeletal ultrasound to diagnose acute injuries in a Level 1 Trauma Center. Methods: Patients with potential MSK injuries were identified in the emergency room. A focused MSK ultrasound was performed by expert operators and compared to standard radiographs. A repeat examination was performed by non-expert operators who received a short, just-in-time multimedia education aid. The sensitivity and specificity of the expert and novice ultrasound examinations were compared to gold standard radiography. Results: Over 800 patients were enrolled in this study. The sensitivity and specificity of expert performed ultrasound exceeded 98% for MSK injuries. Novice operators achieved 97% sensitivity and 99% specificity for targeted examinations with the greatest error in fractures involving the hand and foot. Conclusion: Point of care ultrasound is a sensitive and specific diagnostic test for MSK injury when performed by experts and just-in-time trained novice operators.

Cardiac risk stratification in renal transplantation using a form of artificial intelligence.

PubMed

Heston, T F; Norman, D J; Barry, J M; Bennett, W M; Wilson, R A

1997-02-15

The purpose of this study was to determine if an expert network, a form of artificial intelligence, could effectively stratify cardiac risk in candidates for renal transplant. Input into the expert network consisted of clinical risk factors and thallium-201 stress test data. Clinical risk factor screening alone identified 95 of 189 patients as high risk. These 95 patients underwent thallium-201 stress testing, and 53 had either reversible or fixed defects. The other 42 patients were classified as low risk. This algorithm made up the "expert system," and during the 4-year follow-up period had a sensitivity of 82%, specificity of 77%, and accuracy of 78%. An artificial neural network was added to the expert system, creating an expert network. Input into the neural network consisted of both clinical variables and thallium-201 stress test data. There were 5 hidden nodes and the output (end point) was cardiac death. The expert network increased the specificity of the expert system alone from 77% to 90% (p < 0.001), the accuracy from 78% to 89% (p < 0.005), and maintained the overall sensitivity at 88%. An expert network based on clinical risk factor screening and thallium-201 stress testing had an accuracy of 89% in predicting the 4-year cardiac mortality among 189 renal transplant candidates.

Expert Opinion Is Necessary: Delphi Panel Methodology Facilitates a Scientific Approach to Consensus.

PubMed

Hohmann, Erik; Brand, Jefferson C; Rossi, Michael J; Lubowitz, James H

2018-02-01

Our current trend and focus on evidence-based medicine is biased in favor of randomized controlled trials, which are ranked highest in the hierarchy of evidence while devaluing expert opinion, which is ranked lowest in the hierarchy. However, randomized controlled trials have weaknesses as well as strengths, and no research method is flawless. Moreover, stringent application of scientific research techniques, such as the Delphi Panel methodology, allows survey of experts in a high quality and scientific manner. Level V evidence (expert opinion) remains a necessary component in the armamentarium used to determine the answer to a clinical question. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

CLIPS: A tool for corn disease diagnostic system and an aid to neural network for automated knowledge acquisition

NASA Technical Reports Server (NTRS)

Wu, Cathy; Taylor, Pam; Whitson, George; Smith, Cathy

1990-01-01

This paper describes the building of a corn disease diagnostic expert system using CLIPS, and the development of a neural expert system using the fact representation method of CLIPS for automated knowledge acquisition. The CLIPS corn expert system diagnoses 21 diseases from 52 symptoms and signs with certainty factors. CLIPS has several unique features. It allows the facts in rules to be broken down to object-attribute-value (OAV) triples, allows rule-grouping, and fires rules based on pattern-matching. These features combined with the chained inference engine result to a natural user query system and speedy execution. In order to develop a method for automated knowledge acquisition, an Artificial Neural Expert System (ANES) is developed by a direct mapping from the CLIPS system. The ANES corn expert system uses the same OAV triples in the CLIPS system for its facts. The LHS and RHS facts of the CLIPS rules are mapped into the input and output layers of the ANES, respectively; and the inference engine of the rules is imbedded in the hidden layer. The fact representation by OAC triples gives a natural grouping of the rules. These features allow the ANES system to automate rule-generation, and make it efficient to execute and easy to expand for a large and complex domain.

Application and Evaluation of an Expert Judgment Elicitation Procedure for Correlations.

PubMed

Zondervan-Zwijnenburg, Mariëlle; van de Schoot-Hubeek, Wenneke; Lek, Kimberley; Hoijtink, Herbert; van de Schoot, Rens

2017-01-01

The purpose of the current study was to apply and evaluate a procedure to elicit expert judgments about correlations, and to update this information with empirical data. The result is a face-to-face group elicitation procedure with as its central element a trial roulette question that elicits experts' judgments expressed as distributions. During the elicitation procedure, a concordance probability question was used to provide feedback to the experts on their judgments. We evaluated the elicitation procedure in terms of validity and reliability by means of an application with a small sample of experts. Validity means that the elicited distributions accurately represent the experts' judgments. Reliability concerns the consistency of the elicited judgments over time. Four behavioral scientists provided their judgments with respect to the correlation between cognitive potential and academic performance for two separate populations enrolled at a specific school in the Netherlands that provides special education to youth with severe behavioral problems: youth with autism spectrum disorder (ASD), and youth with diagnoses other than ASD. Measures of face-validity, feasibility, convergent validity, coherence, and intra-rater reliability showed promising results. Furthermore, the current study illustrates the use of the elicitation procedure and elicited distributions in a social science application. The elicited distributions were used as a prior for the correlation, and updated with data for both populations collected at the school of interest. The current study shows that the newly developed elicitation procedure combining the trial roulette method with the elicitation of correlations is a promising tool, and that the results of the procedure are useful as prior information in a Bayesian analysis.

The importance of expert feedback during endovascular simulator training.

PubMed

Boyle, Emily; O'Keeffe, Dara A; Naughton, Peter A; Hill, Arnold D K; McDonnell, Ciaran O; Moneley, Daragh

2011-07-01

Complex endovascular skills are difficult to obtain in the clinical environment. Virtual reality (VR) simulator training is a valuable addition to current training curricula, but is there a benefit in the absence of expert trainers? Eighteen endovascular novices performed a renal artery angioplasty/stenting (RAS) on the Vascular Interventional Surgical Trainer simulator. They were randomized into three groups: Group A (n = 6, control), no performance feedback; Group B (n = 6, nonexpert feedback), feedback after every procedure from a nonexpert facilitator; and Group C (n = 6, expert feedback), feedback after every procedure from a consultant vascular surgeon. Each trainee completed RAS six times. Simulator-measured performance metrics included procedural and fluoroscopy time, contrast volume, accuracy of balloon placement, and handling errors. Clinical errors were also measured by blinded video assessment. Data were analyzed using SPSS version 15. A clear learning curve was observed across the six trials. There were no significant differences between the three groups for the general performance metrics, but Group C made fewer errors than Groups A (P = .009) or B (P = .004). Video-based error assessment showed that Groups B and C performed better than Group A (P = .002 and P = .000, respectively). VR simulator training for novices can significantly improve general performance in the absence of expert trainers. Procedure-specific qualitative metrics are improved with expert feedback, but nonexpert facilitators can also enhance the quality of training and may represent a valuable alternative to expert clinical faculty. Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

Patient–expert partnerships in research: how to stimulate inclusion of patient perspectives

PubMed Central

Elberse, Janneke E.; Caron‐Flinterman, J. Francisca; Broerse, Jacqueline E. W.

2010-01-01

Abstract Objective  To gain more insight into exclusion mechanisms and inclusion strategies in patient–expert partnerships. Background  Patient participation in health research, on the level of ‘partnerships with experts’ is a growing phenomenon. However, little research is conducted whether exclusion mechanisms take place and to what extent patients’ perspectives are included in the final outcomes of these partnerships. Case study  A dialogue meeting attended by experts, patients and patient representatives to develop a joint research agenda. Different inclusion strategies were applied during the dialogue meeting to avoid possible exclusion. Method  Data were collected by the means of audio and video recordings, observations, document analysis and evaluative interviews. The data are clustered using a framework that divides exclusion mechanisms in three categories: circumstances, behaviour and verbal communication. The data are analysed focusing on the experiences of participants, observation of occurrence of exclusion and difference between input and outcome of the dialogue meeting. Results  The circumstances of the dialogue and the behaviour of the participants were experienced as mainly inclusive. Some exclusion was observed particularly with respect to verbal communication. The input of the patients was less visible in the outcome of the dialogue meeting compared to the input of the experts. Conclusion  This case study reveals that exclusion of patients’ perspective occurred during a dialogue meeting with experts, despite the fact that inclusion strategies were used and patients experienced the dialogue meeting as inclusive. To realize a more effective patient–expert partnership, more attention should be paid to the application of some additional inclusion strategies. PMID:21176013

High-level user interfaces for transfer function design with semantics.

PubMed

Salama, Christof Rezk; Keller, Maik; Kohlmann, Peter

2006-01-01

Many sophisticated techniques for the visualization of volumetric data such as medical data have been published. While existing techniques are mature from a technical point of view, managing the complexity of visual parameters is still difficult for non-expert users. To this end, this paper presents new ideas to facilitate the specification of optical properties for direct volume rendering. We introduce an additional level of abstraction for parametric models of transfer functions. The proposed framework allows visualization experts to design high-level transfer function models which can intuitively be used by non-expert users. The results are user interfaces which provide semantic information for specialized visualization problems. The proposed method is based on principal component analysis as well as on concepts borrowed from computer animation.

Proposing "the burns suite" as a novel simulation tool for advancing the delivery of burns education.

PubMed

Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

2014-01-01

Educational theory highlights the importance of contextualized simulation for effective learning. We explored this concept in a burns scenario in a novel, low-cost, high-fidelity, portable, immersive simulation environment (referred to as distributed simulation). This contextualized simulation/distributed simulation combination was named "The Burns Suite" (TBS). A pediatric burn resuscitation scenario was selected after high trainee demand. It was designed on Advanced Trauma and Life Support and Emergency Management of Severe Burns principles and refined using expert opinion through cognitive task analysis. TBS contained "realism" props, briefed nurses, and a simulated patient. Novices and experts were recruited. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's α was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twelve participants completed TBS scenario. Mean face and content validity ratings were high (4.6 and 4.5, respectively; range, 4-5). The internal consistency of questions was high. Qualitative data analysis revealed that participants felt 1) the experience was "real" and they were "able to behave as if in a real resuscitation environment," and 2) TBS "addressed what Advanced Trauma and Life Support and Emergency Management of Severe Burns didn't" (including the efficacy of incorporating nontechnical skills). TBS provides a novel, effective simulation tool to significantly advance the delivery of burns education. Recreating clinical challenge is crucial to optimize simulation training. This low-cost approach also has major implications for surgical education, particularly during increasing financial austerity. Alternative scenarios and/or procedures can be recreated within TBS, providing a diverse educational immersive simulation experience.

Development of a Curriculum on the Child With Medical Complexity: Filling a Gap When Few Practice Guidelines Exist.

PubMed

Shah, Neha H; Anspacher, Melanie; Davis, Aisha; Bhansali, Priti

2015-01-01

Pediatric hospitalists are increasingly involved in the clinical management of children with medical complexity (CMC), specifically those with neurologic impairment and technology dependence. Clinical care guidelines and educational resources on management of the diseases and devices prevalent in CMC are scarce. The objective of this study was to develop and evaluate a web-based curriculum on care of CMC for hospitalists at our institution using a novel approach to validate educational content. Junior faculty collaborated with senior hospitalist peer mentors to create multimedia learning modules on highly-desired topics as determined by needs assessment. Module authors were encouraged to work with subspecialty experts from within the institution and to submit their modules for external peer review. Pilot study participants were asked to complete all modules, associated knowledge tests, and evaluations over a 4-month period. Sixteen of 33 eligible hospitalists completed the curriculum and associated assessments. High scores with respect to satisfaction were seen across all modules. There was a significant increase in posttest knowledge scores (P < 0.001) with sustained retention at 6 months posttest (P < 0.013). Participants were most likely to make changes to their teaching and clinical practice based on participation in this curriculum. We used a novel approach for content development in this curriculum that incorporated consultation with experts and external peer review, resulting in improved knowledge, high satisfaction, and behavior change. Our approach may be a useful method to improve content validity for educational resources on topics that do not have established clinical care guidelines.

Information Expensiveness Perceived by Vietnamese Patients with Respect to Healthcare Provider’s Choice

PubMed Central

Quan-Hoang, Vuong

2016-01-01

Background: Patients have to acquire information to support their decision on choosing a suitable healthcare provider. But in developing countries like Vietnam, accessibility issues remain an obstacle, thus adversely affect both quality and costliness of healthcare information. Vietnamese use both sources from health professionals and friends/relatives, especially when quality of the Internet-based cheaper sources appear to be still questionable. The search of information from both professionals and friends/relatives incurs some cost, which can be viewed as low or high depending low or high accessibility to the sources. These views potentially affect their choices. Aim and Objectives: To investigate the effects that medical/health services information on perceived expensiveness of patients’ labor costs. Two related objectives are a) establishing empirical relations between accessibility to sources and expensiveness; and, b) probabilistic trends of probabilities for perceived expensiveness. Results: There is evidence for established relations among the variables “Convexp” and “Convrel” (all p’s < 0.01), indicating that both information sources (experts and friends/relatives) have influence on patients perception of information expensiveness. The use of experts source tends to increase the probability of perceived expensiveness. Conclusion: a) Probabilistic trends show Vietnamese patients have propensity to value healthcare information highly and do not see it as “expensive”; b) The majority of Vietnamese households still take non-professional advices at their own risks; c) There is more for the public healthcare information system to do to reduce costliness and risk of information. The Internet-based health service users communities cannot replace this system. PMID:28077894

Representation and matching of knowledge to design digital systems

NASA Technical Reports Server (NTRS)

Jones, J. U.; Shiva, S. G.

1988-01-01

A knowledge-based expert system is described that provides an approach to solve a problem requiring an expert with considerable domain expertise and facts about available digital hardware building blocks. To design digital hardware systems from their high level VHDL (Very High Speed Integrated Circuit Hardware Description Language) representation to their finished form, a special data representation is required. This data representation as well as the functioning of the overall system is described.

Interface management of pharmacotherapy. Joint hospital and primary care drug recommendations.

PubMed

Björkhem-Bergman, Linda; Andersén-Karlsson, Eva; Laing, Richard; Diogene, Eduardo; Melien, Oyvind; Jirlow, Malena; Malmström, Rickard E; Vogler, Sabine; Godman, Brian; Gustafsson, Lars L

2013-05-01

In September 2012 an interactive course on the "Interface Management of Pharmacotherapy" was organized by the Stockholm Drug and Therapeutics Committee in cooperation with Department of Clinical Pharmacology at Karolinska Institutet and at Karolinska University Hospital in Stockholm, Sweden, in collaboration with the WHO. The basis for the course was the "Stockholm model" for the rational use of medicines but also contained presentations about successful models in interface management of pharmacotherapy in other European countries. The "Stockholm model" consists of 8 components: 1) Independent Drug and Therapeutics Committee with key role for respected drug experts with policy for "interest of conflicts", 2) The "Wise List", recommendations of medicines jointly for primary and hospital care, 3) Communication strategy with continuous medical education, 4) Systematic introduction of new expensive medicines, 5) E-pharmacological support at "point of care", 6) Methods and tools for follow-up of medicines use, 7) Medicines policy strategy and 8) Operative resources. The course highlighted the importance of efficient and targeted communication of drug recommendations building on trust among prescribers and patients for the guidelines to achieve high adherence. Trust is achieved by independent Drug and Therapeutics Committees with a key role for respected experts and a strict policy for "conflicts of interest". Representations of GPs are also crucial for successful implementation, being the link between evidence based medicine and practice. The successful models in Scotland and in Stockholm as well as the ongoing work in Catalonia were considered as examples of multifaceted approaches to improve the quality of medicine use across primary and hospital care.

Systematic Correlation Matrix Evaluation (SCoMaE) - a bottom-up, science-led approach to identifying indicators

NASA Astrophysics Data System (ADS)

Mengis, Nadine; Keller, David P.; Oschlies, Andreas

2018-01-01

This study introduces the Systematic Correlation Matrix Evaluation (SCoMaE) method, a bottom-up approach which combines expert judgment and statistical information to systematically select transparent, nonredundant indicators for a comprehensive assessment of the state of the Earth system. The methods consists of two basic steps: (1) the calculation of a correlation matrix among variables relevant for a given research question and (2) the systematic evaluation of the matrix, to identify clusters of variables with similar behavior and respective mutually independent indicators. Optional further analysis steps include (3) the interpretation of the identified clusters, enabling a learning effect from the selection of indicators, (4) testing the robustness of identified clusters with respect to changes in forcing or boundary conditions, (5) enabling a comparative assessment of varying scenarios by constructing and evaluating a common correlation matrix, and (6) the inclusion of expert judgment, for example, to prescribe indicators, to allow for considerations other than statistical consistency. The example application of the SCoMaE method to Earth system model output forced by different CO2 emission scenarios reveals the necessity of reevaluating indicators identified in a historical scenario simulation for an accurate assessment of an intermediate-high, as well as a business-as-usual, climate change scenario simulation. This necessity arises from changes in prevailing correlations in the Earth system under varying climate forcing. For a comparative assessment of the three climate change scenarios, we construct and evaluate a common correlation matrix, in which we identify robust correlations between variables across the three considered scenarios.

Mapping High Dimensional Sparse Customer Requirements into Product Configurations

NASA Astrophysics Data System (ADS)

Jiao, Yao; Yang, Yu; Zhang, Hongshan

2017-10-01

Mapping customer requirements into product configurations is a crucial step for product design, while, customers express their needs ambiguously and locally due to the lack of domain knowledge. Thus the data mining process of customer requirements might result in fragmental information with high dimensional sparsity, leading the mapping procedure risk uncertainty and complexity. The Expert Judgment is widely applied against that background since there is no formal requirements for systematic or structural data. However, there are concerns on the repeatability and bias for Expert Judgment. In this study, an integrated method by adjusted Local Linear Embedding (LLE) and Naïve Bayes (NB) classifier is proposed to map high dimensional sparse customer requirements to product configurations. The integrated method adjusts classical LLE to preprocess high dimensional sparse dataset to satisfy the prerequisite of NB for classifying different customer requirements to corresponding product configurations. Compared with Expert Judgment, the adjusted LLE with NB performs much better in a real-world Tablet PC design case both in accuracy and robustness.

An online expert network for high quality information on occupational safety and health: cross-sectional study of user satisfaction and impact

PubMed Central

2011-01-01

Background Many people have difficulties finding information on health questions, including occupational safety and health (OSH) issues. One solution to alleviate these difficulties could be to offer questioners free-of-charge, online access to a network of OSH experts who provide tailored, high-quality information. The aim of this study was to assess whether network quality, respectively information quality, as perceived by the questioners, is associated with questioners' overall satisfaction and to explore the impact of the information received on questioners' knowledge, work and work functioning. Methods We evaluated the experiences of OSH questioners with the online network ArboAntwoord.com over a two-year period. In this network, approximately 80 qualified experts are available to answer OSH questions. By means of a questionnaire, we assessed questioners' overall satisfaction with the network, whether the network was user-friendly, easily accessible and easy to handle and whether the information provided was complete, applicable and received in a timely manner. The impact of the information on questioners' knowledge, work or work functioning was explored with seven questions. In the study period, 460 unique OSH questioners asked 851 OSH questions. In total, 205 of the 460 questioners completed the questionnaire (response rate 45%). Results Of the responders, 71% were satisfied with the ArboAntwoord network. Multiple logistic regression analysis showed that the applicability of the information had a positive influence on the questioners' overall satisfaction (OR = 16.0, 95% CI: 7.0-36.4). Also, user friendliness of the network (OR = 3.3, 95% CI: 1.3-8.6) and completeness of the information provided (OR = 3.0, 95% CI: 1.3-6.8) were positively related to the questioners' satisfaction. For 74% of the questioners, the information helped to increase their knowledge and understanding. Overall, 25% of the questioners indicated that the received information improved their work, work functioning or health. Conclusions A free-of-charge, online expert network in the field of OSH can be a useful strategy to provide OSH questioners with applicable, complete and timely information that may help improve safety and health at work. This study provides more insight in how to satisfy network questioners and about the potential impact of provided information on OSH. PMID:22111587

An online expert network for high quality information on occupational safety and health: cross-sectional study of user satisfaction and impact.

PubMed

Rhebergen, Martijn D F; Lenderink, Annet F; van Dijk, Frank J H; Hulshof, Carel T J

2011-11-23

Many people have difficulties finding information on health questions, including occupational safety and health (OSH) issues. One solution to alleviate these difficulties could be to offer questioners free-of-charge, online access to a network of OSH experts who provide tailored, high-quality information. The aim of this study was to assess whether network quality, respectively information quality, as perceived by the questioners, is associated with questioners' overall satisfaction and to explore the impact of the information received on questioners' knowledge, work and work functioning. We evaluated the experiences of OSH questioners with the online network ArboAntwoord.com over a two-year period. In this network, approximately 80 qualified experts are available to answer OSH questions. By means of a questionnaire, we assessed questioners' overall satisfaction with the network, whether the network was user-friendly, easily accessible and easy to handle and whether the information provided was complete, applicable and received in a timely manner. The impact of the information on questioners' knowledge, work or work functioning was explored with seven questions. In the study period, 460 unique OSH questioners asked 851 OSH questions. In total, 205 of the 460 questioners completed the questionnaire (response rate 45%). Of the responders, 71% were satisfied with the ArboAntwoord network. Multiple logistic regression analysis showed that the applicability of the information had a positive influence on the questioners' overall satisfaction (OR = 16.0, 95% CI: 7.0-36.4). Also, user friendliness of the network (OR = 3.3, 95% CI: 1.3-8.6) and completeness of the information provided (OR = 3.0, 95% CI: 1.3-6.8) were positively related to the questioners' satisfaction. For 74% of the questioners, the information helped to increase their knowledge and understanding. Overall, 25% of the questioners indicated that the received information improved their work, work functioning or health. A free-of-charge, online expert network in the field of OSH can be a useful strategy to provide OSH questioners with applicable, complete and timely information that may help improve safety and health at work. This study provides more insight in how to satisfy network questioners and about the potential impact of provided information on OSH.

Automated Diagnosis of Plus Disease in Retinopathy of Prematurity Using Deep Convolutional Neural Networks.

PubMed

Brown, James M; Campbell, J Peter; Beers, Andrew; Chang, Ken; Ostmo, Susan; Chan, R V Paul; Dy, Jennifer; Erdogmus, Deniz; Ioannidis, Stratis; Kalpathy-Cramer, Jayashree; Chiang, Michael F

2018-05-02

Retinopathy of prematurity (ROP) is a leading cause of childhood blindness worldwide. The decision to treat is primarily based on the presence of plus disease, defined as dilation and tortuosity of retinal vessels. However, clinical diagnosis of plus disease is highly subjective and variable. To implement and validate an algorithm based on deep learning to automatically diagnose plus disease from retinal photographs. A deep convolutional neural network was trained using a data set of 5511 retinal photographs. Each image was previously assigned a reference standard diagnosis (RSD) based on consensus of image grading by 3 experts and clinical diagnosis by 1 expert (ie, normal, pre-plus disease, or plus disease). The algorithm was evaluated by 5-fold cross-validation and tested on an independent set of 100 images. Images were collected from 8 academic institutions participating in the Imaging and Informatics in ROP (i-ROP) cohort study. The deep learning algorithm was tested against 8 ROP experts, each of whom had more than 10 years of clinical experience and more than 5 peer-reviewed publications about ROP. Data were collected from July 2011 to December 2016. Data were analyzed from December 2016 to September 2017. A deep learning algorithm trained on retinal photographs. Receiver operating characteristic analysis was performed to evaluate performance of the algorithm against the RSD. Quadratic-weighted κ coefficients were calculated for ternary classification (ie, normal, pre-plus disease, and plus disease) to measure agreement with the RSD and 8 independent experts. Of the 5511 included retinal photographs, 4535 (82.3%) were graded as normal, 805 (14.6%) as pre-plus disease, and 172 (3.1%) as plus disease, based on the RSD. Mean (SD) area under the receiver operating characteristic curve statistics were 0.94 (0.01) for the diagnosis of normal (vs pre-plus disease or plus disease) and 0.98 (0.01) for the diagnosis of plus disease (vs normal or pre-plus disease). For diagnosis of plus disease in an independent test set of 100 retinal images, the algorithm achieved a sensitivity of 93% with 94% specificity. For detection of pre-plus disease or worse, the sensitivity and specificity were 100% and 94%, respectively. On the same test set, the algorithm achieved a quadratic-weighted κ coefficient of 0.92 compared with the RSD, outperforming 6 of 8 ROP experts. This fully automated algorithm diagnosed plus disease in ROP with comparable or better accuracy than human experts. This has potential applications in disease detection, monitoring, and prognosis in infants at risk of ROP.

Utilization of a cognitive task analysis for laparoscopic appendectomy to identify differentiated intraoperative teaching objectives.

PubMed

Smink, Douglas S; Peyre, Sarah E; Soybel, David I; Tavakkolizadeh, Ali; Vernon, Ashley H; Anastakis, Dimitri J

2012-04-01

Experts become automated when performing surgery, making it difficult to teach complex procedures to trainees. Cognitive task analysis (CTA) enables experts to articulate operative steps and cognitive decisions in complex procedures such as laparoscopic appendectomy, which can then be used to identify central teaching points. Three local surgeon experts in laparoscopic appendectomy were interviewed using critical decision method-based CTA methodology. Interview transcripts were analyzed, and a cognitive demands table (CDT) was created for each expert. The individual CDTs were reviewed by each expert for completeness and then combined into a master CDT. Percentage agreement on operative steps and decision points was calculated for each expert. The experts then participated in a consensus meeting to review the master CDT. Each surgeon expert was asked to identify in the master CDT the most important teaching objectives for junior-level and senior-level residents. The experts' responses for junior-level and senior-level residents were compared using a χ(2) test. The surgeon experts identified 24 operative steps and 27 decision points. Eighteen of the 24 operative steps (75%) were identified by all 3 surgeon experts. The percentage of operative steps identified was high for each surgeon expert (96% for surgeon 1, 79% for surgeon 2, and 83% for surgeon 3). Of the 27 decision points, only 5 (19%) were identified by all 3 surgeon experts. The percentage of decision points identified varied by surgeon expert (78% for surgeon 1, 59% for surgeon 2, and 48% for surgeon 3). When asked to identify key teaching points, the surgeon experts were more likely to identify operative steps for junior residents (9 operative steps and 6 decision points) and decision points for senior residents (4 operative steps and 13 decision points) (P < .01). CTA can deconstruct the essential operative steps and decision points associated with performing a laparoscopic appendectomy. These results provide a framework to identify key teaching principles to guide intraoperative instruction. These learning objectives could be used to guide resident level-appropriate teaching of an essential general surgery procedure. Copyright © 2012 Elsevier Inc. All rights reserved.

Intra- and interobserver agreement among obstetric experts in court regarding the review of abnormal fetal heart rate tracings and obstetrical management.

PubMed

Sabiani, Laura; Le Dû, Renaud; Loundou, Anderson; d'Ercole, Claude; Bretelle, Florence; Boubli, Léon; Carcopino, Xavier

2015-12-01

The objective of the study was to evaluate the intra- and interobserver agreement among obstetric experts in court regarding the retrospective review of abnormal fetal heart rate tracings and obstetrical management of patients with abnormal fetal heart rate during labor. A total of 22 French obstetric experts in court reviewed 30 cases of term deliveries of singleton pregnancies diagnosed with at least 1 hour of abnormal fetal heart rate, including 10 cases with adverse neonatal outcome. The experts reviewed all cases twice within a 3-month interval, with the first review being blinded to neonatal outcome. For each case reviewed, the experts were provided with the obstetric data and copies of the complete fetal heart rate recording and the partogram. The experts were asked to classify the abnormal fetal heart rate tracing and to express whether they agreed with the obstetrical management performed. When they disagreed, the experts were asked whether they concluded that an error had been made and whether they considered the obstetrical management as the cause of cerebral palsy in children if any. Compared with blinded review, the experts were significantly more likely to agree with the obstetric management performed (P < .001) and with the mode of delivery (P < .001) when informed about the neonatal outcome and were less likely to conclude that an error had been made (P < .001) or to establish a link with potential cerebral palsy (P = .003). The experts' intraobserver agreement for the review of abnormal fetal heart rate tracing and obstetrical management were both mediocre (kappa = 0.46-0.51 and kappa = 0.48-0.53, respectively). The interobserver agreement for the review of abnormal fetal heart rate tracing was low and was not improved by knowledge of the neonatal outcome (kappa = 0.11-0.18). The interobserver agreement for the interpretation of obstetrical management was also low (kappa = 0.08-0.19) but appeared to be improved by knowledge of the neonatal outcome (kappa = 0.15-0.32). The intra- and interobserver agreement among obstetric experts in court for the review of abnormal fetal heart rate tracing and the appropriateness of obstetrical care is poor, suggesting a lack of objectivity of obstetrical expertise as currently performed in court. Copyright © 2015 Elsevier Inc. All rights reserved.

Increased cerebellar gray matter volume in head chefs.

PubMed

Cerasa, Antonio; Sarica, Alessia; Martino, Iolanda; Fabbricatore, Carmelo; Tomaiuolo, Francesco; Rocca, Federico; Caracciolo, Manuela; Quattrone, Aldo

2017-01-01

Chefs exert expert motor and cognitive performances on a daily basis. Neuroimaging has clearly shown that that long-term skill learning (i.e., athletes, musicians, chess player or sommeliers) induces plastic changes in the brain thus enabling tasks to be performed faster and more accurately. How a chef's expertise is embodied in a specific neural network has never been investigated. Eleven Italian head chefs with long-term brigade management expertise and 11 demographically-/ psychologically- matched non-experts underwent morphological evaluations. Voxel-based analysis performed with SUIT, as well as, automated volumetric measurement assessed with Freesurfer, revealed increased gray matter volume in the cerebellum in chefs compared to non-experts. The most significant changes were detected in the anterior vermis and the posterior cerebellar lobule. The magnitude of the brigade staff and the higher performance in the Tower of London test correlated with these specific gray matter increases, respectively. We found that chefs are characterized by an anatomical variability involving the cerebellum. This confirms the role of this region in the development of similar expert brains characterized by learning dexterous skills, such as pianists, rock climbers and basketball players. However, the nature of the cellular events underlying the detected morphological differences remains an open question.

Integration of an expert system into a user interface language demonstration

NASA Technical Reports Server (NTRS)

Stclair, D. C.

1986-01-01

The need for a User Interface Language (UIL) has been recognized by the Space Station Program Office as a necessary tool to aid in minimizing the cost of software generation by multiple users. Previous history in the Space Shuttle Program has shown that many different areas of software generation, such as operations, integration, testing, etc., have each used a different user command language although the types of operations being performed were similar in many respects. Since the Space Station represents a much more complex software task, a common user command language--a user interface language--is required to support the large spectrum of space station software developers and users. To assist in the selection of an appropriate set of definitions for a UIL, a series of demonstration programs was generated with which to test UIL concepts against specific Space Station scenarios using operators for the astronaut and scientific community. Because of the importance of expert system in the space station, it was decided that an expert system should be embedded in the UIL. This would not only provide insight into the UIL components required but would indicate the effectiveness with which an expert system could function in such an environment.

Brain mechanisms of persuasion: how 'expert power' modulates memory and attitudes.

PubMed

Klucharev, Vasily; Smidts, Ale; Fernández, Guillén

2008-12-01

Human behaviour is affected by various forms of persuasion. The general persuasive effect of high expertise of the communicator, often referred to as 'expert power', is well documented. We found that a single exposure to a combination of an expert and an object leads to a long-lasting positive effect on memory for and attitude towards the object. Using functional magnetic resonance imaging, we probed the neural processes predicting these behavioural effects. Expert context was associated with distributed left-lateralized brain activity in prefrontal and temporal cortices related to active semantic elaboration. Furthermore, experts enhanced subsequent memory effects in the medial temporal lobe (i.e. in hippocampus and parahippocampal gyrus) involved in memory formation. Experts also affected subsequent attitude effects in the caudate nucleus involved in trustful behaviour, reward processing and learning. These results may suggest that the persuasive effect of experts is mediated by modulation of caudate activity resulting in a re-evaluation of the object in terms of its perceived value. Results extend our view of the functional role of the dorsal striatum in social interaction and enable us to make the first steps toward a neuroscientific model of persuasion.

Adaptability of expert visual anticipation in baseball batting.

PubMed

Müller, Sean; Fadde, Peter J; Harbaugh, Allen G

2017-09-01

By manipulating stimulus variation in terms of opponent pitcher actions, this study investigated the capability of expert (n = 30) and near-expert (n = 95) professional baseball batters to adapt anticipation skill when using the video simulation temporal occlusion paradigm. Participants watched in-game footage of two pitchers, one after the other, that was temporally occluded at ball release and various points during ball flight. They were required to make a written prediction of pitch types and locations. Per cent accuracy was calculated for pitch type, for pitch location, and for type and location combined. Results indicated that experts and near-experts could adapt their anticipation to predict above guessing level across both pitchers, but adaptation to the left-handed pitcher was poorer than the right-handed pitcher. Small-to-moderate effect sizes were found in terms of superior adaptation by experts over near-experts at the ball release and early ball flight occlusion conditions. The findings of this study extend theoretical and applied knowledge of expertise in striking sports. Practical application of the instruments and findings are discussed in terms of applied researchers, practitioners and high-performance staff in professional sporting organisations.

The adversarial court system and the expert medical witness: 'The truth the whole truth and nothing but the truth?'.

PubMed

Ryan, Matthew

2003-06-01

This discussion aims to provide the occasional medical expert witness with background knowledge of the adversarial court system and the role of the medical expert witness within it. The parallel evolution of the adversarial and inquisitorial legal systems has been more out of tradition rather than any systematic review of the effectiveness of one system or the other. Both legal systems have their merits and limitations. Witnesses within the adversarial system are required to present evidence in a structured and highly stylized format consisting of 'evidence in chief' followed by 'cross-examination'. This format is an attempt to exclude unreliable evidence. The medical witness is an 'expert' by means of specialized knowledge not possessed by the general public. This distinction allows the expert medical witness to offer his or her opinion as evidence. There remain several limitations to the expert's evidence and these relate to common knowledge, field of expertise and the 'ultimate issue'. The current practice of selection of expert medical witnesses is seriously flawed with several pressures operating to maximise bias and inaccurate testimony. Doctors should not only anticipate change in this area they should lead reform in this area.

A theory of expert leadership (TEL) in psychiatry.

PubMed

Goodall, Amanda H

2016-06-01

Leaders' technical competence - 'expert knowledge' - has been shown in many settings to be associated with better organizational performance. In universities, for example, there is longitudinal evidence that research-focused scholars make the best leaders; results from a hospital study show that doctors instead of professional managers are most closely associated with the best performing institutions. To explain these patterns, and raise hypotheses, a theory of expert leadership (TEL) has been developed that might explain these patterns. In this paper the framework for expert leadership is applied to psychiatry. The TEL proposes that psychiatric leaders, as opposed to non-expert managers, improve organizational performance through several channels. First, experts' knowledge influences organizational strategy. Second, having been 'one of them', a psychiatrist understands how to create the optimal work environment for psychiatric teams, through appropriate goal-setting, evaluation and support. These factors are positively associated with workers' wellbeing and performance. Third, exceptional psychiatrist-leaders are likely to set high standards for hiring. Fourth, leaders' credibility extends their influence among core workers, and also signals organizational priorities to stakeholders. Finally, a necessary prerequisite of TEL is that expert leaders have direct executive power inclusive of budgetary and strategic oversight. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Expert scientific judgment and cancer risk assessment: a pilot study of pharmacokinetic data.

PubMed

Hawkins, N C; Graham, J D

1988-12-01

When high-dose tumor data are extrapolated to low doses, it is typically assumed that the dose of a carcinogen delivered to target cells is proportional to the dose administered to test animals, even at exposure levels below the experimental range. Since pharmacokinetic data are becoming available that in some cases question the validity of this assumption, risk assessors must decide whether to maintain the standard assumption. A pilot study of formaldehyde is reported that was undertaken to demonstrate how expert scientific judgment can help guide a controversial risk assessment where pharmacokinetic data are considered inconclusive. Eight experts on pharmacokinetic data were selected by a formal procedure, and each was interviewed personally using a structured interview protocol. The results suggest that expert scientific opinion is polarized in this case, a situation that risk assessors can respond to with a range of risk characterizations considered biologically plausible by the experts. Convergence of expert opinion is likely in this case of several specific research strategies ar executed in a competent fashion. Elicitation of expert scientific judgment is a promising vehicle for evaluating the quality of pharmacokinetic data, expressing uncertainty in risk assessment, and fashioning a research agenda that offers possible forging of scientific consensus.

CLIPS: The C language integrated production system

NASA Technical Reports Server (NTRS)

Riley, Gary

1994-01-01

Expert systems are computer programs which emulate human expertise in well defined problem domains. The potential payoff from expert systems is high: valuable expertise can be captured and preserved, repetitive and/or mundane tasks requiring human expertise can be automated, and uniformity can be applied in decision making processes. The C Language Integrated Production System (CLIPS) is an expert system building tool, developed at the Johnson Space Center, which provides a complete environment for the development and delivery of rule and/or object based expert systems. CLIPS was specifically designed to provide a low cost option for developing and deploying expert system applications across a wide range of hardware platforms. The commercial potential of CLIPS is vast. Currently, CLIPS is being used by over 5,000 individuals throughout the public and private sector. Because the CLIPS source code is readily available, numerous groups have used CLIPS as the basis for their own expert system tools. To date, three commercially available tools have been derived from CLIPS. In general, the development of CLIPS has helped to improve the ability to deliver expert system technology throughout the public and private sectors for a wide range of applications and diverse computing environments.

Brain mechanisms of persuasion: how ‘expert power’ modulates memory and attitudes

PubMed Central

Smidts, Ale; Fernández, Guillén

2008-01-01

Human behaviour is affected by various forms of persuasion. The general persuasive effect of high expertise of the communicator, often referred to as ’expert power’, is well documented. We found that a single exposure to a combination of an expert and an object leads to a long-lasting positive effect on memory for and attitude towards the object. Using functional magnetic resonance imaging, we probed the neural processes predicting these behavioural effects. Expert context was associated with distributed left-lateralized brain activity in prefrontal and temporal cortices related to active semantic elaboration. Furthermore, experts enhanced subsequent memory effects in the medial temporal lobe (i.e. in hippocampus and parahippocampal gyrus) involved in memory formation. Experts also affected subsequent attitude effects in the caudate nucleus involved in trustful behaviour, reward processing and learning. These results may suggest that the persuasive effect of experts is mediated by modulation of caudate activity resulting in a re-evaluation of the object in terms of its perceived value. Results extend our view of the functional role of the dorsal striatum in social interaction and enable us to make the first steps toward a neuroscientific model of persuasion. PMID:19015077

Expert Review of Cervical Cytology: Does it Affect Patient Care?

PubMed

Mark, Jaron; Morrell, Kayla; Eng, Kevin; Alfiero, Alexandra; Frederick, Peter J

2018-04-01

The aim of the study was to evaluate whether expert review of outside cervical cytology affects patient care. A retrospective study was conducted of 424 new patient referrals for cervical dysplasia between 2004 and 2016 at Roswell Park Cancer Institute. Records were analyzed for outside cervical cytology reports and compared with expert cervical cytology review. Differences between expert review and outside reports were documented. Charts with a difference were then assessed for additional evaluation and procedures performed. We specifically analyzed the data for cytology being upgraded or downgraded after expert review. Two hundred forty-six patient charts were eligible for this study. We identified 165 patients with congruent pathology reports. Of the 81 different reports, 41 led to significant pathologic differences. Twenty-four reports with different pathology were low-grade squamous intraepithelial lesions (LSIL) upgraded to high-grade squamous intraepithelial lesions (HSIL). Six were HSIL downgraded to LSIL, 4 LSIL downgraded to negative, 3 AGC upgraded to HSIL, 2 AGC upgraded to cancer, 1 each for HSIL downgraded to negative, and AGC downgraded to negative. Of the 24 patients whose cytology changed from low grade to high grade, 17 underwent an excisional procedure and 1 had a laser ablative procedure. Cervical intraepithelial neoplasia 2 or 3 was found in 11 specimens. Cervical intraepithelial neoplasia 1 was found in 4 of excisional specimens and no dysplasia found in 2. Expert review of cervical cytology significantly impacts patient management at a tertiary referral center, resulting in both upgrading and downgrading of community cytology reports.

Development of a knowledge acquisition tool for an expert system flight status monitor

NASA Technical Reports Server (NTRS)

Disbrow, J. D.; Duke, E. L.; Regenie, V. A.

1986-01-01

Two of the main issues in artificial intelligence today are knowledge acquisition dion and knowledge representation. The Dryden Flight Research Facility of NASA's Ames Research Center is presently involved in the design and implementation of an expert system flight status monitor that will provide expertise and knowledge to aid the flight systems engineer in monitoring today's advanced high-performance aircraft. The flight status monitor can be divided into two sections: the expert system itself and the knowledge acquisition tool. The knowledge acquisition tool, the means it uses to extract knowledge from the domain expert, and how that knowledge is represented for computer use is discussed. An actual aircraft system has been codified by this tool with great success. Future real-time use of the expert system has been facilitated by using the knowledge acquisition tool to easily generate a logically consistent and complete knowledge base.

Development of a knowledge acquisition tool for an expert system flight status monitor

NASA Technical Reports Server (NTRS)

Disbrow, J. D.; Duke, E. L.; Regenie, V. A.

1986-01-01

Two of the main issues in artificial intelligence today are knowledge acquisition and knowledge representation. The Dryden Flight Research Facility of NASA's Ames Research Center is presently involved in the design and implementation of an expert system flight status monitor that will provide expertise and knowledge to aid the flight systems engineer in monitoring today's advanced high-performance aircraft. The flight status monitor can be divided into two sections: the expert system itself and the knowledge acquisition tool. This paper discusses the knowledge acquisition tool, the means it uses to extract knowledge from the domain expert, and how that knowledge is represented for computer use. An actual aircraft system has been codified by this tool with great success. Future real-time use of the expert system has been facilitated by using the knowledge acquisition tool to easily generate a logically consistent and complete knowledge base.

Motor Experts Care about Consistency and Are Reluctant to Change Motor Outcome.

PubMed

Kast, Volker; Leukel, Christian

2016-01-01

Thousands of hours of physical practice substantially change the way movements are performed. The mechanisms underlying altered behavior in highly-trained individuals are so far little understood. We studied experts (handballers) and untrained individuals (novices) in visuomotor adaptation of free throws, where subjects had to adapt their throwing direction to a visual displacement induced by prismatic glasses. Before visual displacement, experts expressed lower variability of motor errors than novices. Experts adapted and de-adapted slower, and also forgot the adaptation slower than novices. The variability during baseline was correlated with the learning rate during adaptation. Subjects adapted faster when variability was higher. Our results indicate that experts produced higher consistency of motor outcome. They were still susceptible to the sensory feedback informing about motor error, but made smaller adjustments than novices. The findings of our study relate to previous investigations emphasizing the importance of action exploration, expressed in terms of outcome variability, to facilitate learning.

Early Childhood Discipline: A Review of the Literature

ERIC Educational Resources Information Center

Firmin, Michael W.; Castle, Sally L.

2008-01-01

In this literature review concerning early childhood discipline we particularly highlight American children's discipline with respect to historical perspectives, generational theories, gender issues, parental styles, methods of discipline, and corporal punishment. We also address corporal punishment's history, the debate among experts, beliefs and…

Managing a Crisis

ERIC Educational Resources Information Center

Pierce, Dennis

2016-01-01

Planning ahead, practicing your response for various scenarios, being open and honest, showing empathy and respect for other peoples' perspectives and assuring stakeholders that you have the situation covered are the foundations of communicating successfully during a crisis, experts say. This article provides strategies for Community College…

Quantitative investigation of inappropriate regression model construction and the importance of medical statistics experts in observational medical research: a cross-sectional study.

PubMed

Nojima, Masanori; Tokunaga, Mutsumi; Nagamura, Fumitaka

2018-05-05

To investigate under what circumstances inappropriate use of 'multivariate analysis' is likely to occur and to identify the population that needs more support with medical statistics. The frequency of inappropriate regression model construction in multivariate analysis and related factors were investigated in observational medical research publications. The inappropriate algorithm of using only variables that were significant in univariate analysis was estimated to occur at 6.4% (95% CI 4.8% to 8.5%). This was observed in 1.1% of the publications with a medical statistics expert (hereinafter 'expert') as the first author, 3.5% if an expert was included as coauthor and in 12.2% if experts were not involved. In the publications where the number of cases was 50 or less and the study did not include experts, inappropriate algorithm usage was observed with a high proportion of 20.2%. The OR of the involvement of experts for this outcome was 0.28 (95% CI 0.15 to 0.53). A further, nation-level, analysis showed that the involvement of experts and the implementation of unfavourable multivariate analysis are associated at the nation-level analysis (R=-0.652). Based on the results of this study, the benefit of participation of medical statistics experts is obvious. Experts should be involved for proper confounding adjustment and interpretation of statistical models. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

PubMed

Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

2017-06-01

To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

Using expert opinion to quantify unmeasured confounding bias parameters.

PubMed

Navadeh, Soodabeh; Mirzazadeh, Ali; McFarland, Willi; Woolf-King, Sarah; Mansournia, Mohammad Ali

2016-06-27

To develop and apply a method to quantify bias parameters in the case example of the association between alcohol use and HIV-serodiscordant condomless anal sex with potential confounding by sensation seeking among men who have sex with men (MSM), using expert opinion as an external data source. Through an online survey, we sought the input of 41 epidemiologist and behavioural scientists to quantify six parameters in the population of MSM: the proportion of high sensation seeking among heavy-drinking MSM, the proportion of sensation seeking among low-level drinking MSM, and the risk ratio (RR) of the association between sensation seeking and condomless anal sex, for HIV-positive and HIV-negative MSM. Eleven experts responded. For HIV-positive heavy drinkers, the proportion of high sensation seeking was 53.6% (beta distribution [α=5.50, β=4.78]), and 41.1% (beta distribution [α=3.10, β=4.46]) in HIV-negative heavy drinkers. In HIV-positive low-level alcohol drinkers, high sensation seeking was 26.9% (beta distribution [α=1.81, β=4.92]), similar to high sensation seeking among HIV-negative low-level alcohol drinkers (25.3%) (beta distribution [α=2.00, β=5.89]). The lnRR for the association between sensation seeking and condomless anal sex was ln(2.4) (normal distribution [μ=0.889, σ=0.438]) in HIV-positive and ln(1.5) (normal distribution [μ=0.625, σ=0.391]) in HIV-negative MSM. Expert opinion can be a simple and efficient method for deriving bias parameters to quantify and adjust for hypothesized confounding. In this test case, expert opinion confirmed sensation seeking as a confounder for the effect of alcohol on condomless anal sex and provided the parameters necessary for probabilistic bias analysis.

Relation of Knowledge and Performance in Boys' Tennis: Age and Expertise.

ERIC Educational Resources Information Center

McPherson, Sue L.; Thomas, Jerry R.

1989-01-01

Examined 10- to 13-year-old boys' development of knowledge structure and sport performance in tennis by comparing skills and knowledge of experts and novices. Experts focused on higher concepts and exhibited greater decision-making ability because of their more highly developed knowledge structure. (SAK)

The feasibility of introducing advanced minimally invasive surgery into surgical practice

PubMed Central

Birch, Daniel W.; Misra, Monali; Farrokhyar, Forough

2007-01-01

Background This study investigates the feasibility of performing advanced minimally invasive surgery (MIS) in a nonspecialized practice environment. Methods We conducted a cross-sectional survey of all community general surgeons currently practising in Ontario. Results Few community surgeons perform a high volume (> 10 procedures per yr) of advanced MIS. Most (70%) believe it is important to acquire additional skills in advanced MIS. The most appropriate methods for learning advanced MIS are believed to be expert mentoring (79.7%), courses (77.2%) and a colleague mentor (63.9%). A total of 57.6% of respondents have attended a course in MIS while in practice, and most have access to a reasonable variety of instrumentation. Respondents believe that 57.6% of assistants, 54.8% of nurses and 43.4% of anaesthetists are relatively inexperienced with advanced MIS. Barriers to establishing advanced MIS include limited operating room access (50%), resources or equipment (45.2%) and limited expert mentoring (43.6%). Surgeons with less than 10 years of practice found lack of trained nursing staff (7.9% v. 4.2%, p = 0.01) and experienced assistants (12% v. 6.2%, p = 0.008) to be more important barriers than did those with over 10 years of practice, respectively. Conclusion Most general surgeons working in Ontario are self-taught with respect to MIS skills, and few perform a high volume of advanced MIS. Only one-half of all respondents have access to skilled MIS operating room nurses, surgical assistants or anesthesiology. Despite this, general surgeons perceive the greatest barriers to introducing advanced MIS procedures to be limited access to operating rooms, resources or equipment and limited mentoring. This study has shown that the role of the surgical team in advanced MIS may be underestimated by many general surgeons. These data have important implications in training general surgeons and in incorporating additional advanced MIS procedures into the armamentarium of general surgeons. PMID:17897513

[Construction of a psychological aging scale for healthy people].

PubMed

Lin, Fei; Long, Yao; Zeng, Ni; Wu, Lei; Huang, Helang

2017-04-28

To construct a psychological aging scale, and to provide a tool and indexes for scientific evaluation on aging.
 Methods: The age-related psychological items were collected through literature screening and expert interview. The importance, feasibilityand the degree of authority for the psychological index system were graded by two rounds of Delphi method. Using analytic hierarchy process, the weight of dimensions and items were determined. The analysis for internal consistency reliability, correlation and exploratory factor was performed to evaluate the reliability and validity of the scales.
 Results: By two rounds of Delphi method, 17 experts offered the results as follows: the coefficient of expert authorities was 0.88±0.06, the coordination coefficients for the importance and feasibility in second round were 0.456 (P<0.01) and 0.666 (P<0.01), respectively. The consistency was good. The psychological aging scale for healthy people included 4 dimensions as follows: cognitive function, emotion, personality and motivation. The weight coefficients for the 4 dimensions were 0.338, 0.250, 0.166 and 0.258, respectively. The Cronbach's α coefficient for the scale was 0.822, the reliability was 0.817, the content validity index (CVI) was 0.847, and the cumulative contribution rate for the 5 factors was51.42%.
 Conclusion: The psychological aging scale is satisfied, which can provide reference for the evaluation for aging. The indicators were representative and well-recognized.

Is Beauty in the Eyes of the Beholder? Aesthetic Quality versus Technical Skill in Movement Evaluation of Tai Chi.

PubMed

Zamparo, Paola; Zorzi, Elena; Marcantoni, Sara; Cesari, Paola

2015-01-01

The aim of this study was to compare experts to naïve practitioners in rating the beauty and the technical quality of a Tai Chi sequence observed in video-clips (of high and middle level performances). Our hypothesis are: i) movement evaluation will correlate with the level of skill expressed in the kinematics of the observed action but ii) only experts will be able to unravel the technical component from the aesthetic component of the observed action. The judgments delivered indicate that both expert and non-expert observers are able to discern a good from a mediocre performance; however, as expected, only experts discriminate the technical from the aesthetic component of the action evaluated and do this independently of the level of skill shown by the model (high or middle level performances). Furthermore, the judgments delivered were strongly related to the kinematic variables measured in the observed model, indicating that observers rely on specific movement kinematics (e.g. movement amplitude, jerk and duration) for action evaluation. These results provide evidence of the complementary functional role of visual and motor action representation in movement evaluation and underline the role of expertise in judging the aesthetic quality of movements.

Are all types of expertise created equal? Car experts use different spatial frequency scales for subordinate categorization of cars and faces.

PubMed

Harel, Assaf; Bentin, Shlomo

2013-01-01

A much-debated question in object recognition is whether expertise for faces and expertise for non-face objects utilize common perceptual information. We investigated this issue by assessing the diagnostic information required for different types of expertise. Specifically, we asked whether face categorization and expert car categorization at the subordinate level relies on the same spatial frequency (SF) scales. Fifteen car experts and fifteen novices performed a category verification task with spatially filtered images of faces, cars, and airplanes. Images were categorized based on their basic (e.g. "car") and subordinate level (e.g. "Japanese car") identity. The effect of expertise was not evident when objects were categorized at the basic level. However, when the car experts categorized faces and cars at the subordinate level, the two types of expertise required different kinds of SF information. Subordinate categorization of faces relied on low SFs more than on high SFs, whereas subordinate expert car categorization relied on high SFs more than on low SFs. These findings suggest that expertise in the recognition of objects and faces do not utilize the same type of information. Rather, different types of expertise require different types of diagnostic visual information.

Are All Types of Expertise Created Equal? Car Experts Use Different Spatial Frequency Scales for Subordinate Categorization of Cars and Faces

PubMed Central

Harel, Assaf; Bentin, Shlomo

2013-01-01

A much-debated question in object recognition is whether expertise for faces and expertise for non-face objects utilize common perceptual information. We investigated this issue by assessing the diagnostic information required for different types of expertise. Specifically, we asked whether face categorization and expert car categorization at the subordinate level relies on the same spatial frequency (SF) scales. Fifteen car experts and fifteen novices performed a category verification task with spatially filtered images of faces, cars, and airplanes. Images were categorized based on their basic (e.g. “car”) and subordinate level (e.g. “Japanese car”) identity. The effect of expertise was not evident when objects were categorized at the basic level. However, when the car experts categorized faces and cars at the subordinate level, the two types of expertise required different kinds of SF information. Subordinate categorization of faces relied on low SFs more than on high SFs, whereas subordinate expert car categorization relied on high SFs more than on low SFs. These findings suggest that expertise in the recognition of objects and faces do not utilize the same type of information. Rather, different types of expertise require different types of diagnostic visual information. PMID:23826188

Comparison of expert and nonexpert swimmers' opinions about the value, potency, and activity of four standard swimming strokes and underwater undulatory swimming.

PubMed

Collard, L; Oboeuf, A

2009-04-01

Underwater undulatory swimming (UUS) is often perceived to be a nonessential aspect of aquatic propulsion. Given their solid theoretical and practical training in swimming, physical education students should be capable of judging the true value of the "fifth stroke," since it appears to be the most efficient technique in high level, competitive swimming. To compare opinions and connotations associated with the stroke and the four official strokes (butterfly, backstroke, breaststroke, and crawl), 198 students (32 of whom were expert swimmers; M age = 20.6 yr., SD = 1.2), were surveyed using the semantic differential of Osgood, Suci, and Tannenbaum. Although answers of expert and nonexpert swimmers differed significantly (p < .01, except for the breaststroke), participants considered overall that undulatory stroke was less attractive, less powerful, and less rapid than the four surface strokes (d = 2.88 for the expert swimmers). Putting one arm in front of the other and repeating the sequence still remains the most solidly held representation of "the right way" to swim. However, the high observed standard deviations for the underwater undulatory stimulus (SD > or = 1.1 with SD max = 3 for the expert swimmers) attests to the view being less strongly held by swimming specialists.

Is Beauty in the Eyes of the Beholder? Aesthetic Quality versus Technical Skill in Movement Evaluation of Tai Chi

PubMed Central

2015-01-01

The aim of this study was to compare experts to naïve practitioners in rating the beauty and the technical quality of a Tai Chi sequence observed in video-clips (of high and middle level performances). Our hypothesis are: i) movement evaluation will correlate with the level of skill expressed in the kinematics of the observed action but ii) only experts will be able to unravel the technical component from the aesthetic component of the observed action. The judgments delivered indicate that both expert and non-expert observers are able to discern a good from a mediocre performance; however, as expected, only experts discriminate the technical from the aesthetic component of the action evaluated and do this independently of the level of skill shown by the model (high or middle level performances). Furthermore, the judgments delivered were strongly related to the kinematic variables measured in the observed model, indicating that observers rely on specific movement kinematics (e.g. movement amplitude, jerk and duration) for action evaluation. These results provide evidence of the complementary functional role of visual and motor action representation in movement evaluation and underline the role of expertise in judging the aesthetic quality of movements. PMID:26047473

A mathematical framework for combining decisions of multiple experts toward accurate and remote diagnosis of malaria using tele-microscopy.

PubMed

Mavandadi, Sam; Feng, Steve; Yu, Frank; Dimitrov, Stoyan; Nielsen-Saines, Karin; Prescott, William R; Ozcan, Aydogan

2012-01-01

We propose a methodology for digitally fusing diagnostic decisions made by multiple medical experts in order to improve accuracy of diagnosis. Toward this goal, we report an experimental study involving nine experts, where each one was given more than 8,000 digital microscopic images of individual human red blood cells and asked to identify malaria infected cells. The results of this experiment reveal that even highly trained medical experts are not always self-consistent in their diagnostic decisions and that there exists a fair level of disagreement among experts, even for binary decisions (i.e., infected vs. uninfected). To tackle this general medical diagnosis problem, we propose a probabilistic algorithm to fuse the decisions made by trained medical experts to robustly achieve higher levels of accuracy when compared to individual experts making such decisions. By modelling the decisions of experts as a three component mixture model and solving for the underlying parameters using the Expectation Maximisation algorithm, we demonstrate the efficacy of our approach which significantly improves the overall diagnostic accuracy of malaria infected cells. Additionally, we present a mathematical framework for performing 'slide-level' diagnosis by using individual 'cell-level' diagnosis data, shedding more light on the statistical rules that should govern the routine practice in examination of e.g., thin blood smear samples. This framework could be generalized for various other tele-pathology needs, and can be used by trained experts within an efficient tele-medicine platform.

Determining the Essential Components of State and Institution Dual Credit Program Policy in New Mexico: A Delphi Study with High School and College Experts

ERIC Educational Resources Information Center

Carlson, Gregory Dean

2013-01-01

The purpose of this Delphi study was to determine the essential components of dual credit in New Mexico. Dual credit experts from colleges and high schools in New Mexico were asked to participate in a three-round Delphi study to determine what the future policy of dual credit should be, and why it should be that way. Definitions of dual credit may…

Development and content validation of performance assessments for endoscopic third ventriculostomy.

PubMed

Breimer, Gerben E; Haji, Faizal A; Hoving, Eelco W; Drake, James M

2015-08-01

This study aims to develop and establish the content validity of multiple expert rating instruments to assess performance in endoscopic third ventriculostomy (ETV), collectively called the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT). The important aspects of ETV were identified through a review of current literature, ETV videos, and discussion with neurosurgeons, fellows, and residents. Three assessment measures were subsequently developed: a procedure-specific checklist (CL), a CL of surgical errors, and a global rating scale (GRS). Neurosurgeons from various countries, all identified as experts in ETV, were then invited to participate in a modified Delphi survey to establish the content validity of these instruments. In each Delphi round, experts rated their agreement including each procedural step, error, and GRS item in the respective instruments on a 5-point Likert scale. Seventeen experts agreed to participate in the study and completed all Delphi rounds. After item generation, a total of 27 procedural CL items, 26 error CL items, and 9 GRS items were posed to Delphi panelists for rating. An additional 17 procedural CL items, 12 error CL items, and 1 GRS item were added by panelists. After three rounds, strong consensus (>80% agreement) was achieved on 35 procedural CL items, 29 error CL items, and 10 GRS items. Moderate consensus (50-80% agreement) was achieved on an additional 7 procedural CL items and 1 error CL item. The final procedural and error checklist contained 42 and 30 items, respectively (divided into setup, exposure, navigation, ventriculostomy, and closure). The final GRS contained 10 items. We have established the content validity of three ETV assessment measures by iterative consensus of an international expert panel. Each measure provides unique assessment information and thus can be used individually or in combination, depending on the characteristics of the learner and the purpose of the assessment. These instruments must now be evaluated in both the simulated and operative settings, to determine their construct validity and reliability. Ultimately, the measures contained in the NEVAT may prove suitable for formative assessment during ETV training and potentially as summative assessment measures during certification.

Research on Expert Systems,

DTIC Science & Technology

1981-03-01

AD-AllS 905 STANFORD UNIV CA DEPT OF COMPUTER SCIENCE F/B 9/2 IRESEARCH ON EXPERT STSTEMS,IU) IMAR 81 B S BUCHANAN N0001479-C0302 I UNCLASSIFIED...STANCS-81-837 NL EE, hEEVmmhhhhEo flflfflfll...l* f MarcL 1981 Report No . S I AN-( S -81-837|I/ O. .51) ,umb,.reJb LEVEVf oResearch on Expert Systems I1...definition, knowledge that ’ s not codified in print. Thus high performance r-, s to be courted with patience. In addition to utility and performance, I have

Expert system application education project

NASA Technical Reports Server (NTRS)

Gonzelez, Avelino J.; Ragusa, James M.

1988-01-01

Artificial intelligence (AI) technology, and in particular expert systems, has shown potential applicability in many areas of operation at the Kennedy Space Center (KSC). In an era of limited resources, the early identification of good expert system applications, and their segregation from inappropriate ones can result in a more efficient use of available NASA resources. On the other hand, the education of students in a highly technical area such as AI requires an extensive hands-on effort. The nature of expert systems is such that proper sample applications for the educational process are difficult to find. A pilot project between NASA-KSC and the University of Central Florida which was designed to simultaneously address the needs of both institutions at a minimum cost. This project, referred to as Expert Systems Prototype Training Project (ESPTP), provided NASA with relatively inexpensive development of initial prototype versions of certain applications. University students likewise benefit by having expertise on a non-trivial problem accessible to them at no cost. Such expertise is indispensible in a hands-on training approach to developing expert systems.

Can masses of non-experts train highly accurate image classifiers? A crowdsourcing approach to instrument segmentation in laparoscopic images.

PubMed

Maier-Hein, Lena; Mersmann, Sven; Kondermann, Daniel; Bodenstedt, Sebastian; Sanchez, Alexandro; Stock, Christian; Kenngott, Hannes Gotz; Eisenmann, Mathias; Speidel, Stefanie

2014-01-01

Machine learning algorithms are gaining increasing interest in the context of computer-assisted interventions. One of the bottlenecks so far, however, has been the availability of training data, typically generated by medical experts with very limited resources. Crowdsourcing is a new trend that is based on outsourcing cognitive tasks to many anonymous untrained individuals from an online community. In this work, we investigate the potential of crowdsourcing for segmenting medical instruments in endoscopic image data. Our study suggests that (1) segmentations computed from annotations of multiple anonymous non-experts are comparable to those made by medical experts and (2) training data generated by the crowd is of the same quality as that annotated by medical experts. Given the speed of annotation, scalability and low costs, this implies that the scientific community might no longer need to rely on experts to generate reference or training data for certain applications. To trigger further research in endoscopic image processing, the data used in this study will be made publicly available.

An inter-observer agreement study of autofluorescence endoscopy in Barrett's esophagus among expert and non-expert endoscopists.

PubMed

Mannath, J; Subramanian, V; Telakis, E; Lau, K; Ramappa, V; Wireko, M; Kaye, P V; Ragunath, K

2013-02-01

Autofluorescence imaging (AFI), which is a "red flag" technique during Barrett's surveillance, is associated with significant false positive results. The aim of this study was to assess the inter-observer agreement (IOA) in identifying AFI-positive lesions and to assess the overall accuracy of AFI. Anonymized AFI and high resolution white light (HRE) images were prospectively collected. The AFI images were presented in random order, followed by corresponding AFI + HRE images. Three AFI experts and 3 AFI non-experts scored images after a training presentation. The IOA was calculated using kappa and accuracy was calculated with histology as gold standard. Seventy-four sets of images were prospectively collected from 63 patients (48 males, mean age 69 years). The IOA for number of AF positive lesions was fair when AFI images were presented. This improved to moderate with corresponding AFI and HRE images [experts 0.57 (0.44-0.70), non-experts 0.47 (0.35-0.62)]. The IOA for the site of AF lesion was moderate for experts and fair for non-experts using AF images, which improved to substantial for experts [κ = 0.62 (0.50-0.72)] but remained at fair for non-experts [κ = 0.28 (0.18-0.37)] with AFI + HRE. Among experts, the accuracy of identifying dysplasia was 0.76 (0.7-0.81) using AFI images and 0.85 (0.79-0.89) using AFI + HRE images. The accuracy was 0.69 (0.62-0.74) with AFI images alone and 0.75 (0.70-0.80) using AFI + HRE among non-experts. The IOA for AF positive lesions is fair to moderate using AFI images which improved with addition of HRE. The overall accuracy of identifying dysplasia was modest, and was better when AFI and HRE images were combined.

Multiple neural network approaches to clinical expert systems

NASA Astrophysics Data System (ADS)

Stubbs, Derek F.

1990-08-01

We briefly review the concept of computer aided medical diagnosis and more extensively review the the existing literature on neural network applications in the field. Neural networks can function as simple expert systems for diagnosis or prognosis. Using a public database we develop a neural network for the diagnosis of a major presenting symptom while discussing the development process and possible approaches. MEDICAL EXPERTS SYSTEMS COMPUTER AIDED DIAGNOSIS Biomedicine is an incredibly diverse and multidisciplinary field and it is not surprising that neural networks with their many applications are finding more and more applications in the highly non-linear field of biomedicine. I want to concentrate on neural networks as medical expert systems for clinical diagnosis or prognosis. Expert Systems started out as a set of computerized " ifthen" rules. Everything was reduced to boolean logic and the promised land of computer experts was said to be in sight. It never came. Why? First the computer code explodes as the number of " ifs" increases. All the " ifs" have to interact. Second experts are not very good at reducing expertise to language. It turns out that experts recognize patterns and have non-verbal left-brain intuition decision processes. Third learning by example rather than learning by rule is the way natural brains works and making computers work by rule-learning is hideously labor intensive. Neural networks can learn from example. They learn the results

[Cross-cultural adaptation and validation of the Health and Taste Attitude Scale (HTAS) in Portuguese].

PubMed

Koritar, Priscila; Philippi, Sonia Tucunduva; Alvarenga, Marle dos Santos; Santos, Bernardo dos

2014-08-01

The scope of this study was to show the cross-cultural adaptation and validation of the Health and Taste Attitude Scale in Portuguese. The methodology included translation of the scale; evaluation of conceptual, operational and item-based equivalence by 14 experts and 51 female undergraduates; semantic equivalence and measurement assessment by 12 bilingual women by the paired t-test, the Pearson correlation coefficient and the coefficient intraclass correlation; internal consistency and test-retest reliability by Cronbach's alpha and intraclass correlation coefficient, respectively, after application on 216 female undergraduates; assessment of discriminant and concurrent validity via the t-test and Spearman's correlation coefficient, respectively, in addition to Confirmatory Factor and Exploratory Factor Analysis. The scale was considered adequate and easily understood by the experts and university students and presented good internal consistency and reliability (µ 0.86, ICC 0.84). The results show that the scale is valid and can be used in studies with women to better understand attitudes related to taste.

Synthesis and application of molecularly imprinted nanoparticles combined ultrasonic assisted for highly selective solid phase extraction trace amount of celecoxib from human plasma samples using design expert (DXB) software.

PubMed

Arabi, Maryam; Ghaedi, Mehrorang; Ostovan, Abbas; Tashkhourian, Javad; Asadallahzadeh, Hamideh

2016-11-01

In this work molecular imprinted nanoparticles (MINPs) was synthesized and applied for ultrasonic assisted solid phase extraction of celecoxib (CEL) from human plasma sample following its combination by HPLC-UV. The MINPs were prepared in a non-covalent approach using methacrylic acid as monomer, CEL as template, ethylene glycol dimethacrylate as cross-linker, and 2,2-azobisisobutyronitrile (AIBN) as the initiator of polymerization. pH, volume of rinsing and eluent solvent and amount of sorbent influence on response were investigated using factorial experimental design, while optimum point was achieved and set as 250mg sorbent, pH 7.0, 1.5mL washing solvent and 2mL eluent by analysis of results according to design expert (DX) software. At above specified conditions, CEL in human plasma with complicated matrices with acceptable high recoveries (96%) and RSD% lower than 10% was quantified and estimated. The proposed MISPE-HPLC-UV method has linear responses among peak area and concentrations of CEL in the range of 0.2-2000μgL(-1), with regression coefficient of 0.98. The limit of detection (LOD) and quantification (LOQ) based on three and ten times of the noise of HPLC peaks correspond to blank solution were 0.08 and 0.18μgL(-1), respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ.

PubMed

Liou, Yiing Mei; Jwo, Clark J C; Yao, Kaiping Grace; Chiang, Li-Chi; Huang, Lian-Hua

2008-12-01

In order to analyze the health risks of insufficient activity by international comparisons, the first author obtained the permission to translate and develop a Taiwan version of the International Physical Activity Questionnaire (IPAQ). The objective was to determine culturally sensitive Chinese translations for the terms "moderate", "vigorous" and "physical activity" as well as to identify representative types of physical activity for Taiwanese. This study used discussions by 12 expert focus groups, 6 expert audits, a scale survey, field study, Cognitive Aspect Survey Methodology (CASM), dual independent translation and back-translation to establish a consensus on physical activity-related concepts, terminologies and types that define the intensity of common activities of Taiwanese by integrating both local and foreign studies. The Chinese terms "fei li", "zhong deng fei li" and "shen ti huo dong", respectively, were identified as suitable and adequate translations for the English terms "vigorous", "moderate" and "physical activity". The common Taiwanese activities were accurately categorized and listed in questionnaires, forming culturally sensitive scales. Taiwan versions of IPAQ's self-administered long version (SL), self-administered short version (SS), and telephone interview short version (TS) were developed. Their content validity indices were .992, .994, and .980, as well as .994, .992, and .994 for language equivalence and meaning similarity between the English and Chinese versions of the IPAQ-LS, IPAQ-SS, and IPAQ-TS, respectively. Consistency values for the English and Chinese versions in terms of intraclass correlation coefficients were .945, .704, and .894, respectively. The IPAQ-Taiwan is not only a sensitive and precise tool, but also shows the effectiveness of the methodology (CASM) used in tool development. Subjects who did not regularly exercise and had an education less than a junior high school level underestimated the moderate-intensity physical activity.

[Early diagnosis and early treatment for liver cancer in Qidong: survival of patients and effectiveness of screening].

PubMed

Chen, J G; Zhang, Y H; Zhu, J; Lu, J H; Wang, J B; Sun, Y; Xue, X F; Lu, L L; Chen, Y S; Wu, Y; Jiang, X P; Ding, L L; Zhang, Q N; Zhu, Y R

2017-12-23

Objective: To evaluate the patients' survival and effectiveness of the live cancer screening for population at high risk for liver cancer in Qidong. Methods: According to the Expert Scheme proposed the Expert Committee of Early Detection and Early Treatment, China Cancer Foundation, diagnostical screening by using combined methods of alpha-fetoprotein and B ultrasound monitoring were carried out biannually in individuals with positive HBsAg who were screened from Qidong area. The evaluation indices of the effectiveness are task completion rate of screening, detection rate of liver cancer, early diagnosis rate, and treatment rate. The deadline of the follow-up for the surviving outcome was March 31, 2016. The life-table method was used to calculate the observed survival, and to make comparison and significant tests between survival rates in Group A (those found via repeated periodic screening) and Group B (those diagnosed without periodic screening). Results: Since 2007, 38 016 target population have been screened, and 3 703(9.74%) individuals with positive HBsAg were found. Except for 29 patients with liver cancer at the initial screening, 3 674 persons in the cohort were followed up; 268 patients with liver cancer were detected from the 33 199 person-times screening, with an annual detection rate of 1.61%. Of them, 186 patients were found in Group A(1.12%), in which 149 patients were the early cases, with an early detection rate of 80.11%; 167 out of 186(89.78%) patients received treatment after diagnosis. The incidence of liver cancer in this HBsAg (+ ) cohort of 25 452 person-years was 1 052.96 per 100 000 annually, 187 cases in males(1 488.45/100 000)and 81 cases in females(628.46/100 000). The 1-, 3-, 5-, and 8-year survival of all patients with liver cancer were 64.55%, 40.50%, 32.54%, and 19.65%, respectively. The 1-, 3-, 5-, and 8-year survival rates were 77.16%, 49.04%, 38.53%, and 24.25% in Group A, and were 36.25%, 21.21%, 21.21%, and 0% in Group B, respectively, with significant differences between two groups ( P <0.05). Conclusion: The findings show that screening of individuals at high-risk of development of liver cancer, with semiannual AFP and B ultrasound, according to the Expert Scheme, is effective not only in increasing detection rate but also in detecting liver cancer at early stage, and in improving patients' survival as well.

Diagnostic accuracy of a clinical diagnosis of idiopathic pulmonary fibrosis: an international case–cohort study

PubMed Central

Maher, Toby M.; Kolb, Martin; Poletti, Venerino; Nusser, Richard; Richeldi, Luca; Vancheri, Carlo; Wilsher, Margaret L.; Antoniou, Katerina M.; Behr, Jüergen; Bendstrup, Elisabeth; Brown, Kevin; Calandriello, Lucio; Corte, Tamera J.; Crestani, Bruno; Flaherty, Kevin; Glaspole, Ian; Grutters, Jan; Inoue, Yoshikazu; Kokosi, Maria; Kondoh, Yasuhiro; Kouranos, Vasileios; Kreuter, Michael; Johannson, Kerri; Judge, Eoin; Ley, Brett; Margaritopoulos, George; Martinez, Fernando J.; Molina-Molina, Maria; Morais, António; Nunes, Hilario; Raghu, Ganesh; Ryerson, Christopher J.; Selman, Moises; Spagnolo, Paolo; Taniguchi, Hiroyuki; Tomassetti, Sara; Valeyre, Dominique; Wijsenbeek, Marlies; Wuyts, Wim; Hansell, David; Wells, Athol

2017-01-01

We conducted an international study of idiopathic pulmonary fibrosis (IPF) diagnosis among a large group of physicians and compared their diagnostic performance to a panel of IPF experts. A total of 1141 respiratory physicians and 34 IPF experts participated. Participants evaluated 60 cases of interstitial lung disease (ILD) without interdisciplinary consultation. Diagnostic agreement was measured using the weighted kappa coefficient (κw). Prognostic discrimination between IPF and other ILDs was used to validate diagnostic accuracy for first-choice diagnoses of IPF and were compared using the C-index. A total of 404 physicians completed the study. Agreement for IPF diagnosis was higher among expert physicians (κw=0.65, IQR 0.53–0.72, p<0.0001) than academic physicians (κw=0.56, IQR 0.45–0.65, p<0.0001) or physicians with access to multidisciplinary team (MDT) meetings (κw=0.54, IQR 0.45–0.64, p<0.0001). The prognostic accuracy of academic physicians with >20 years of experience (C-index=0.72, IQR 0.0–0.73, p=0.229) and non-university hospital physicians with more than 20 years of experience, attending weekly MDT meetings (C-index=0.72, IQR 0.70–0.72, p=0.052), did not differ significantly (p=0.229 and p=0.052 respectively) from the expert panel (C-index=0.74 IQR 0.72–0.75). Experienced respiratory physicians at university-based institutions diagnose IPF with similar prognostic accuracy to IPF experts. Regular MDT meeting attendance improves the prognostic accuracy of experienced non-university practitioners to levels achieved by IPF experts. PMID:28860269

Holistic processing of fingerprints by expert forensic examiners.

PubMed

Vogelsang, Macgregor D; Palmeri, Thomas J; Busey, Thomas A

2017-01-01

Holistic processing is often characterized as a process by which objects are perceived as a whole rather than a compilation of individual features. This mechanism may play an important role in the development of perceptual expertise because it allows for rapid integration across image regions. The present work explores whether holistic processing is present in latent fingerprint examiners, who compare fingerprints collected from crime scenes against a set of standards taken from a suspect. We adapted a composite task widely used in the face recognition and perceptual expertise literatures, in which participants were asked to match only a particular half of a fingerprint with a previous image while ignoring the other half. We tested both experts and novices, using both upright and inverted fingerprints. For upright fingerprints, we found weak evidence for holistic processing, but with no differences between experts and novices with respect to holistic processing. For inverted fingerprints, we found stronger evidence of holistic processing, with weak evidence for differences between experts and novices. These relatively weak holistic processing effects contrast with robust evidence for holistic processing with faces and with objects in other domains of perceptual expertise. The data constrain models of holistic processing by demonstrating that latent fingerprint experts and novices may not substantively differ in terms of the amount of holistic processing and that inverted stimuli actually produced more evidence for holistic processing than upright stimuli. Important differences between the present fingerprint stimuli and those in the literature include the lack of verbal labels for experts and the absence of strong vertical asymmetries, both of which might contribute to stronger holistic processing signatures in other stimulus domains.

Impact of side-effects of atypical antipsychotics on non-compliance, relapse and cost.

PubMed

Mortimer, A; Williams, P; Meddis, D

2003-01-01

Atypical antipsychotics generally have milder side-effects than conventional antipsychotics, but also differ among themselves in this respect. This study aimed to compare the impact of different side-effect profiles of individual atypical antipsychotics on non-compliance, relapse and cost in schizophrenia. A state-transition model was built using literature data supplemented by expert opinion. The model found that quetiapine and ziprasidone were similar in estimated non-compliance and relapse rates. Olanzapine and risperidone had higher estimated non-compliance and relapse rates, and incremental, 1-year, per-patient direct costs, using US-based cost data, of approximately $530 (95% confidence interval [CI] approximately $275, $800), and approximately $485 (95% CI approximately $235, $800), respectively, compared with quetiapine. Incremental costs attributable to different side-effect profiles were highly significant. This study shows that differing side-effect profiles of the newer antipsychotic agents are likely to lead to different compliance rates, and consequent variation in relapse rates. The cost implications of these heterogenous clinical outcomes are substantial.

Patient Blood Management: An International Perspective.

PubMed

Eichbaum, Quentin; Murphy, Michael; Liu, Yu; Kajja, Isaac; Hajjar, Ludhmila Abrahao; Smit Sibinga, Cees Th; Shan, Hua

2016-12-01

This article describes practices in patient blood management (PBM) in 4 countries on different continents that may provide insights for anesthesiologists and other physicians working in global settings. The article has its foundation in the proceedings of a session at the 2014 AABB annual meeting during which international experts from England, Uganda, China, and Brazil presented the programs and implementation strategies in PBM developed in their respective countries. To systematize the review and enhance the comparability between these countries on different continents, authors were requested to respond to the same set of 6 key questions with respect to their country's PBM program(s). Considerable variation exists between these country regions that is driven both by differences in health contexts and by disparities in resources. Comparing PBM strategies from low-, middle-, and high-income countries, as described in this article, allows them to learn bidirectionally from one another and to work toward implementing innovative and preferably evidence-based strategies for improvement. Sharing and distributing knowledge from such programs will ultimately also improve transfusion outcomes and patient safety.

A Model of Expertise: A Case Study of a Second Language Teacher Educator

ERIC Educational Resources Information Center

Asaba, Mayumi

2018-01-01

This study investigates the characteristics of an L2 expert teacher educator. The expert participant was selected based on the criteria suggested by educational expertise studies: years of teaching experience, high reputation among multiple constituencies, and evidence of impact on student performance. The data collection included observations,…

Strategic Uses of Music in the U.S. History Classroom

ERIC Educational Resources Information Center

Baker, Glenda

2011-01-01

This study investigated the strategic uses of music in the U.S. history classroom of six expert secondary U.S. history teachers identified by their administrators as expert teachers based on the merit of national certification, exemplary student and/or administration evaluations, high achieving teacher awards, or a combination of these criteria.…

76 FR 55673 - Vulnerability Assessments in Support of the Climate Ready Estuaries Program: A Novel Approach...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

... exercise was designed to elicit judgments from experts in a workshop setting, regarding climate change... influence under both current and future climate change scenarios. The experts also discussed the high impact... in the diagram, and the potential for threshold changes. These reports show how climate-sensitive...

SKIPing with Head Start Teachers: Influence of T-SKIP on Object-Control Skills

ERIC Educational Resources Information Center

Brian, Ali; Goodway, Jacqueline D.; Logan, Jessica A.; Sutherland, Sue

2017-01-01

Purpose: Children from disadvantaged settings are at risk for delays in their object-control (OC) skills. Fundamental motor skill interventions, such as the Successful Kinesthetic Instruction for Preschoolers (SKIP) Program, are highly successful when led by motor development experts. However, few preschools employ such experts. This study…

Expert-Novice Differences in Memory, Abstraction, and Reasoning in the Domain of Literature.

ERIC Educational Resources Information Center

Zeitz, Colleen M.

1994-01-01

Explored the information processing abilities associated with expertise in literature in high school and college students. Found that literary experts were superior to novices in gist-level recall, extraction of interpretations, and breadth of aspects addressed of literary texts but not in comprehension of scientific texts. (AA)

Fire Protection for Buildings

ERIC Educational Resources Information Center

Edmunds, Jane

1972-01-01

Reviews attack on fire safety in high rise buildings made by a group of experts representing the iron and steel industry at a recent conference. According to one expert, fire problems are people oriented, which calls for emphasis on fire prevention rather than reliance on fire suppression and for fire pretection to be built into a structure.…

High School Students Debate the Use of Embryonic Stem Cells: The influence of context on decision-making

NASA Astrophysics Data System (ADS)

Molinatti, Grégoire; Girault, Yves; Hammond, Constance

2010-11-01

The present study analyzes decision-making and argumentation by high school students in a debate situation on a socioscientific issue, the use of embryonic stem cells in research and therapy. We tested the influence on the debates of two different contexts. Adolescent students at the high school level in the same grade (mean age 16.4 years) from rural and urban zones of Provence, France, participated in three debate sessions. During the first session, the students listed the background questions they wanted to ask the expert(s). They were also required to identify one or two major issues that would serve as an outline for the future debate. They then discussed these with the expert(s) during the second session and took note of the answers. During this session, the control groups met with a neuroscientist whereas the experimental 'contextualized' group met with the same neuroscientist together with a representative of an association of patients suffering from a neurodegenerative disease. Analysis of the students' arguments and decision-making revealed that contextualization introduced dynamism in the students' exchanges: they paid more attention to their peers' arguments and were more motivated to argue their own opinion. However, this type of contextualization may contribute to reinforcing ideology in scientific progress.

Collaboration Expertise in Medicine - No Evidence for Cross-Domain Application from a Memory Retrieval Study.

PubMed

Kiesewetter, Jan; Fischer, Frank; Fischer, Martin R

2016-01-01

Is there evidence for expertise on collaboration and, if so, is there evidence for cross-domain application? Recall of stimuli was used to measure so-called internal collaboration scripts of novices and experts in two studies. Internal collaboration scripts refer to an individual's knowledge about how to interact with others in a social situation. METHOD— Ten collaboration experts and ten novices of the content domain social science were presented with four pictures of people involved in collaborative activities. The recall texts were coded, distinguishing between superficial and collaboration script information. RESULTS— Experts recalled significantly more collaboration script information (M = 25.20; SD = 5.88) than did novices (M = 13.80; SD = 4.47). Differences in superficial information were not found. Study 2 tested whether the differences found in Study 1 could be replicated. Furthermore, the cross-domain application of internal collaboration scripts was explored. METHOD— Twenty collaboration experts and 20 novices of the content domain medicine were presented with four pictures and four videos of their content domain and a video and picture of another content domain. All stimuli showed collaborative activities typical for the respective content domains. RESULTS— As in Study 1, experts recalled significantly more collaboration script information of their content domain (M = 71.65; SD = 33.23) than did novices (M = 54.25; SD = 15.01). For the novices, no differences were found for the superficial information nor for the retrieval of collaboration script information recalled after the other content domain stimuli. There is evidence for expertise on collaboration in memory tasks. The results show that experts hold substantially more collaboration script information than did novices. Furthermore, the differences between collaboration novices and collaboration experts occurred only in their own content domain, indicating that internal collaboration scripts are not easily stored and retrieved in memory tasks other than in the own content domain.

International recommendations for national patient safety incident reporting systems: an expert Delphi consensus-building process.

PubMed

Howell, Ann-Marie; Burns, Elaine M; Hull, Louise; Mayer, Erik; Sevdalis, Nick; Darzi, Ara

2017-02-01

Patient safety incident reporting systems (PSRS) have been established for over a decade, but uncertainty remains regarding the role that they can and ought to play in quantifying healthcare-related harm and improving care. To establish international, expert consensus on the purpose of PSRS regarding monitoring and learning from incidents and developing recommendations for their future role. After a scoping review of the literature, semi-structured interviews with experts in PSRS were conducted. Based on these findings, a survey-based questionnaire was developed and subsequently completed by a larger expert panel. Using a Delphi approach, consensus was reached regarding the ideal role of PSRSs. Recommendations for best practice were devised. Forty recommendations emerged from the Delphi procedure on the role and use of PSRS. Experts agreed reporting system should not be used as an epidemiological tool to monitor the rate of harm over time or to appraise the relative safety of hospitals. They agreed reporting is a valuable mechanism for identifying organisational safety needs. The benefit of a national system was clear with respect to medication error, device failures, hospital-acquired infections and never events as these problems often require solutions at a national level. Experts recommended training for senior healthcare professionals in incident investigation. Consensus recommendation was for hospitals to take responsibility for creating safety solutions locally that could be shared nationally. We obtained reasonable consensus among experts on aims and specifications of PSRS. This information can be used to reflect on existing and future PSRS, and their role within the wider patient safety landscape. The role of PSRS as instruments for learning needs to be elaborated and developed further internationally. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Validation of the da Vinci Surgical Skill Simulator across three surgical disciplines: A pilot study

PubMed Central

Alzahrani, Tarek; Haddad, Richard; Alkhayal, Abdullah; Delisle, Josée; Drudi, Laura; Gotlieb, Walter; Fraser, Shannon; Bergman, Simon; Bladou, Frank; Andonian, Sero; Anidjar, Maurice

2013-01-01

Objective: In this paper, we evaluate face, content and construct validity of the da Vinci Surgical Skills Simulator (dVSSS) across 3 surgical disciplines. Methods: In total, 48 participants from urology, gynecology and general surgery participated in the study as novices (0 robotic cases performed), intermediates (1–74) or experts (≥75). Each participant completed 9 tasks (Peg board level 2, match board level 2, needle targeting, ring and rail level 2, dots and needles level 1, suture sponge level 2, energy dissection level 1, ring walk level 3 and tubes). The Mimic Technologies software scored each task from 0 (worst) to 100 (best) using several predetermined metrics. Face and content validity were evaluated by a questionnaire administered after task completion. Wilcoxon test was used to perform pair wise comparisons. Results: The expert group comprised of 6 attending surgeons. The intermediate group included 4 attending surgeons, 3 fellows and 5 residents. The novices included 1 attending surgeon, 1 fellow, 13 residents, 13 medical students and 2 research assistants. The median number of robotic cases performed by experts and intermediates were 250 and 9, respectively. The median overall realistic score (face validity) was 8/10. Experts rated the usefulness of the simulator as a training tool for residents (content validity) as 8.5/10. For construct validity, experts outperformed novices in all 9 tasks (p < 0.05). Intermediates outperformed novices in 7 of 9 tasks (p < 0.05); there were no significant differences in the energy dissection and ring walk tasks. Finally, experts scored significantly better than intermediates in only 3 of 9 tasks (matchboard, dots and needles and energy dissection) (p < 0.05). Conclusions: This study confirms the face, content and construct validities of the dVSSS across urology, gynecology and general surgery. Larger sample size and more complex tasks are needed to further differentiate intermediates from experts. PMID:23914275

Collaboration Expertise in Medicine - No Evidence for Cross-Domain Application from a Memory Retrieval Study

PubMed Central

Kiesewetter, Jan; Fischer, Frank; Fischer, Martin R.

2016-01-01

Background Is there evidence for expertise on collaboration and, if so, is there evidence for cross-domain application? Recall of stimuli was used to measure so-called internal collaboration scripts of novices and experts in two studies. Internal collaboration scripts refer to an individual’s knowledge about how to interact with others in a social situation. Method—Study 1 Ten collaboration experts and ten novices of the content domain social science were presented with four pictures of people involved in collaborative activities. The recall texts were coded, distinguishing between superficial and collaboration script information. Results—Study 1 Experts recalled significantly more collaboration script information (M = 25.20; SD = 5.88) than did novices (M = 13.80; SD = 4.47). Differences in superficial information were not found. Study 2 Study 2 tested whether the differences found in Study 1 could be replicated. Furthermore, the cross-domain application of internal collaboration scripts was explored. Method—Study 2 Twenty collaboration experts and 20 novices of the content domain medicine were presented with four pictures and four videos of their content domain and a video and picture of another content domain. All stimuli showed collaborative activities typical for the respective content domains. Results—Study 2 As in Study 1, experts recalled significantly more collaboration script information of their content domain (M = 71.65; SD = 33.23) than did novices (M = 54.25; SD = 15.01). For the novices, no differences were found for the superficial information nor for the retrieval of collaboration script information recalled after the other content domain stimuli. Discussion There is evidence for expertise on collaboration in memory tasks. The results show that experts hold substantially more collaboration script information than did novices. Furthermore, the differences between collaboration novices and collaboration experts occurred only in their own content domain, indicating that internal collaboration scripts are not easily stored and retrieved in memory tasks other than in the own content domain. PMID:26866801

An expert review of the scientific literature on independent wheelchair transfers.

PubMed

Koontz, Alicia; Toro, Maria; Kankipati, Padmaja; Naber, Megan; Cooper, Rory

2012-01-01

The purpose of this study was to perform a literature review and seek expert opinion on the relevance and strength of the evidence concerning setup and transfer performance. Scientific literature databases were searched until June 2009 using 43 keywords resulting in 339 articles. These were internally reviewed and narrowed to 41 articles which were formally assessed by 13 external experts. Articles that 80% or more of the reviewers scored as moderately or highly relevant were included in the final results. Nineteen articles met the relevancy criteria. The aspects of setup that experts felt were addressed to some degree included vertical transfer distance, transferring across a gap and position of the mobility device relative to target destination. None of the 19 articles were scored as having strong to very strong resulting evidence. There is a consensus among studies that transferring to a higher surface implies greater exertion of the upper limb. However, there is no evidence concerning how high or low, how close, and how much space is needed next to the target surface so it can be accessible by a majority of wheelchair users.

A biomechanical comparison between expert and novice manual materials handlers using a multi-joint EMG-assisted optimization musculoskeletal model of the lumbar spine.

PubMed

Gagnon, Denis; Plamondon, André; Larivière, Christian

2016-09-06

Expertise is a key factor modulating the risk of low back disorders (LBD). Through years of practice in the workplace, the typical expert acquires high level specific skills and maintains a clean record of work-related injuries. Ergonomic observations of manual materials handling (MMH) tasks show that expert techniques differ from those of novices, leading to the idea that expert techniques are safer. Biomechanical studies of MMH tasks performed by experts/novices report mixed results for kinematic/kinetic variables, evoking potential internal effect of expertise. In the context of series of box transfers simulated by actual workers, detailed internal loads predicted by a multiple-joint EMG-assisted optimization lumbar spine model are compared between experts and novices. The results confirmed that the distribution of internal moments are modulated by worker expertise. Experts flexed less their lumbar spine and exerted more active muscle forces while novices relied more on passive resistance of the muscles and ligamentous spine. More specifically for novices, the passive contributions came from global extensor muscles, selected local extensor muscles, and passive structures of the lumbar spine (ligaments and discs). The distinctive distribution of internal forces was not concomitant with a similar effect on joint forces, these forces being dependent on external loading which was equivalent between experts and novices. From a safety standpoint, the present results suggest that experts were more efficient than novices in partitioning internal moment contributions to balance net (external) loading. Thus, safer handling practices might be seen as a result of experts׳ experience. Copyright © 2016 Elsevier Ltd. All rights reserved.

A New School for Brats: Improving the K-12 Education of Military Connected Children

DTIC Science & Technology

2017-09-01

Christensen introduces his theory of “disruptive innovation” to explain how successful companies fail when they neglect to address changes in “the... High : One School, How Experts Tried to Fail It, and the Students and Teachers Who Made It Triumph (New York: Nation Books, 2015), 64. 47 John Dewey and...Sheila Curran Bernard and Sarah Mondale, 63–70. Boston: Beacon Press, 2001. Rizga, Kristin. Mission High : One School, How Experts Tried to Fail It, and

Measuring Certified Registered Nurse Anesthetist Organizational Climate: Instrument Adaptation.

PubMed

Boyd, Donald; Poghosyan, Lusine

2017-08-01

No tool exists measuring certified registered nurse anesthetist (CRNA) organizational climate. The study's purpose is to adapt a validated tool to measure CRNA organizational climate. Content validity of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ) was established. Pilot testing was conducted to determine internal reliability consistency of the subscales. Experts rated the tool as content valid. The subscales had high internal consistency reliability (with respective Cronbach's alphas): CRNA-Anesthesiologist Relations (.753), CRNA-Physician Relations (.833), CRNA-Administration Relations (.895), Independent Practice (.830), Support for CRNA Practice (.683), and Professional Visibility (.772). Further refinement of the CRNA-OCQ is necessary. Measurement and assessment of CRNA organizational climate may produce evidence needed to improve provider and patient outcomes.

Embedding Human Expert Cognition Into Autonomous UAS Trajectory Planning.

PubMed

Narayan, Pritesh; Meyer, Patrick; Campbell, Duncan

2013-04-01

This paper presents a new approach for the inclusion of human expert cognition into autonomous trajectory planning for unmanned aerial systems (UASs) operating in low-altitude environments. During typical UAS operations, multiple objectives may exist; therefore, the use of multicriteria decision aid techniques can potentially allow for convergence to trajectory solutions which better reflect overall mission requirements. In that context, additive multiattribute value theory has been applied to optimize trajectories with respect to multiple objectives. A graphical user interface was developed to allow for knowledge capture from a human decision maker (HDM) through simulated decision scenarios. The expert decision data gathered are converted into value functions and corresponding criteria weightings using utility additive theory. The inclusion of preferences elicited from HDM data within an automated decision system allows for the generation of trajectories which more closely represent the candidate HDM decision preferences. This approach has been demonstrated in this paper through simulation using a fixed-wing UAS operating in low-altitude environments.

A consensus reaching model for 2-tuple linguistic multiple attribute group decision making with incomplete weight information

NASA Astrophysics Data System (ADS)

Zhang, Wancheng; Xu, Yejun; Wang, Huimin

2016-01-01

The aim of this paper is to put forward a consensus reaching method for multi-attribute group decision-making (MAGDM) problems with linguistic information, in which the weight information of experts and attributes is unknown. First, some basic concepts and operational laws of 2-tuple linguistic label are introduced. Then, a grey relational analysis method and a maximising deviation method are proposed to calculate the incomplete weight information of experts and attributes respectively. To eliminate the conflict in the group, a weight-updating model is employed to derive the weights of experts based on their contribution to the consensus reaching process. After conflict elimination, the final group preference can be obtained which will give the ranking of the alternatives. The model can effectively avoid information distortion which is occurred regularly in the linguistic information processing. Finally, an illustrative example is given to illustrate the application of the proposed method and comparative analysis with the existing methods are offered to show the advantages of the proposed method.

[Liability of surgeons with respect to injuries to the bile duct during laparoscopic cholecystectomy : Analyses of malpractice litigations in the years 1996-2009].

PubMed

Fellmer, P T; Fellmer, J; Jonas, S

2011-01-01

Injuries to the bile duct during laparoscopic cholecystectomy are often a cause of malpractice litigations. A total of 13 legal verdicts as a result of bile duct injury from 1996 to 2009 were reviewed. Comments on the verdicts and the opinions of expert witnesses were analyzed. Out of 13 claims, 7 were upheld and 6 were rejected. Most expert witnesses from 1996 to 2002 stated that not carrying out a cholangiography and insufficient preparation of the cystic duct constituted a performance below the standard of care expected. Expert witness testimonies from 2004 to 2009, however, regarded injury to the bile duct as predominantly inherent to treatment. With the expansion and acceptance of laparoscopic interventions, changes in the results of malpractice litigation have become evident. In contrast to the phase during establishment of the technology, an injury to the bile duct is nowadays judged predominantly as inherent to treatment.

Using structured expert judgment to assess invasive species prevention: Asian carp and the Mississippi-Great Lakes hydrologic connection.

PubMed

Wittmann, Marion E; Cooke, Roger M; Rothlisberger, John D; Lodge, David M

2014-02-18

Recently, authors have theorized that invasive species prevention is more cost-effective than control in protecting ecosystem services. However, quantification of the effectiveness of prevention is rare because experiments at field scales are expensive or infeasible. We therefore used structured expert judgment to quantify the efficacy of 17 proposed strategies to prevent Asian carp invasion of the Laurentian Great Lakes via the hydrologic connection between the Mississippi and Great Lakes watersheds. Performance-weighted expert estimates indicated that hydrologic separation would prevent 99% (95,100; median, 5th and 95th percentiles) of Asian carp access, while electric and acoustic-bubble-strobe barriers would prevent 92% (85,95) and 92% (75,95), respectively. For all other strategies, estimated effectiveness was lower, with greater uncertainty. When potential invasions by other taxa are considered, the effectiveness of hydrologic separation increases relative to strategies that are effective primarily for fishes. These results could help guide invasive species management in many waterways globally.

Plus disease in retinopathy of prematurity: a continuous spectrum of vascular abnormality as basis of diagnostic variability

PubMed Central

Campbell, J. Peter; Kalpathy-Cramer, Jayashree; Erdogmus, Deniz; Tian, Peng; Kedarisetti, Dharanish; Moleta, Chace; Reynolds, James D.; Hutcheson, Kelly; Shapiro, Michael J.; Repka, Michael X.; Ferrone, Philip; Drenser, Kimberly; Horowitz, Jason; Sonmez, Kemal; Swan, Ryan; Ostmo, Susan; Jonas, Karyn E.; Chan, R.V. Paul; Chiang, Michael F.

2016-01-01

Objective To identify patterns of inter-expert discrepancy in plus disease diagnosis in retinopathy of prematurity (ROP). Design We developed two datasets of clinical images of varying disease severity (100 images and 34 images) as part of the Imaging and Informatics in ROP study, and determined a consensus reference standard diagnosis (RSD) for each image, based on 3 independent image graders and the clinical exam. We recruited 8 expert ROP clinicians to classify these images and compared the distribution of classifications between experts and the RSD. Subjects, Participants, and/or Controls Images obtained during routine ROP screening in neonatal intensive care units. 8 participating experts with >10 years of clinical ROP experience and >5 peer-reviewed ROP publications. Methods, Intervention, or Testing Expert classification of images of plus disease in ROP. Main Outcome Measures Inter-expert agreement (weighted kappa statistic), and agreement and bias on ordinal classification between experts (ANOVA) and the RSD (percent agreement). Results There was variable inter-expert agreement on diagnostic classifications between the 8 experts and the RSD (weighted kappa 0 – 0.75, mean 0.30). RSD agreement ranged from 80 – 94% agreement for the dataset of 100 images, and 29 – 79% for the dataset of 34 images. However, when images were ranked in order of disease severity (by average expert classification), the pattern of expert classification revealed a consistent systematic bias for each expert consistent with unique cut points for the diagnosis of plus disease and pre-plus disease. The two-way ANOVA model suggested a highly significant effect of both image and user on the average score (P<0.05, adjusted R2=0.82 for dataset A, and P< 0.05 and adjusted R2 =0.6615 for dataset B). Conclusions and Relevance There is wide variability in the classification of plus disease by ROP experts, which occurs because experts have different “cut-points” for the amounts of vascular abnormality required for presence of plus and pre-plus disease. This has important implications for research, teaching and patient care for ROP, and suggests that a continuous ROP plus disease severity score may more accurately reflect the behavior of expert ROP clinicians, and may better standardize classification in the future. PMID:27591053

Key motion characteristics of side-step movements in hip-hop dance and their effect on the evaluation by judges.

PubMed

Sato, Nahoko; Nunome, Hiroyuki; Ikegami, Yasuo

2016-06-01

In hip-hop dance, the elements of motion that discriminate the skill levels of dancers and that influence the evaluations by judges have not been clearly identified. This study set out to extract these motion characteristics from the side-step movements of hip-hop dancing. Eight expert and eight non-expert dancers performed side-step movements, which were recorded using a motion capture system. Nine experienced judges evaluated the dancers' performances. Several parameters, including the range of motion (ROM) of the joint angles (neck, trunk, hip, knee, and face inclination) and phase delays between these angular motions were calculated. A quarter-cycle phase delay between the neck motion and other body parts, seen only in the expert dancers, is highlighted as an element that can distinguish dancers' skill levels. This feature of the expert dancers resulted in a larger ROM during the face inclination than that for the non-expert dancers. In addition, the experts exhibited a bottom-to-top segmental sequence in the horizontal direction while the non-experts did not demonstrate any such sequential motion. Of these kinematic parameters, only the ROM of the face inclination was highly correlated to the judging score and is regarded as being the most appealing element of the side-step movement.

Identifying key conservation threats to Alpine birds through expert knowledge

PubMed Central

Pedrini, Paolo; Brambilla, Mattia; Rolando, Antonio; Girardello, Marco

2016-01-01

Alpine biodiversity is subject to a range of increasing threats, but the scarcity of data for many taxa means that it is difficult to assess the level and likely future impact of a given threat. Expert opinion can be a useful tool to address knowledge gaps in the absence of adequate data. Experts with experience in Alpine ecology were approached to rank threat levels for 69 Alpine bird species over the next 50 years for the whole European Alps in relation to ten categories: land abandonment, climate change, renewable energy, fire, forestry practices, grazing practices, hunting, leisure, mining and urbanization. There was a high degree of concordance in ranking of perceived threats among experts for most threat categories. The major overall perceived threats to Alpine birds identified through expert knowledge were land abandonment, urbanization, leisure and forestry, although other perceived threats were ranked highly for particular species groups (renewable energy and hunting for raptors, hunting for gamebirds). For groups of species defined according to their breeding habitat, open habitat species and treeline species were perceived as the most threatened. A spatial risk assessment tool based on summed scores for the whole community showed threat levels were highest for bird communities of the northern and western Alps. Development of the approaches given in this paper, including addressing biases in the selection of experts and adopting a more detailed ranking procedure, could prove useful in the future in identifying future threats, and in carrying out risk assessments based on levels of threat to the whole bird community. PMID:26966659

Women-Family in Quality Perspective

ERIC Educational Resources Information Center

Fatimah, Rika P. L.; Aziz, J. Abdul; Ibrahim, K.

2008-01-01

Bringing together women and family in quality perspective brings about interesting discussions in this paper. By integrating previous studies and considering expert opinions, we determine the variables and dimensions with respect to women's existence regarding their roles both in the family and at work. Many activities carried out by women…

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2012 CFR

2012-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

17 CFR 201.102 - Appearance and practice before the Commission.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., opinion or other paper by any attorney, accountant, engineer or other professional or expert, filed with... rules and regulations thereunder. (iv) With respect to persons licensed to practice as accountants... accountant knows, or should know, that heightened scrutiny is warranted. (2) Repeated instances of...

7 CFR 3403.10 - Proposal review.

Code of Federal Regulations, 2011 CFR

2011-01-01

... BUSINESS INNOVATION RESEARCH GRANTS PROGRAM Submission and Evaluation of Proposals § 3403.10 Proposal.... USDA is under no obligation to fund any proposal or any specific number of proposals in a given topic... are uniquely qualified by training and experience in their respective fields to render expert advice...

Strategies for addressing adherence problems in patients with serious and persistent mental illness: recommendations from the expert consensus guidelines.

PubMed

Velligan, Dawn I; Weiden, Peter J; Sajatovic, Martha; Scott, Jan; Carpenter, Daniel; Ross, Ruth; Docherty, John P

2010-09-01

Poor adherence to medication can have devastating consequences for patients with serious mental illness. The literature review and recommendations in this article are reprinted from The Expert Consensus Guideline Series: Adherence Problems in Patients with Serious and Persistent Mental Illness, published in 2009. The expert consensus survey (39 questions, 521 options) on adherence problems in schizophrenia and bipolar disorder was completed by 41 experts in 2008. This article first reviews the literature on interventions aimed at improving adherence. It then presents the experts' recommendations for targeting factors that can contribute to nonadherence and relates them to the literature. The following psychosocial/programmatic and pharmacologic interventions were rated first line for specific problems that can lead to nonadherence: ongoing symptom/ side-effect monitoring for persistent symptoms or side effects; services targeting logistic problems; medication monitoring/environmental supports (e.g., Cognitive Adaptation Training, assertive community treatment) for lack of routines or cognitive deficits; and adjusting the dose or switching to a different oral antipsychotic for persistent side effects (also high second-line for persistent symptoms). Among pharmacologic interventions, the experts gave high second-line ratings to switching to a long-acting antipsychotic when lack of insight, substance use, persistent symptoms, logistic problems, lack of routines, or lack of family/ social support interfere with adherence and to simplifying the treatment regimen when logistic problems, lack of routines, cognitive deficits, or lack of family/social support interfere with adherence. Psychosocial/programmatic interventions that received high second-line ratings in a number of situations included medication monitoring/environmental supports, patient psychoeducation, more frequent and/or longer visits if possible, cognitive behavioral therapy (CBT), family-focused therapy, and services targeting logistic problems. It is important to identify specific factors that may be contributing to a patient's adherence problems in order to customize interventions and to consider using a multifaceted approach since multiple problems may be involved.

Children's Rights and School Psychology: An Introduction to the Multiple Journal Series Honoring the 25th Anniversary of the United Nations Convention on the Rights of the Child

ERIC Educational Resources Information Center

Mcloughlin, Caven S.; Hart, Stuart N.

2014-01-01

This year, 2014, is the 25th anniversary of the United Nations Convention on the Rights of the Child--the world's "positive ideology" and its clearest statement of commitments to and respect and aspirations for the dignity of the child. To commemorate this landmark, a program of articles by respected experts has been organized to advance…

Fully automatic registration and segmentation of first-pass myocardial perfusion MR image sequences.

PubMed

Gupta, Vikas; Hendriks, Emile A; Milles, Julien; van der Geest, Rob J; Jerosch-Herold, Michael; Reiber, Johan H C; Lelieveldt, Boudewijn P F

2010-11-01

Derivation of diagnostically relevant parameters from first-pass myocardial perfusion magnetic resonance images involves the tedious and time-consuming manual segmentation of the myocardium in a large number of images. To reduce the manual interaction and expedite the perfusion analysis, we propose an automatic registration and segmentation method for the derivation of perfusion linked parameters. A complete automation was accomplished by first registering misaligned images using a method based on independent component analysis, and then using the registered data to automatically segment the myocardium with active appearance models. We used 18 perfusion studies (100 images per study) for validation in which the automatically obtained (AO) contours were compared with expert drawn contours on the basis of point-to-curve error, Dice index, and relative perfusion upslope in the myocardium. Visual inspection revealed successful segmentation in 15 out of 18 studies. Comparison of the AO contours with expert drawn contours yielded 2.23 ± 0.53 mm and 0.91 ± 0.02 as point-to-curve error and Dice index, respectively. The average difference between manually and automatically obtained relative upslope parameters was found to be statistically insignificant (P = .37). Moreover, the analysis time per slice was reduced from 20 minutes (manual) to 1.5 minutes (automatic). We proposed an automatic method that significantly reduced the time required for analysis of first-pass cardiac magnetic resonance perfusion images. The robustness and accuracy of the proposed method were demonstrated by the high spatial correspondence and statistically insignificant difference in perfusion parameters, when AO contours were compared with expert drawn contours. Copyright © 2010 AUR. Published by Elsevier Inc. All rights reserved.

Diagnostic accuracy of the Bedside Lung Ultrasound in Emergency protocol for the diagnosis of acute respiratory failure in spontaneously breathing patients*,**

PubMed Central

Dexheimer, Felippe Leopoldo; de Andrade, Juliana Mara Stormovski; Raupp, Ana Carolina Tabajara; Townsend, Raquel da Silva; Beltrami, Fabiana Gabe; Brisson, Hélène; Lu, Qin; Dalcin, Paulo de Tarso Roth

2015-01-01

Objective: Bedside lung ultrasound (LUS) is a noninvasive, readily available imaging modality that can complement clinical evaluation. The Bedside Lung Ultrasound in Emergency (BLUE) protocol has demonstrated a high diagnostic accuracy in patients with acute respiratory failure (ARF). Recently, bedside LUS has been added to the medical training program of our ICU. The aim of this study was to investigate the accuracy of LUS based on the BLUE protocol, when performed by physicians who are not ultrasound experts, to guide the diagnosis of ARF. Methods: Over a one-year period, all spontaneously breathing adult patients consecutively admitted to the ICU for ARF were prospectively included. After training, 4 non-ultrasound experts performed LUS within 20 minutes of patient admission. They were blinded to patient medical history. LUS diagnosis was compared with the final clinical diagnosis made by the ICU team before patients were discharged from the ICU (gold standard). Results: Thirty-seven patients were included in the analysis (mean age, 73.2 ± 14.7 years; APACHE II, 19.2 ± 7.3). LUS diagnosis had a good agreement with the final diagnosis in 84% of patients (overall kappa, 0.81). The most common etiologies for ARF were pneumonia (n = 17) and hemodynamic lung edema (n = 15). The sensitivity and specificity of LUS as measured against the final diagnosis were, respectively, 88% and 90% for pneumonia and 86% and 87% for hemodynamic lung edema. Conclusions: LUS based on the BLUE protocol was reproducible by physicians who are not ultrasound experts and accurate for the diagnosis of pneumonia and hemodynamic lung edema. PMID:25750675

Plasticity of white matter connectivity in phonetics experts.

PubMed

Vandermosten, Maaike; Price, Cathy J; Golestani, Narly

2016-09-01

Phonetics experts are highly trained to analyze and transcribe speech, both with respect to faster changing, phonetic features, and to more slowly changing, prosodic features. Previously we reported that, compared to non-phoneticians, phoneticians had greater local brain volume in bilateral auditory cortices and the left pars opercularis of Broca's area, with training-related differences in the grey-matter volume of the left pars opercularis in the phoneticians group (Golestani et al. 2011). In the present study, we used diffusion MRI to examine white matter microstructure, indexed by fractional anisotropy, in (1) the long segment of arcuate fasciculus (AF_long), which is a well-known language tract that connects Broca's area, including left pars opercularis, to the temporal cortex, and in (2) the fibers arising from the auditory cortices. Most of these auditory fibers belong to three validated language tracts, namely to the AF_long, the posterior segment of the arcuate fasciculus and the middle longitudinal fasciculus. We found training-related differences in phoneticians in left AF_long, as well as group differences relative to non-experts in the auditory fibers (including the auditory fibers belonging to the left AF_long). Taken together, the results of both studies suggest that grey matter structural plasticity arising from phonetic transcription training in Broca's area is accompanied by changes to the white matter fibers connecting this very region to the temporal cortex. Our findings suggest expertise-related changes in white matter fibers connecting fronto-temporal functional hubs that are important for phonetic processing. Further studies can pursue this hypothesis by examining the dynamics of these expertise related grey and white matter changes as they arise during phonetic training.

High-resolution modeling of antibody structures by a combination of bioinformatics, expert knowledge, and molecular simulations.

PubMed

Shirai, Hiroki; Ikeda, Kazuyoshi; Yamashita, Kazuo; Tsuchiya, Yuko; Sarmiento, Jamica; Liang, Shide; Morokata, Tatsuaki; Mizuguchi, Kenji; Higo, Junichi; Standley, Daron M; Nakamura, Haruki

2014-08-01

In the second antibody modeling assessment, we used a semiautomated template-based structure modeling approach for 11 blinded antibody variable region (Fv) targets. The structural modeling method involved several steps, including template selection for framework and canonical structures of complementary determining regions (CDRs), homology modeling, energy minimization, and expert inspection. The submitted models for Fv modeling in Stage 1 had the lowest average backbone root mean square deviation (RMSD) (1.06 Å). Comparison to crystal structures showed the most accurate Fv models were generated for 4 out of 11 targets. We found that the successful modeling in Stage 1 mainly was due to expert-guided template selection for CDRs, especially for CDR-H3, based on our previously proposed empirical method (H3-rules) and the use of position specific scoring matrix-based scoring. Loop refinement using fragment assembly and multicanonical molecular dynamics (McMD) was applied to CDR-H3 loop modeling in Stage 2. Fragment assembly and McMD produced putative structural ensembles with low free energy values that were scored based on the OSCAR all-atom force field and conformation density in principal component analysis space, respectively, as well as the degree of consensus between the two sampling methods. The quality of 8 out of 10 targets improved as compared with Stage 1. For 4 out of 10 Stage-2 targets, our method generated top-scoring models with RMSD values of less than 1 Å. In this article, we discuss the strengths and weaknesses of our approach as well as possible directions for improvement to generate better predictions in the future. © 2014 Wiley Periodicals, Inc.

DISCONTOOLS: a database to identify research gaps on vaccines, pharmaceuticals and diagnostics for the control of infectious diseases of animals.

PubMed

O'Brien, Declan; Scudamore, Jim; Charlier, Johannes; Delavergne, Morgane

2017-01-03

The public and private sector in the EU spend around €800 million per year on animal health and welfare related research. An objective process to identify critical gaps in knowledge and available control tools should aid the prioritisation of research in order to speed up the development of new or improved diagnostics, vaccines and pharmaceuticals and reduce the burden of animal diseases. Here, we describe the construction of a database based on expert consultation for 52 infectious diseases of animals. For each disease, an expert group produced a disease and product analysis document that formed the basis for gap analysis and prioritisation. The prioritisation model was based on a closed scoring system, employing identical weights for six evaluation criteria (disease knowledge; impact on animal health and welfare; impact on public health; impact on wider society; impact on trade; control tools). The diseases were classified into three groups: epizootic diseases, food-producing animal complexes or zoonotic diseases. The highly ranked diseases in the prioritisation model comprised mostly zoonotic and epizootic diseases with important gaps identified in vaccine development and pharmaceuticals, respectively. The most important outcome is the identification of key research needs by disease. The rankings and research needs by disease are provided on a public website ( www.discontools.eu ) which is currently being updated based on new expert consultations. As such, it can become a reference point for funders of research including the European Commission, member states, foundations, trusts along with private industry to prioritise research. This will deliver benefits in terms of animal health and welfare but also public health, societal benefits and a safe and secure food supply.

Combination and selection of traffic safety expert judgments for the prevention of driving risks.

PubMed

Cabello, Enrique; Conde, Cristina; de Diego, Isaac Martín; Moguerza, Javier M; Redchuk, Andrés

2012-11-02

In this paper, we describe a new framework to combine experts’ judgments for the prevention of driving risks in a cabin truck. In addition, the methodology shows how to choose among the experts the one whose predictions fit best the environmental conditions. The methodology is applied over data sets obtained from a high immersive cabin truck simulator in natural driving conditions. A nonparametric model, based in Nearest Neighbors combined with Restricted Least Squared methods is developed. Three experts were asked to evaluate the driving risk using a Visual Analog Scale (VAS), in order to measure the driving risk in a truck simulator where the vehicle dynamics factors were stored. Numerical results show that the methodology is suitable for embedding in real time systems.

Best Practices for Reduction of Uncertainty in CFD Results

NASA Technical Reports Server (NTRS)

Mendenhall, Michael R.; Childs, Robert E.; Morrison, Joseph H.

2003-01-01

This paper describes a proposed best-practices system that will present expert knowledge in the use of CFD. The best-practices system will include specific guidelines to assist the user in problem definition, input preparation, grid generation, code selection, parameter specification, and results interpretation. The goal of the system is to assist all CFD users in obtaining high quality CFD solutions with reduced uncertainty and at lower cost for a wide range of flow problems. The best-practices system will be implemented as a software product which includes an expert system made up of knowledge databases of expert information with specific guidelines for individual codes and algorithms. The process of acquiring expert knowledge is discussed, and help from the CFD community is solicited. Benefits and challenges associated with this project are examined.

An expert system for spectroscopic analysis of rocket engine plumes

NASA Technical Reports Server (NTRS)

Reese, Greg; Valenti, Elizabeth; Alphonso, Keith; Holladay, Wendy

1991-01-01

The expert system described in this paper analyzes spectral emissions of rocket engine exhaust plumes and shows major promise for use in engine health diagnostics. Plume emission spectroscopy is an important tool for diagnosing engine anomalies, but it is time-consuming and requires highly skilled personnel. The expert system was created to alleviate such problems. The system accepts a spectral plot in the form of wavelength vs intensity pairs and finds the emission peaks in the spectrum, lists the elemental emitters present in the data and deduces the emitter that produced each peak. The system consists of a conventional language component and a commercially available inference engine that runs on an Apple Macintosh computer. The expert system has undergone limited preliminary testing. It detects elements well and significantly decreases analysis time.

Interactive knowledge discovery with the doctor-in-the-loop: a practical example of cerebral aneurysms research.

PubMed

Girardi, Dominic; Küng, Josef; Kleiser, Raimund; Sonnberger, Michael; Csillag, Doris; Trenkler, Johannes; Holzinger, Andreas

2016-09-01

Established process models for knowledge discovery find the domain-expert in a customer-like and supervising role. In the field of biomedical research, it is necessary to move the domain-experts into the center of this process with far-reaching consequences for both their research output and the process itself. In this paper, we revise the established process models for knowledge discovery and propose a new process model for domain-expert-driven interactive knowledge discovery. Furthermore, we present a research infrastructure which is adapted to this new process model and demonstrate how the domain-expert can be deeply integrated even into the highly complex data-mining process and data-exploration tasks. We evaluated this approach in the medical domain for the case of cerebral aneurysms research.

Register of hydrogen technology experts

NASA Technical Reports Server (NTRS)

Ludtke, P. R.

1975-01-01

This register presents the names of approximately 235 individuals who are considered experts, or very knowledgeable, in various fields of technology related to hydrogen. Approximately 90 organizations are represented. Each person is listed by organizational affiliation, address, and principal area of expertise. The criteria for selection of names for the register are extensive experience in a given field of work, participation in or supervision of relevant research programs, contributions to the literature, or being recognized as an expert in a particular field. The purpose of the register is to present, in easy form, sources of dependable information regarding highly technical areas of hydrogen technology, with particular emphasis on safety. The register includes two indexes: an alphabetical listing of the experts and an alphabetical listing of the organizations with which they are affiliated.

What Do Geoscience Experts and Novices Look At and What Do They See When Viewing and Interpreting Data Visualizations?

NASA Astrophysics Data System (ADS)

Kastens, K. A.; Shipley, T. F.; Boone, A.

2012-12-01

When geoscience experts look at data visualizations, they can "see" structures, and processes and traces of Earth history. When students look at those same visualizations, they may see only blotches of color, dots or squiggles. What are those experts doing, and how can students learn to do the same? We report on a study in which experts (>10 years of geoscience research experience) and novices (undergrad psychology students) examine shaded-relief/color-coded images of topography/bathymetry, while answering questions aloud and being eye-tracked. Images were a global map, two high-res images of continental terrain and two of oceanic terrain, with hi-res localities chosen to display distinctive traces of important earth processes. The differences in what they look at as recorded by eye-tracking are relatively subtle. On the global image, novices tend to focus on continents, whereas experts distribute their attention more evenly across continents and oceans. Experts universally access the available scale information (distance scale, lat/long axes), whereas most students do not. Novices do attend substantially and spontaneously to the salient geomorphological features in the high-res images: seamounts, mid-ocean ridge/transform intersection, erosional river channels, and compressional ridges and valley system. The more marked differences come in what respondents see, as captured in video recordings of their words and gestures in response to experimenter's questions. When their attention is directed to a small and distinctive part of a high-res image and they are asked to "….describe what you see…", experts typically produce richly detailed descriptions that may include the regional depth/altitude, local relief, shape and spatial distribution of major features, symmetry or lack thereof, cross-cutting relationships, presence of lineations and their orientations, and similar geomorphological details. Following or interwoven with these rich descriptions, some experts also offer interpretations of causal Earth processes. We identified four types of novice answers: (a) "flat" answers, in which the student describes the patches of color on the screen with no mention of shape or relief; (b) "thing" answers, in which the student mentions an inappropriate object, such as "the Great Wall of China," (c) geomorphology answers, in which the student talks about depth/altitude, relief, or shapes of landforms, and (d) process answers, in which student talks about earth processes, such as earthquakes, erosion, or plate tectonics. Novice "geomorphology" (c) answers resemble expert responses, but lack the rich descriptive detail. The "process" (d) category includes many interpretations that lack any grounding in the evidentiary base available in the viewed data. These findings suggest that instruction around earth data should include an emphasis on thoroughly and accurately describing the features that are present in the data--a skill that our experts display and our novices mostly lack. It is unclear, though, how best to sequence the teaching of descriptive and interpretive skills, since the experts' attention to empirical features in the data is steered by their knowledge of which features have causal significance.

Essential Concepts of Nanoscale Science and Technology for High School Students Based on a Delphi Study by the Expert Community

NASA Astrophysics Data System (ADS)

Sakhnini, Sohair; Blonder, Ron

2015-07-01

Nanoscale science and technology (NST) is an important new field in modern science. In the current study, we seek to answer the question: 'What are the essential concepts of NST that should be taught in high school'? A 3-round Delphi study methodology was applied based on 2 communities of experts in nanotechnology research and science education. Eight essential concepts in NST were identified. Each concept is accompanied by its explanation, definition, importance and includes subcategories that compose it. Three concepts emerged in the Delphi study, which were not identified before: functionality, classification of nanomaterials, and the making of nanotechnology. Differences between the concepts suggested by the 2 communities of experts were found. The results of this study serve as a tool to examine different nanotechnology programs that were reported thus far and to make recommendations for designing a NST program for high school students that includes the essential concepts.

High definition systems in Japan

NASA Technical Reports Server (NTRS)

Elkus, Richard J., Jr.; Cohen, Robert B.; Dayton, Birney D.; Messerschmitt, David G.; Schreiber, William F.; Tannas, Lawrence E., Jr.; Shelton, Duane

1991-01-01

The successful implementation of a strategy to produce high-definition systems within the Japanese economy will favorably affect the fundamental competitiveness of Japan relative to the rest of the world. The development of an infrastructure necessary to support high-definition products and systems in that country involves major commitments of engineering resources, plants and equipment, educational programs and funding. The results of these efforts appear to affect virtually every aspect of the Japanese industrial complex. The results of assessments of the current progress of Japan toward the development of high-definition products and systems are presented. The assessments are based on the findings of a panel of U.S. experts made up of individuals from U.S. academia and industry, and derived from a study of the Japanese literature combined with visits to the primary relevant industrial laboratories and development agencies in Japan. Specific coverage includes an evaluation of progress in R&D for high-definition television (HDTV) displays that are evolving in Japan; high-definition standards and equipment development; Japanese intentions for the use of HDTV; economic evaluation of Japan's public policy initiatives in support of high-definition systems; management analysis of Japan's strategy of leverage with respect to high-definition products and systems.

Evaluation of an Expert System for the Generation of Speech and Language Therapy Plans.

PubMed

Robles-Bykbaev, Vladimir; López-Nores, Martín; García-Duque, Jorge; Pazos-Arias, José J; Arévalo-Lucero, Daysi

2016-07-01

Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient. We aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs' work and leads to more accurate, consistent, and complete therapy plans for their patients. We examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results. The evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency, and completeness of the proposed activities with 4.65, 4.6, and 4.6 points (to a maximum of 5), respectively. The ratings for the subplans generated for the areas of hearing, oral structure and function, and linguistic formulation were nearly perfect, whereas the subplans for expressive language and articulation and for receptive language failed to deal properly with some of the subject cases. Overall, the SLPs indicated that over 90% of the subplans generated automatically were "better than" or "as good as" what the SLPs would have created manually if given the average time they can devote to the task. The cross-validation experiment yielded very similar results. The results show that the SPELTA expert system provides valuable input for SLPs to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually. The algorithms worked well even in the presence of a sparse corpus, and the evidence suggests that the system will become more reliable as it is trained with more subjects.

Evaluation of an Expert System for the Generation of Speech and Language Therapy Plans

PubMed Central

López-Nores, Martín; García-Duque, Jorge; Pazos-Arias, José J; Arévalo-Lucero, Daysi

2016-01-01

Background Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient. Objective We aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs’ work and leads to more accurate, consistent, and complete therapy plans for their patients. Methods We examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results. Results The evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency, and completeness of the proposed activities with 4.65, 4.6, and 4.6 points (to a maximum of 5), respectively. The ratings for the subplans generated for the areas of hearing, oral structure and function, and linguistic formulation were nearly perfect, whereas the subplans for expressive language and articulation and for receptive language failed to deal properly with some of the subject cases. Overall, the SLPs indicated that over 90% of the subplans generated automatically were “better than” or “as good as” what the SLPs would have created manually if given the average time they can devote to the task. The cross-validation experiment yielded very similar results. Conclusions The results show that the SPELTA expert system provides valuable input for SLPs to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually. The algorithms worked well even in the presence of a sparse corpus, and the evidence suggests that the system will become more reliable as it is trained with more subjects. PMID:27370070

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

Quality Control of Epidemiological Lectures Online: Scientific Evaluation of Peer Review

PubMed Central

Linkov, Faina; Lovalekar, Mita; LaPorte, Ronald

2007-01-01

Aim To examine the feasibility of using peer review for the quality control of online materials. Methods We analyzed the inter-rater agreement on the quality of epidemiological lectures online, based on the Global Health Network Supercourse lecture library. We examined the agreement among reviewers by looking at κ statistics and intraclass correlations. Seven expert reviewers examined and rated a random sample of 100 Supercourse lectures. Their reviews were compared with the reviews of the lay Supercourse reviewers. Results Both expert and non-expert reviewers rated lectures very highly, with a mean overall score of 4 out of 5. Kappa (κ) statistic and intraclass correlations indicated that inter-rater agreement for experts and non-experts was surprisingly low (below 0.4). Conclusions To our knowledge, this was the first time that poor inter-rater agreement was demonstrated for the Internet lectures. Future research studies need to evaluate the alternatives to the peer review system, especially for online materials. PMID:17436390

Expert Consensus for Discharge Referral Decisions Using Online Delphi

PubMed Central

Bowles, Kathy H.; Holmes, John H.; Naylor, Mary D.; Liberatore, Matthew; Nydick, Robert

2003-01-01

This paper describes the results of using a modified Delphi approach designed to achieve consensus from eight discharge planning experts regarding the decision to refer hospitalized older adults for post-discharge follow-up. Experts reviewed 150 cases using an online website designed to facilitate their interaction and efforts to reach agreement on the need for a referral for post-discharge care and the appropriate site for such care. In contrast to an average of eight weeks to complete just 50 cases using the traditional mail method, the first online Delphi round for 150 cases were completed in six weeks. Data provided by experts suggest that online Delphi is a time efficient and acceptable methodology for reaching group consensus. Other benefits include instant access to Delphi decision results, live knowledge of the time requirements and progress of each expert, and cost savings in postage, paper, copying, and storage of paper documents. This online Delphi methodology is highly recommended. PMID:14728143

The Griffiths Question Map: A Forensic Tool For Expert Witnesses' Assessments of Witnesses and Victims' Statements.

PubMed

Dodier, Olivier; Denault, Vincent

2018-01-01

Expert witnesses are sometimes asked to assess the reliability of young witnesses and victims' statements because of their high susceptibility to memory biases. This technical note aims to highlight the relevance of the Griffiths Question Map (GQM) as a professional forensic tool to improve expert witnesses' assessments of young witnesses and victims' testimonies. To do so, this innovative question type assessment grid was used to proceed to an in-depth analysis of the interview of an alleged 13-year-old victim of a sexual assault and two rapes. Overall, the GQM stressed how the interview was mainly conducted in an inappropriate manner. The results are examined with regard to scientific knowledge on young witnesses and victims' memory. Finally, it is argued that expert witnesses in inquisitorial systems might use the GQM while encountering difficulties to fulfill the legal standards for expert evidence in adversarial systems because of the lack of studies regarding its reliability. © 2017 American Academy of Forensic Sciences.

Fighting rabies in Eastern Europe, the Middle East and Central Asia--experts call for a regional initiative for rabies elimination.

PubMed

Aikimbayev, A; Briggs, D; Coltan, G; Dodet, B; Farahtaj, F; Imnadze, P; Korejwo, J; Moiseieva, A; Tordo, N; Usluer, G; Vodopija, R; Vranješ, N

2014-05-01

MEEREB is an informal network of rabies experts from the Middle East, Eastern Europe and Central Asia, seeking to eliminate rabies from the region. They met for the second time to review the current rabies situation, both globally and in their respective countries, highlighting current rabies control problems and potential solutions. Success stories in Latin America, in Western Europe, in some Asian countries, as well as in Croatia and Serbia prove that elimination of human rabies is achievable in the MEEREB region. It requires political willingness and cooperation of all stakeholders, including Ministries of Health and of Agriculture; adequate management of animal bites through post-exposure prophylaxis; pre-exposure prophylaxis for populations at high risk of rabies exposure, animal vaccination and humane control of stray dog populations. MEEREB members called for a regional initiative for rabies elimination in Eastern Europe and the Middle East. They are confident that the elimination of human rabies of canine origin can be achieved in the region through adopting a One Health approach, and that campaigns for rabies elimination will have significant benefit for public health, including strengthening the structure for control of other zoonoses. © 2013 Blackwell Verlag GmbH.

Myocardial scar segmentation from magnetic resonance images using convolutional neural network

NASA Astrophysics Data System (ADS)

Zabihollahy, Fatemeh; White, James A.; Ukwatta, Eranga

2018-02-01

Accurate segmentation of the myocardial fibrosis or scar may provide important advancements for the prediction and management of malignant ventricular arrhythmias in patients with cardiovascular disease. In this paper, we propose a semi-automated method for segmentation of myocardial scar from late gadolinium enhancement magnetic resonance image (LGE-MRI) using a convolutional neural network (CNN). In contrast to image intensitybased methods, CNN-based algorithms have the potential to improve the accuracy of scar segmentation through the creation of high-level features from a combination of convolutional, detection and pooling layers. Our developed algorithm was trained using 2,336,703 image patches extracted from 420 slices of five 3D LGE-MR datasets, then validated on 2,204,178 patches from a testing dataset of seven 3D LGE-MR images including 624 slices, all obtained from patients with chronic myocardial infarction. For evaluation of the algorithm, we compared the algorithmgenerated segmentations to manual delineations by experts. Our CNN-based method reported an average Dice similarity coefficient (DSC), precision, and recall of 94.50 +/- 3.62%, 96.08 +/- 3.10%, and 93.96 +/- 3.75% as the accuracy of segmentation, respectively. As compared to several intensity threshold-based methods for scar segmentation, the results of our developed method have a greater agreement with manual expert segmentation.

Virtual Character Animation Based on Affordable Motion Capture and Reconfigurable Tangible Interfaces.

PubMed

Lamberti, Fabrizio; Paravati, Gianluca; Gatteschi, Valentina; Cannavo, Alberto; Montuschi, Paolo

2018-05-01

Software for computer animation is generally characterized by a steep learning curve, due to the entanglement of both sophisticated techniques and interaction methods required to control 3D geometries. This paper proposes a tool designed to support computer animation production processes by leveraging the affordances offered by articulated tangible user interfaces and motion capture retargeting solutions. To this aim, orientations of an instrumented prop are recorded together with animator's motion in the 3D space and used to quickly pose characters in the virtual environment. High-level functionalities of the animation software are made accessible via a speech interface, thus letting the user control the animation pipeline via voice commands while focusing on his or her hands and body motion. The proposed solution exploits both off-the-shelf hardware components (like the Lego Mindstorms EV3 bricks and the Microsoft Kinect, used for building the tangible device and tracking animator's skeleton) and free open-source software (like the Blender animation tool), thus representing an interesting solution also for beginners approaching the world of digital animation for the first time. Experimental results in different usage scenarios show the benefits offered by the designed interaction strategy with respect to a mouse & keyboard-based interface both for expert and non-expert users.

A hospital-based child protection programme evaluation instrument: a modified Delphi study.

PubMed

Wilson, Denise; Koziol-McLain, Jane; Garrett, Nick; Sharma, Pritika

2010-08-01

Refine instrument for auditing hospital-based child abuse and neglect violence intervention programmes prior to field-testing. A modified Delphi study to identify and rate items and domains indicative of an effective and quality child abuse and neglect intervention programme. Experts participated in four Delphi rounds: two surveys, a one-day workshop and the opportunity to comment on the penultimate instrument. New Zealand. Twenty-four experts in the field of care and protection of children. Items with panel agreement >or=85% and mean importance rating >or=4.0 (scale from 1 (not important) to 5 (very important)). There was high-level consensus on items across Rounds 1 and 2 (89% and 85%, respectively). In Round 3 an additional domain (safety and security) was agreed upon and cultural issues, alert systems for children at risk, and collaboration among primary care, community, non-government and government agencies were discussed. The final instrument included nine domains ('policies and procedures', 'safety and security', 'collaboration', 'cultural environment', 'training of providers', 'intervention services', 'documentation' 'evaluation' and 'physical environment') and 64 items. The refined instrument represents the hallmarks of an ideal child abuse and neglect programme given current knowledge and experience. The instrument enables rigorous evaluations of hospital-based child abuse and neglect intervention programmes for quality improvement and benchmarking with other programmes.

Increased cerebellar gray matter volume in head chefs

PubMed Central

Sarica, Alessia; Martino, Iolanda; Fabbricatore, Carmelo; Tomaiuolo, Francesco; Rocca, Federico; Caracciolo, Manuela; Quattrone, Aldo

2017-01-01

Objective Chefs exert expert motor and cognitive performances on a daily basis. Neuroimaging has clearly shown that that long-term skill learning (i.e., athletes, musicians, chess player or sommeliers) induces plastic changes in the brain thus enabling tasks to be performed faster and more accurately. How a chef's expertise is embodied in a specific neural network has never been investigated. Methods Eleven Italian head chefs with long-term brigade management expertise and 11 demographically-/ psychologically- matched non-experts underwent morphological evaluations. Results Voxel-based analysis performed with SUIT, as well as, automated volumetric measurement assessed with Freesurfer, revealed increased gray matter volume in the cerebellum in chefs compared to non-experts. The most significant changes were detected in the anterior vermis and the posterior cerebellar lobule. The magnitude of the brigade staff and the higher performance in the Tower of London test correlated with these specific gray matter increases, respectively. Conclusions We found that chefs are characterized by an anatomical variability involving the cerebellum. This confirms the role of this region in the development of similar expert brains characterized by learning dexterous skills, such as pianists, rock climbers and basketball players. However, the nature of the cellular events underlying the detected morphological differences remains an open question. PMID:28182712

Development and validation of a high-fidelity phonomicrosurgical trainer.

PubMed

Klein, Adam M; Gross, Jennifer

2017-04-01

To validate the use of a high-fidelity phonomicrosurgical trainer. A high-fidelity phonomicrosurgical trainer, based on a previously validated model by Contag et al., 1 was designed with multilayered vocal folds that more closely mimic the consistency of true vocal folds, containing intracordal lesions to practice phonomicrosurgical removal. A training module was developed to simulate the true phonomicrosurgical experience. A validation study with novice and expert surgeons was conducted. Novices and experts were instructed to remove the lesion from the synthetic vocal folds, and novices were given four training trials. Performances were measured by the amount of time spent and tissue injury (microflap, superficial, deep) to the vocal fold. An independent Student t test and Fisher exact tests were used to compare subjects. A matched-paired t test and Wilcoxon signed rank tests were used to compare novice performance on the first and fourth trials and assess for improvement. Experts completed the excision with less total errors than novices (P = .004) and made less injury to the microflap (P = .05) and superficial tissue (P = .003). Novices improved their performance with training, making less total errors (P = .002) and superficial tissue injuries (P = .02) and spending less time for removal (P = .002) after several practice trials. This high-fidelity phonomicrosurgical trainer has been validated for novice surgeons. It can distinguish between experts and novices; and after training, it helped to improve novice performance. N/A. Laryngoscope, 127:888-893, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

[Creation of expert centers on endometriosis].

PubMed

Daraï, Emile; Bendifallah, Sofiane; Chabbert-Buffet, Nathalie; Golfier, François

2017-12-01

Endometriosis is a frequent pathology with a high incidence of deep infiltrating endometriosis and complex forms that can affect 20% of patients with endometriosis. The incidence of infertility associated with endometriosis can reach 50%. The complexity of care requires the creation of expert centers working in networks with general practitioners. Criteria for defining these expert centers are being drawn up, based on structural criteria (multidisciplinary consultation meeting), links with medical assistance structures for procreation and activity criteria for severe and complex forms (number of interventions per center and per surgeon). Copyright © 2017. Published by Elsevier Masson SAS.

Identifying the Essential Elements of Effective Science Communication: What Do the Experts Say?

ERIC Educational Resources Information Center

Bray, Belinda; France, Bev; Gilbert, John K.

2012-01-01

Experts in science communication were asked to identify the essential elements of a science communication course for post-graduate students. A Delphi methodology provided a framework for a research design that accessed their opinions and allowed them to contribute to, reflect on and identify 10 essential elements. There was a high level of…

Impact of Secondary Students' Content Knowledge on Their Communication Skills in Science

ERIC Educational Resources Information Center

Kulgemeyer, Christoph

2018-01-01

The "expert blind spot" (EBS) hypothesis implies that even some experts with a high content knowledge might have problems in science communication because they are using the structure of the content rather than their addressee's prerequisites as an orientation. But is that also true for students? Explaining science to peers is a crucial…

Cloud Coaching: Web-Based Learning Holds Promise, Especially for Districts with Limited Resources

ERIC Educational Resources Information Center

Matsumura, Lindsay Clare; Bickel, Donna DiPrima; Zook-Howell, Dena; Correnti, Richard; Walsh, Marguerite

2016-01-01

Web-based coaching shows significant promise for linking teachers to highly expert practitioners. This is particularly important in districts that cannot afford to hire full-time school-based coaches or to train and support coaches to be experts in all content areas. While web-based teacher professional development shows a great deal of potential…

Using Historical Knowledge to Reason about Contemporary Political Issues: An Expert-Novice Study

ERIC Educational Resources Information Center

Shreiner, Tamara L.

2014-01-01

People often justify history's place in the curriculum by its relationship to citizenship, yet there is little research to help educators picture how people use historical knowledge for civic purposes. This expert-novice study used the think-aloud method to examine how eight political scientists and eight high school students employed…

Understanding the Life Cycle of Computer-Based Models: The Role of Expert Contributions in Design, Development and Implementation

ERIC Educational Resources Information Center

Waight, Noemi; Liu, Xiufeng; Gregorius, Roberto Ma.

2015-01-01

This paper examined the nuances of the background process of design and development and follow up classroom implementation of computer-based models for high school chemistry. More specifically, the study examined the knowledge contributions of an interdisciplinary team of experts; points of tensions, negotiations and non-negotiable aspects of…

Elements of Emotional Intelligence that Facilitate Exper-to-Peer Tacit Knowledge Transfer

ERIC Educational Resources Information Center

Berry, Catherine M.

2010-01-01

The purpose of this quantitative study was to compare the emotional intelligence competencies of a group of technical experts with high skills in problem-solving, leadership and mentoring (Group A) with a group of technical experts with lower skills in problem solving, leadership, and mentoring (Group B) at a semiconductor manufacturing factory in…

Assistance Focus: Africa

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

The Clean Energy Solutions Center, an initiative of the Clean Energy Ministerial, helps countries throughout the world create policies and programs that advance the deployment of clean energy technologies. Through the Solutions Center's no-cost 'Ask an Expert' service, a team of international experts has delivered assistance to countries in all regions of the world. High-impact examples from Africa are featured here.

Emergent Expertise?

ERIC Educational Resources Information Center

McGivern, Patrick

2014-01-01

The concept of emergence appears in various places within the literature on expertise and expert practice. Here, I examine some of these applications of emergence in the light of two prominent accounts of emergence from the philosophy of science and philosophy of mind. I evaluate these accounts with respect to several specific contexts in which…

A Changing World: Expectations of Higher Education

ERIC Educational Resources Information Center

Daniel, John

2017-01-01

The vocabulary of higher education is being devalued. The use of "expert" and "elite" as pejorative terms undermines the trust on which successful societies are based. In a "post-factual" society, universities have to re-establish a respect for objective truth and powerful arguments, becoming trust building as well as…

Teaching and Understanding of Quantum Interpretations in Modern Physics Courses

ERIC Educational Resources Information Center

Baily, Charles; Finkelstein, Noah D.

2010-01-01

Just as expert physicists vary in their personal stances on interpretation in quantum mechanics, instructors vary on whether and how to teach interpretations of quantum phenomena in introductory modern physics courses. In this paper, we document variations in instructional approaches with respect to interpretation in two similar modern physics…

Learning To Program in BASIC through the Use of Graphics.

ERIC Educational Resources Information Center

Connor, Timothy J.

Many organizations and experts in the field of mathematics education have recommended the inclusion of technology and, more specifically, computer programing within the course of study for the teaching of school mathematics. The incorporation of these recommendations with respect to the teaching of remedial mathematics poses a problem, since…

Interdisciplinary Research Funding: Reaching Outside the Boundaries of Kinesiology

ERIC Educational Resources Information Center

Freedson, Patty

2009-01-01

Interdisciplinary research requires that experts from multiple disciplines work together to combine methods and ideas in an integrative fashion to generate new knowledge. In many respects, the field of kinesiology is ideally positioned to take advantage of its inherent multidisciplinary design. Because of the multidisciplinary structure of…

A Customized Campaign against Bullying

ERIC Educational Resources Information Center

Ruder, Robert

2005-01-01

Delivering a powerful anti-bullying message to middle school students is a challenge for middle level administrators, their staff members, and their students. However, there are many options to tackle this challenge. One option is to import a well-respected and capable external expert to present an anti-bullying program to students and offer…

Technical Pitfalls in University Rankings

ERIC Educational Resources Information Center

Bougnol, Marie-Laure; Dulá, Jose H.

2015-01-01

Academicians, experts, and other stakeholders have contributed extensively to the literature on university rankings also known as "league tables". Often the tone is critical usually focused on the subjective aspects of the process; e.g., the list of the universities' attributes used in the rankings, their respective weights, and the size…

Maintaining Pedagogical Integrity of a Computer Mediated Course Delivery in Social Foundations

ERIC Educational Resources Information Center

Stewart, Shelley; Cobb-Roberts, Deirdre; Shircliffe, Barbara J.

2013-01-01

Transforming a face to face course to a computer mediated format in social foundations (interdisciplinary field in education), while maintaining pedagogical integrity, involves strategic collaboration between instructional technologists and content area experts. This type of planned partnership requires open dialogue and a mutual respect for prior…

38 CFR 14.808 - Expert or opinion testimony.

Code of Federal Regulations, 2010 CFR

2010-07-01

... appropriate authority that, in light of the factors listed in § 14.804, there are exceptional circumstances... official of such order. If the responsible VA official determines that no further legal review of or..., however, the affected VA personnel shall respectfully decline to comply with the demand, request or order...

A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence?

PubMed

Paul, Christine L; Turon, Heidi; Bonevski, Billie; Bryant, Jamie; McElduff, Patrick

2013-12-08

There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p's < .0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based.

Evaluating the ability of artificial neural network and PCA-M5P models in predicting leachate COD load in landfills.

PubMed

Azadi, Sama; Amiri, Hamid; Rakhshandehroo, G Reza

2016-09-01

Waste burial in uncontrolled landfills can cause serious environmental damages and unpleasant consequences. Leachates produced in landfills have the potential to contaminate soil and groundwater resources. Leachate management is one of the major issues with respect to landfills environmental impacts. Improper design of landfills can lead to leachate spread in the environment, and hence, engineered landfills are required to have leachate monitoring programs. The high cost of such programs may be greatly reduced and cost efficiency of the program may be optimized if one can predict leachate contamination level and foresee management and treatment strategies. The aim of this study is to develop two expert systems consisting of Artificial Neural Network (ANN) and Principal Component Analysis-M5P (PCA-M5P) models to predict Chemical Oxygen Demand (COD) load in leachates produced in lab-scale landfills. Measured data from three landfill lysimeters, including rainfall depth, number of days after waste deposition, thickness of top and bottom Compacted Clay Liners (CCLs), and thickness of top cover over the lysimeter, were utilized to develop, train, validate, and test the expert systems and predict the leachate COD load. Statistical analysis of the prediction results showed that both models possess good prediction ability with a slight superiority for ANN over PCA-M5P. Based on test datasets, the mean absolute percentage error for ANN and PCA-M5P models were 4% and 12%, respectively, and the correlation coefficient for both models was greater than 0.98. Developed models may be used as a rough estimate for leachate COD load prediction in primary landfill designs, where the effect of a top and/or bottom liner is disputed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Achieving high quality standards in laparoscopic colon resection for cancer: A Delphi consensus-based position paper.

PubMed

Lorenzon, Laura; Biondi, Alberto; Carus, Thomas; Dziki, Adam; Espin, Eloy; Figueiredo, Nuno; Ruiz, Marcos Gomez; Mersich, Tamas; Montroni, Isacco; Tanis, Pieter J; Benz, Stefan Rolf; Bianchi, Paolo Pietro; Biebl, Matthias; Broeders, Ivo; De Luca, Raffaele; Delrio, Paolo; D'Hondt, Mathieu; Fürst, Alois; Grosek, Jan; Guimaraes Videira, Jose Flavio; Herbst, Friedrich; Jayne, David; Lázár, György; Miskovic, Danilo; Muratore, Andrea; Helmer Sjo, Ole; Scheinin, Tom; Tomazic, Ales; Türler, Andreas; Van de Velde, Cornelius; Wexner, Steven D; Wullstein, Christoph; Zegarski, Wojciech; D'Ugo, Domenico

2018-04-01

To investigate the rate of laparoscopic colectomies for colon cancer using registries and population-based studies. To provide a position paper on mini-invasive (MIS) colon cancer surgery based on the opinion of experts leader in this field. A systematic review of the literature was conducted using PRISMA guidelines for the rate of laparoscopy in colon cancer. Moreover, Delphi methodology was used to reach consensus among 35 international experts in four study rounds. Consensus was defined as an agreement ≥75.0%. Domains of interest included nosology, essential technical/oncological requirements, outcomes and MIS training. Forty-four studies from 42 articles were reviewed. Although it is still sub-optimal, the rate of MIS for colon cancer increased over the years and it is currently >50% in Korea, Netherlands, UK and Australia. The remaining European countries are un-investigated and presented lower rates with highest variations, ranging 7-35%. Using Delphi methodology, a laparoscopic colectomy was defined as a "colon resection performed using key-hole surgery independently from the type of anastomosis". The panel defined also the oncological requirements recognized essential for the procedure and agreed that when performed by experienced surgeons, it should be marked as best practice in guidelines, given the principles of oncologic surgery be respected (R0 procedure, vessel ligation and mesocolon integrity). The rate of MIS colectomies for cancer in Europe should be further investigated. A panel of leaders in this field defined laparoscopic colectomy as a best practice procedure when performed by an experienced surgeon respecting the standards of surgical oncology. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Social vulnerability of rural households to flood hazards in western mountainous regions of Henan province, China

NASA Astrophysics Data System (ADS)

Liu, Delin; Li, Yue

2016-05-01

Evaluating social vulnerability is a crucial issue in risk and disaster management. In this study, a household social vulnerability index (HSVI) to flood hazards was developed and used to assess the social vulnerability of rural households in western mountainous regions of Henan province, China. Eight key indicators were identified using existing literature and discussions with experts from multiple disciplines and local farmers, and their weights were determined using principle component analysis (PCA) and an expert scoring method. The results showed that (1) the ratio of perennial work in other places, hazard-related training and illiteracy ratio (15+) were the most dominant factors of social vulnerability. (2) The numbers of high, moderate and low vulnerability households were 14, 64 and 16, respectively, which accounted for 14.9, 68.1 and 17.0 % of the total interviewed rural households, respectively. (3) The correlation coefficient between household social vulnerability scores and casualties in a storm flood in July 2010 was significant at 0.05 significance level (r = 0.748), which indicated that the selected indicators and their weights were valid. (4) Some mitigation strategies to reduce household social vulnerability to flood hazards were proposed, which included (1) improving the local residents' income and their disaster-related knowledge and evacuation skills, (2) developing emergency plans and carrying out emergency drills and training, (3) enhancing the accuracy of disaster monitoring and warning systems and (4) establishing a specific emergency management department and comprehensive rescue systems. These results can provide useful information for rural households and local governments to prepare, mitigate and respond to flood hazards, and the corresponding strategies can help local households to reduce their social vulnerability and improve their ability to resist flood hazard.

Opioid use among same-day surgery patients: Prevalence, management and outcomes

PubMed Central

Wilson, Jennifer LC; Poulin, Patricia A; Sikorski, Robert; Nathan, Howard J; Taljaard, Monica; Smyth, Catherine

2015-01-01

OBJECTIVES: To determine whether the prevalence of opioid use among patients requiring elective same-day admission (SDA) surgery is greater than the 2.5% prevalence found in the general population. Secondary objectives were to assess compliance with expert recommendations on acute pain management in opioid-tolerant patients and to examine clinical outcomes. METHODS: A retrospective review of 812 systematically sampled adult SDA surgical cases between April 1, 2008 and March 31, 2009 was conducted. RESULTS: Among 798 eligible patients, 148 (18.5% [95% CI 15.9% to 21.2%]) were prescribed opioids, with 4.4% prescribed long-acting opioids (95% CI 3.0% to 5.8%). Use of opioids was most prevalent among orthopedic and neurosurgery patients. Among the 35 patients on long-acting opioids who had a high likelihood of being tolerant, anesthesiologists correctly identified 33, but only 13 (37%) took their usual opioid preoperatively while 22 (63%) had opioids continued postoperatively. Acetaminophen, nonsteroidal anti-inflammatory drugs and pregabalin were ordered preoperatively in 18 (51%), 15 (43%) and 18 (51%) cases, respectively, while ketamine was used in 15 (43%) patients intraoperatively. Acetaminophen, nonsteroidal anti-inflammatory drugs and pregabalin were ordered postoperatively in 31 (89%), 15 (43%) and 17 (49%) of the cases, respectively. No differences in length of stay, readmissions and emergency room visits were found between opioid-tolerant and opioid-naïve patients. CONCLUSION: Opioid use is more common in SDA surgical patients than in the general population and is most prevalent within orthopedic and neurosurgery patients. Uptake of expert opinion on the management of acute pain in the opioid tolerant patient population is lacking. PMID:26357683

Perceptual expertise in forensic facial image comparison

PubMed Central

White, David; Phillips, P. Jonathon; Hahn, Carina A.; Hill, Matthew; O'Toole, Alice J.

2015-01-01

Forensic facial identification examiners are required to match the identity of faces in images that vary substantially, owing to changes in viewing conditions and in a person's appearance. These identifications affect the course and outcome of criminal investigations and convictions. Despite calls for research on sources of human error in forensic examination, existing scientific knowledge of face matching accuracy is based, almost exclusively, on people without formal training. Here, we administered three challenging face matching tests to a group of forensic examiners with many years' experience of comparing face images for law enforcement and government agencies. Examiners outperformed untrained participants and computer algorithms, thereby providing the first evidence that these examiners are experts at this task. Notably, computationally fusing responses of multiple experts produced near-perfect performance. Results also revealed qualitative differences between expert and non-expert performance. First, examiners' superiority was greatest at longer exposure durations, suggestive of more entailed comparison in forensic examiners. Second, experts were less impaired by image inversion than non-expert students, contrasting with face memory studies that show larger face inversion effects in high performers. We conclude that expertise in matching identity across unfamiliar face images is supported by processes that differ qualitatively from those supporting memory for individual faces. PMID:26336174

Why Bother to Calibrate? Model Consistency and the Value of Prior Information

NASA Astrophysics Data System (ADS)

Hrachowitz, Markus; Fovet, Ophelie; Ruiz, Laurent; Euser, Tanja; Gharari, Shervan; Nijzink, Remko; Savenije, Hubert; Gascuel-Odoux, Chantal

2015-04-01

Hydrological models frequently suffer from limited predictive power despite adequate calibration performances. This can indicate insufficient representations of the underlying processes. Thus ways are sought to increase model consistency while satisfying the contrasting priorities of increased model complexity and limited equifinality. In this study the value of a systematic use of hydrological signatures and expert knowledge for increasing model consistency was tested. It was found that a simple conceptual model, constrained by 4 calibration objective functions, was able to adequately reproduce the hydrograph in the calibration period. The model, however, could not reproduce 20 hydrological signatures, indicating a lack of model consistency. Subsequently, testing 11 models, model complexity was increased in a stepwise way and counter-balanced by using prior information about the system to impose "prior constraints", inferred from expert knowledge and to ensure a model which behaves well with respect to the modeller's perception of the system. We showed that, in spite of unchanged calibration performance, the most complex model set-up exhibited increased performance in the independent test period and skill to reproduce all 20 signatures, indicating a better system representation. The results suggest that a model may be inadequate despite good performance with respect to multiple calibration objectives and that increasing model complexity, if efficiently counter-balanced by available prior constraints, can increase predictive performance of a model and its skill to reproduce hydrological signatures. The results strongly illustrate the need to balance automated model calibration with a more expert-knowledge driven strategy of constraining models.

Why Bother and Calibrate? Model Consistency and the Value of Prior Information.

NASA Astrophysics Data System (ADS)

Hrachowitz, M.; Fovet, O.; Ruiz, L.; Euser, T.; Gharari, S.; Nijzink, R.; Freer, J. E.; Savenije, H.; Gascuel-Odoux, C.

2014-12-01

Hydrological models frequently suffer from limited predictive power despite adequate calibration performances. This can indicate insufficient representations of the underlying processes. Thus ways are sought to increase model consistency while satisfying the contrasting priorities of increased model complexity and limited equifinality. In this study the value of a systematic use of hydrological signatures and expert knowledge for increasing model consistency was tested. It was found that a simple conceptual model, constrained by 4 calibration objective functions, was able to adequately reproduce the hydrograph in the calibration period. The model, however, could not reproduce 20 hydrological signatures, indicating a lack of model consistency. Subsequently, testing 11 models, model complexity was increased in a stepwise way and counter-balanced by using prior information about the system to impose "prior constraints", inferred from expert knowledge and to ensure a model which behaves well with respect to the modeller's perception of the system. We showed that, in spite of unchanged calibration performance, the most complex model set-up exhibited increased performance in the independent test period and skill to reproduce all 20 signatures, indicating a better system representation. The results suggest that a model may be inadequate despite good performance with respect to multiple calibration objectives and that increasing model complexity, if efficiently counter-balanced by available prior constraints, can increase predictive performance of a model and its skill to reproduce hydrological signatures. The results strongly illustrate the need to balance automated model calibration with a more expert-knowledge driven strategy of constraining models.

Unconscious bias when experts are invited - and the results of conscious action

NASA Astrophysics Data System (ADS)

Stadmark, Johanna; Conley, Daniel J.

2016-04-01

Visibility of different kinds is important in academic work. We publish papers, present results at conferences and are invited to give seminars and write contributions and reviews about other scientists' work. A few years back we reacted on the invitation-only sections in two of the leading scientific journals. We asked: "Who are invited to write about other researchers' newly published results?" The short answer could be: Experts in the field. However, we found that it was mainly male experts in the field when we reviewed/categorized the authors of the invitation-only sections News & Views and Perspective in Nature and Science, respectively, during the years 2010 and 2011 (in total 1663 authors). The proportion of female authors was compared to the proportion of female scientists within their respective fields within academia. We found that female scientists were invited less often than their male colleagues. We notified the two journals about the mismatch (Nature 2012: 488) and their encouraging reply was that they needed to improve how they reflect women's contributions to science (Nature 2012: 491). In 2013 and 2014 the invitation-only sections (with in total 1845 authors) had reached parity (compared to the pool of available scientists) for contributions regarding Earth and Environmental Science, and made steps forward for Medical/Biological/Chemical sciences and Physical sciences. By raising awareness about the unconscious biases we all have, e.g. both men and women, we can act to make progress towards parity in science.

AutoNR: an automated system that measures ECAP thresholds with the Nucleus Freedom cochlear implant via machine intelligence.

PubMed

Botros, Andrew; van Dijk, Bas; Killian, Matthijs

2007-05-01

AutoNRT is an automated system that measures electrically evoked compound action potential (ECAP) thresholds from the auditory nerve with the Nucleus Freedom cochlear implant. ECAP thresholds along the electrode array are useful in objectively fitting cochlear implant systems for individual use. This paper provides the first detailed description of the AutoNRT algorithm and its expert systems, and reports the clinical success of AutoNRT to date. AutoNRT determines thresholds by visual detection, using two decision tree expert systems that automatically recognise ECAPs. The expert systems are guided by a dataset of 5393 neural response measurements. The algorithm approaches threshold from lower stimulus levels, ensuring recipient safety during postoperative measurements. Intraoperative measurements use the same algorithm but proceed faster by beginning at stimulus levels much closer to threshold. When searching for ECAPs, AutoNRT uses a highly specific expert system (specificity of 99% during training, 96% during testing; sensitivity of 91% during training, 89% during testing). Once ECAPs are established, AutoNRT uses an unbiased expert system to determine an accurate threshold. Throughout the execution of the algorithm, recording parameters (such as implant amplifier gain) are automatically optimised when needed. In a study that included 29 intraoperative and 29 postoperative subjects (a total of 418 electrodes), AutoNRT determined a threshold in 93% of cases where a human expert also determined a threshold. When compared to the median threshold of multiple human observers on 77 randomly selected electrodes, AutoNRT performed as accurately as the 'average' clinician. AutoNRT has demonstrated a high success rate and a level of performance that is comparable with human experts. It has been used in many clinics worldwide throughout the clinical trial and commercial launch of Nucleus Custom Sound Suite, significantly streamlining the clinical procedures associated with cochlear implant use.

Efficient Geological Modelling of Large AEM Surveys

NASA Astrophysics Data System (ADS)

Bach, Torben; Martlev Pallesen, Tom; Jørgensen, Flemming; Lundh Gulbrandsen, Mats; Mejer Hansen, Thomas

2014-05-01

Combining geological expert knowledge with geophysical observations into a final 3D geological model is, in most cases, not a straight forward process. It typically involves many types of data and requires both an understanding of the data and the geological target. When dealing with very large areas, such as modelling of large AEM surveys, the manual task for the geologist to correctly evaluate and properly utilise all the data available in the survey area, becomes overwhelming. In the ERGO project (Efficient High-Resolution Geological Modelling) we address these issues and propose a new modelling methodology enabling fast and consistent modelling of very large areas. The vision of the project is to build a user friendly expert system that enables the combination of very large amounts of geological and geophysical data with geological expert knowledge. This is done in an "auto-pilot" type functionality, named Smart Interpretation, designed to aid the geologist in the interpretation process. The core of the expert system is a statistical model that describes the relation between data and geological interpretation made by a geological expert. This facilitates fast and consistent modelling of very large areas. It will enable the construction of models with high resolution as the system will "learn" the geology of an area directly from interpretations made by a geological expert, and instantly apply it to all hard data in the survey area, ensuring the utilisation of all the data available in the geological model. Another feature is that the statistical model the system creates for one area can be used in another area with similar data and geology. This feature can be useful as an aid to an untrained geologist to build a geological model, guided by the experienced geologist way of interpretation, as quantified by the expert system in the core statistical model. In this project presentation we provide some examples of the problems we are aiming to address in the project, and show some preliminary results.

Human matching performance of genuine crime scene latent fingerprints.

PubMed

Thompson, Matthew B; Tangen, Jason M; McCarthy, Duncan J

2014-02-01

There has been very little research into the nature and development of fingerprint matching expertise. Here we present the results of an experiment testing the claimed matching expertise of fingerprint examiners. Expert (n = 37), intermediate trainee (n = 8), new trainee (n = 9), and novice (n = 37) participants performed a fingerprint discrimination task involving genuine crime scene latent fingerprints, their matches, and highly similar distractors, in a signal detection paradigm. Results show that qualified, court-practicing fingerprint experts were exceedingly accurate compared with novices. Experts showed a conservative response bias, tending to err on the side of caution by making more errors of the sort that could allow a guilty person to escape detection than errors of the sort that could falsely incriminate an innocent person. The superior performance of experts was not simply a function of their ability to match prints, per se, but a result of their ability to identify the highly similar, but nonmatching fingerprints as such. Comparing these results with previous experiments, experts were even more conservative in their decision making when dealing with these genuine crime scene prints than when dealing with simulated crime scene prints, and this conservatism made them relatively less accurate overall. Intermediate trainees-despite their lack of qualification and average 3.5 years experience-performed about as accurately as qualified experts who had an average 17.5 years experience. New trainees-despite their 5-week, full-time training course or their 6 months experience-were not any better than novices at discriminating matching and similar nonmatching prints, they were just more conservative. Further research is required to determine the precise nature of fingerprint matching expertise and the factors that influence performance. The findings of this representative, lab-based experiment may have implications for the way fingerprint examiners testify in court, but what the findings mean for reasoning about expert performance in the wild is an open, empirical, and epistemological question.

Diagnostic discrepancies in retinopathy of prematurity classification

PubMed Central

Campbell, J. Peter; Ryan, Michael C.; Lore, Emily; Tian, Peng; Ostmo, Susan; Jonas, Karyn; Chan, R.V. Paul; Chiang, Michael F.

2016-01-01

Objective To identify the most common areas for discrepancy in retinopathy of prematurity (ROP) classification between experts. Design Prospective cohort study. Subjects, Participants, and/or Controls 281 infants were identified as part of a multi-center, prospective, ROP cohort study from 7 participating centers. Each site had participating ophthalmologists who provided the clinical classification after routine examination using binocular indirect ophthalmoscopy (BIO), and obtained wide-angle retinal images, which were independently classified by two study experts. Methods Wide-angle retinal images (RetCam; Clarity Medical Systems, Pleasanton, CA) were obtained from study subjects, and two experts evaluated each image using a secure web-based module. Image-based classifications for zone, stage, plus disease, overall disease category (no ROP, mild ROP, Type II or pre-plus, and Type I) were compared between the two experts, and to the clinical classification obtained by BIO. Main Outcome Measures Inter-expert image-based agreement and image-based vs. ophthalmoscopic diagnostic agreement using absolute agreement and weighted kappa statistic. Results 1553 study eye examinations from 281 infants were included in the study. Experts disagreed on the stage classification in 620/1553 (40%) of comparisons, plus disease classification (including pre-plus) in 287/1553 (18%), zone in 117/1553 (8%), and overall ROP category in 618/1553 (40%). However, agreement for presence vs. absence of type 1 disease was >95%. There were no differences between image-based and clinical classification except for zone III disease. Conclusions The most common area of discrepancy in ROP classification is stage, although inter-expert agreement for clinically-significant disease such as presence vs. absence of type 1 and type 2 disease is high. There were no differences between image-based grading and the clinical exam in the ability to detect clinically-significant disease. This study provides additional evidence that image-based classification of ROP reliably detects clinically significant levels of ROP with high accuracy compared to the clinical exam. PMID:27238376

Quality requirements for veterinary hematology analyzers in small animals-a survey about veterinary experts' requirements and objective evaluation of analyzer performance based on a meta-analysis of method validation studies: bench top hematology analyzer.

PubMed

Cook, Andrea M; Moritz, Andreas; Freeman, Kathleen P; Bauer, Natali

2016-09-01

Scarce information exists about quality requirements and objective evaluation of performance of large veterinary bench top hematology analyzers. The study was aimed at comparing the observed total error (TEobs ) derived from meta-analysis of published method validation data to the total allowable error (TEa ) for veterinary hematology variables in small animals based on experts' opinions. Ideally, TEobs should be < TEa . An online survey was sent to veterinary experts in clinical pathology and small animal internal medicine for providing the maximal allowable deviation from a given result for each variable. Percent of TEa = (allowable median deviation/clinical threshold) * 100%. Second, TEobs for 3 laser-based bench top hematology analyzers (ADVIA 2120; Sysmex XT2000iV, and CellDyn 3500) was calculated based on method validation studies published between 2005 and 2013 (n = 4). The percent TEobs = 2 * CV (%) + bias (%). The CV was derived from published studies except for the ADVIA 2120 (internal data), and bias was estimated from the regression equation. A total of 41 veterinary experts (19 diplomates, 8 residents, 10 postgraduate students, 4 anonymous specialists) responded. The proposed range of TEa was wide, but generally ≤ 20%. The TEobs was < TEa for all variables and analyzers except for canine and feline HGB (high bias, low CV) and platelet counts (high bias, high CV). Overall, veterinary bench top analyzers fulfilled experts' requirements except for HGB due to method-related bias, and platelet counts due to known preanalytic/analytic issues. © 2016 American Society for Veterinary Clinical Pathology.

Indirect detection of pulmonary nodule on low-pass filtered and original x-ray images during limited and unlimited display times

NASA Astrophysics Data System (ADS)

Pietrzyk, Mariusz W.; McEntee, Mark; Evanoff, Michael G.; Brennan, Patrick C.

2012-02-01

Aim: This study evaluates the assumption that global impression is created based on low spatial frequency components of posterior-anterior chest radiographs. Background: Expert radiologists precisely and rapidly allocate visual attention on pulmonary nodules chest radiographs. Moreover, the most frequent accurate decisions are produced in the shortest viewing time, thus, the first hundred milliseconds of image perception seems be crucial for correct interpretation. Medical image perception model assumes that during holistic analysis experts extract information based on low spatial frequency (SF) components and creates a mental map of suspicious location for further inspection. The global impression results in flagged regions for detailed inspection with foveal vision. Method: Nine chest experts and nine non-chest radiologists viewed two sets of randomly ordered chest radiographs under 2 timing conditions: (1) 300ms; (2) free search in unlimited time. The same radiographic cases of 25 normal and 25 abnormal digitalized chest films constituted two image sets: low-pass filtered and unfiltered. Subjects were asked to detect nodules and rank confidence level. MRMC ROC DBM analyses were conducted. Results: Experts had improved ROC AUC while high SF components are displayed (p=0.03) or while low SF components were viewed under unlimited time (p=0.02) compared with low SF 300mSec viewings. In contrast, non-chest radiologists showed no significant changes when high SF are displayed under flash conditions compared with free search or while low SF components were viewed under unlimited time compared with flash. Conclusion: The current medical image perception model accurately predicted performance for non-chest radiologists, however chest experts appear to benefit from high SF features during the global impression.

High blood cholesterol levels

MedlinePlus

Cholesterol - high; Lipid disorders; Hyperlipoproteinemia; Hyperlipidemia; Dyslipidemia; Hypercholesterolemia ... A cholesterol test is done to diagnose a lipid disorder. Different experts recommend different starting ages. Recommended ...

An E-health solution for automatic sleep classification according to Rechtschaffen and Kales: validation study of the Somnolyzer 24 x 7 utilizing the Siesta database.

PubMed

Anderer, Peter; Gruber, Georg; Parapatics, Silvia; Woertz, Michael; Miazhynskaia, Tatiana; Klosch, Gerhard; Saletu, Bernd; Zeitlhofer, Josef; Barbanoj, Manuel J; Danker-Hopfe, Heidi; Himanen, Sari-Leena; Kemp, Bob; Penzel, Thomas; Grozinger, Michael; Kunz, Dieter; Rappelsberger, Peter; Schlogl, Alois; Dorffner, Georg

2005-01-01

To date, the only standard for the classification of sleep-EEG recordings that has found worldwide acceptance are the rules published in 1968 by Rechtschaffen and Kales. Even though several attempts have been made to automate the classification process, so far no method has been published that has proven its validity in a study including a sufficiently large number of controls and patients of all adult age ranges. The present paper describes the development and optimization of an automatic classification system that is based on one central EEG channel, two EOG channels and one chin EMG channel. It adheres to the decision rules for visual scoring as closely as possible and includes a structured quality control procedure by a human expert. The final system (Somnolyzer 24 x 7) consists of a raw data quality check, a feature extraction algorithm (density and intensity of sleep/wake-related patterns such as sleep spindles, delta waves, SEMs and REMs), a feature matrix plausibility check, a classifier designed as an expert system, a rule-based smoothing procedure for the start and the end of stages REM, and finally a statistical comparison to age- and sex-matched normal healthy controls (Siesta Spot Report). The expert system considers different prior probabilities of stage changes depending on the preceding sleep stage, the occurrence of a movement arousal and the position of the epoch within the NREM/REM sleep cycles. Moreover, results obtained with and without using the chin EMG signal are combined. The Siesta polysomnographic database (590 recordings in both normal healthy subjects aged 20-95 years and patients suffering from organic or nonorganic sleep disorders) was split into two halves, which were randomly assigned to a training and a validation set, respectively. The final validation revealed an overall epoch-by-epoch agreement of 80% (Cohen's kappa: 0.72) between the Somnolyzer 24 x 7 and the human expert scoring, as compared with an inter-rater reliability of 77% (Cohen's kappa: 0.68) between two human experts scoring the same dataset. Two Somnolyzer 24 x 7 analyses (including a structured quality control by two human experts) revealed an inter-rater reliability close to 1 (Cohen's kappa: 0.991), which confirmed that the variability induced by the quality control procedure, whereby approximately 1% of the epochs (in 9.5% of the recordings) are changed, can definitely be neglected. Thus, the validation study proved the high reliability and validity of the Somnolyzer 24 x 7 and demonstrated its applicability in clinical routine and sleep studies.

Four Common Simplifications of Multi-Criteria Decision Analysis do not hold for River Rehabilitation

PubMed Central

2016-01-01

River rehabilitation aims at alleviating negative effects of human impacts such as loss of biodiversity and reduction of ecosystem services. Such interventions entail difficult trade-offs between different ecological and often socio-economic objectives. Multi-Criteria Decision Analysis (MCDA) is a very suitable approach that helps assessing the current ecological state and prioritizing river rehabilitation measures in a standardized way, based on stakeholder or expert preferences. Applications of MCDA in river rehabilitation projects are often simplified, i.e. using a limited number of objectives and indicators, assuming linear value functions, aggregating individual indicator assessments additively, and/or assuming risk neutrality of experts. Here, we demonstrate an implementation of MCDA expert preference assessments to river rehabilitation and provide ample material for other applications. To test whether the above simplifications reflect common expert opinion, we carried out very detailed interviews with five river ecologists and a hydraulic engineer. We defined essential objectives and measurable quality indicators (attributes), elicited the experts´ preferences for objectives on a standardized scale (value functions) and their risk attitude, and identified suitable aggregation methods. The experts recommended an extensive objectives hierarchy including between 54 and 93 essential objectives and between 37 to 61 essential attributes. For 81% of these, they defined non-linear value functions and in 76% recommended multiplicative aggregation. The experts were risk averse or risk prone (but never risk neutral), depending on the current ecological state of the river, and the experts´ personal importance of objectives. We conclude that the four commonly applied simplifications clearly do not reflect the opinion of river rehabilitation experts. The optimal level of model complexity, however, remains highly case-study specific depending on data and resource availability, the context, and the complexity of the decision problem. PMID:26954353

Volumetric glioma quantification: comparison of manual and semi-automatic tumor segmentation for the quantification of tumor growth.

PubMed

Odland, Audun; Server, Andres; Saxhaug, Cathrine; Breivik, Birger; Groote, Rasmus; Vardal, Jonas; Larsson, Christopher; Bjørnerud, Atle

2015-11-01

Volumetric magnetic resonance imaging (MRI) is now widely available and routinely used in the evaluation of high-grade gliomas (HGGs). Ideally, volumetric measurements should be included in this evaluation. However, manual tumor segmentation is time-consuming and suffers from inter-observer variability. Thus, tools for semi-automatic tumor segmentation are needed. To present a semi-automatic method (SAM) for segmentation of HGGs and to compare this method with manual segmentation performed by experts. The inter-observer variability among experts manually segmenting HGGs using volumetric MRIs was also examined. Twenty patients with HGGs were included. All patients underwent surgical resection prior to inclusion. Each patient underwent several MRI examinations during and after adjuvant chemoradiation therapy. Three experts performed manual segmentation. The results of tumor segmentation by the experts and by the SAM were compared using Dice coefficients and kappa statistics. A relatively close agreement was seen among two of the experts and the SAM, while the third expert disagreed considerably with the other experts and the SAM. An important reason for this disagreement was a different interpretation of contrast enhancement as either surgically-induced or glioma-induced. The time required for manual tumor segmentation was an average of 16 min per scan. Editing of the tumor masks produced by the SAM required an average of less than 2 min per sample. Manual segmentation of HGG is very time-consuming and using the SAM could increase the efficiency of this process. However, the accuracy of the SAM ultimately depends on the expert doing the editing. Our study confirmed a considerable inter-observer variability among experts defining tumor volume from volumetric MRIs. © The Foundation Acta Radiologica 2014.

Does human body odor represent a significant and rewarding social signal to individuals high in social openness?

PubMed

Lübke, Katrin T; Croy, Ilona; Hoenen, Matthias; Gerber, Johannes; Pause, Bettina M; Hummel, Thomas

2014-01-01

Across a wide variety of domains, experts differ from novices in their response to stimuli linked to their respective field of expertise. It is currently unknown whether similar patterns can be observed with regard to social expertise. The current study therefore focuses on social openness, a central social skill necessary to initiate social contact. Human body odors were used as social cues, as they inherently signal the presence of another human being. Using functional MRI, hemodynamic brain responses to body odors of women reporting a high (n = 14) or a low (n = 12) level of social openness were compared. Greater activation within the inferior frontal gyrus and the caudate nucleus was observed in high socially open individuals compared to individuals low in social openness. With the inferior frontal gyrus being a crucial part of the human mirror neuron system, and the caudate nucleus being implicated in social reward, it is discussed whether human body odor might constitute more of a significant and rewarding social signal to individuals high in social openness compared to individuals low in social openness process.

Accuracy of computer-aided diagnosis based on narrow-band imaging endocytoscopy for diagnosing colorectal lesions: comparison with experts.

PubMed

Misawa, Masashi; Kudo, Shin-Ei; Mori, Yuichi; Takeda, Kenichi; Maeda, Yasuharu; Kataoka, Shinichi; Nakamura, Hiroki; Kudo, Toyoki; Wakamura, Kunihiko; Hayashi, Takemasa; Katagiri, Atsushi; Baba, Toshiyuki; Ishida, Fumio; Inoue, Haruhiro; Nimura, Yukitaka; Oda, Msahiro; Mori, Kensaku

2017-05-01

Real-time characterization of colorectal lesions during colonoscopy is important for reducing medical costs, given that the need for a pathological diagnosis can be omitted if the accuracy of the diagnostic modality is sufficiently high. However, it is sometimes difficult for community-based gastroenterologists to achieve the required level of diagnostic accuracy. In this regard, we developed a computer-aided diagnosis (CAD) system based on endocytoscopy (EC) to evaluate cellular, glandular, and vessel structure atypia in vivo. The purpose of this study was to compare the diagnostic ability and efficacy of this CAD system with the performances of human expert and trainee endoscopists. We developed a CAD system based on EC with narrow-band imaging that allowed microvascular evaluation without dye (ECV-CAD). The CAD algorithm was programmed based on texture analysis and provided a two-class diagnosis of neoplastic or non-neoplastic, with probabilities. We validated the diagnostic ability of the ECV-CAD system using 173 randomly selected EC images (49 non-neoplasms, 124 neoplasms). The images were evaluated by the CAD and by four expert endoscopists and three trainees. The diagnostic accuracies for distinguishing between neoplasms and non-neoplasms were calculated. ECV-CAD had higher overall diagnostic accuracy than trainees (87.8 vs 63.4%; [Formula: see text]), but similar to experts (87.8 vs 84.2%; [Formula: see text]). With regard to high-confidence cases, the overall accuracy of ECV-CAD was also higher than trainees (93.5 vs 71.7%; [Formula: see text]) and comparable to experts (93.5 vs 90.8%; [Formula: see text]). ECV-CAD showed better diagnostic accuracy than trainee endoscopists and was comparable to that of experts. ECV-CAD could thus be a powerful decision-making tool for less-experienced endoscopists.

[Applying the Modified Delphi Technique to Develop the Role of HIV Case Managers and Essential Nursing Competencies in HIV Care].

PubMed

Ko, Nai-Ying; Hsieh, Chia-Yin; Chen, Yen-Chin; Tsai, Chen-Hsi; Liu, Hsiao-Ying; Liu, Li-Fang

2015-08-01

Since 2005, the Taiwan Centers for Disease Control (Taiwan CDC) initiated an HIV case management program in AIDS-designated hospitals to provide integrative services and risk-reduction counseling for HIV-infected individuals. In light of the increasingly complex and highly specialized nature of clinical care, expanding and improving competency-based professional education is important to enhance the quality of HIV/AIDS care. The aim of this study was to develop the essential competency framework for HIV care for HIV case managers in Taiwan. We reviewed essential competencies of HIV care from Canada, the United Kingdom, and several African countries and devised descriptions of the roles of case managers and of the associated core competencies for HIV care in Taiwan. The modified Delphi technique was used to evaluate the draft framework of these roles and core competencies. A total of 15 HIV care experts were invited to join the expert panel to review and rank the draft framework. The final framework consisted of 7 roles and 27 competencies for HIV case managers. In Round 1, only 3 items did not receive consensus approval from the experts. After modification based on opinions of the experts, 7 roles and 27 competencies received 97.06% consensus approval in Round 2 and were organized into the final framework for HIV case managers. These roles and associated core competencies were: HIV Care Expert (9 competencies), Communicator (1 competency), Collaborator (4 competencies), Navigator (2 competencies), Manager (4 competencies), Advocate (2 competencies), and Professional (5 competencies). The authors developed an essential competency framework for HIV care using the consensus of a multidisciplinary expert panel. Curriculum developers and advanced nurses and practitioners may use this framework to support developments and to ensure a high quality of HIV care.

Tracking Plasticity: Effects of Long-Term Rehearsal in Expert Dancers Encoding Music to Movement

PubMed Central

Bar, Rachel J.; DeSouza, Joseph F. X.

2016-01-01

Our knowledge of neural plasticity suggests that neural networks show adaptation to environmental and intrinsic change. In particular, studies investigating the neuroplastic changes associated with learning and practicing motor tasks have shown that practicing such tasks results in an increase in neural activation in several specific brain regions. However, studies comparing experts and non-experts suggest that experts employ less neuronal activation than non-experts when performing a familiar motor task. Here, we aimed to determine the long-term changes in neural networks associated with learning a new dance in professional ballet dancers over 34 weeks. Subjects visualized dance movements to music while undergoing fMRI scanning at four time points over 34-weeks. Results demonstrated that initial learning and performance at seven weeks led to increases in activation in cortical regions during visualization compared to the first week. However, at 34 weeks, the cortical networks showed reduced activation compared to week seven. Specifically, motor learning and performance over the 34 weeks showed the typical inverted-U-shaped function of learning. Further, our result demonstrate that learning of a motor sequence of dance movements to music in the real world can be visualized by expert dancers using fMRI and capture highly significant modeled fits of the brain network variance of BOLD signals from early learning to expert level performance. PMID:26824475

Web Based Cattle Disease Expert System Diagnosis with forward Chaining Method

NASA Astrophysics Data System (ADS)

Zamsuri, Ahmad; Syafitri, Wenni; Sadar, Muhamad

2017-12-01

Cattle is one of the livestock who have high economic potential, whether for livestock, cattle seed, or even for food stock. Everything that comes from Cattle is a treasure for example the Milk, the Meat, and Cattle-hide. The factor that cause Cattles to die is the spread of disease that could crock up the Cattle’s health. So that the Expert system is needed to utilize and analye the Cattle’s disease so it could detect the disease without going to the veterinarian. Forward chaining method is one of the correct method in this expert system wherein began with Symptoms to determine the illness. From this matter, we built a web based expert system application on Cattles disease to ease the disease detection and showing the brief information about the Cattles itself.

Reliability and validity of expert assessment based on airborne and urinary measures of nickel and chromium exposure in the electroplating industry.

PubMed

Chen, Yu-Cheng; Coble, Joseph B; Deziel, Nicole C; Ji, Bu-Tian; Xue, Shouzheng; Lu, Wei; Stewart, Patricia A; Friesen, Melissa C

2014-11-01

The reliability and validity of six experts' exposure ratings were evaluated for 64 nickel-exposed and 72 chromium-exposed workers from six Shanghai electroplating plants based on airborne and urinary nickel and chromium measurements. Three industrial hygienists and three occupational physicians independently ranked the exposure intensity of each metal on an ordinal scale (1-4) for each worker's job in two rounds: the first round was based on responses to an occupational history questionnaire and the second round also included responses to an electroplating industry-specific questionnaire. The Spearman correlation (r(s)) was used to compare each rating's validity to its corresponding subject-specific arithmetic mean of four airborne or four urinary measurements. Reliability was moderately high (weighted kappa range=0.60-0.64). Validity was poor to moderate (r(s)=-0.37-0.46) for both airborne and urinary concentrations of both metals. For airborne nickel concentrations, validity differed by plant. For dichotomized metrics, sensitivity and specificity were higher based on urinary measurements (47-78%) than airborne measurements (16-50%). Few patterns were observed by metal, assessment round, or expert type. These results suggest that, for electroplating exposures, experts can achieve moderately high agreement and (reasonably) distinguish between low and high exposures when reviewing responses to in-depth questionnaires used in population-based case-control studies.

Professional expertise amongst speech-language therapists: "willing to share".

PubMed

Jackson, Bianca N; Purdy, Suzanne Carolyn; Cooper-Thomas, Helena

2017-09-18

Purpose The current healthcare environment provides several challenges to the existing roles of healthcare professionals. The value of the professional expert is also under scrutiny. The purpose of this paper is to generate a construction of professional expertise amongst practitioners in the current healthcare environment. It used the speech-language therapy community in New Zealand (NZ) as an example. Design/methodology/approach Speech-language therapists currently practicing in NZ completed an online survey including qualitative and quantitative components. The range of experience and work settings of participants ( n=119) was representative of the workforce. Findings Participants clearly identified being "highly experienced" and "having in-depth knowledge" as essential elements of professional expertise. Thematic analysis generated two interconnected themes of a professional expert being a personal leader and teacher, and a highly experienced, knowledgeable and skilful practitioner. Additionally, practitioners needed to be seen to contribute to the community in order to be known as experts. Clinical practice was valued differently from research generation. Originality/value This study is novel in exploring a construction of professional expertise amongst practitioners in a current healthcare community. Within that community, experts could be viewed as highly effective practitioners that visibly contribute to the professional community. The study draws attention to the role of reputation and the impacts of being a clinical teacher or leader compared with pursuing a research role. This could be particularly relevant in the promotion of evidence-based practice.

The expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary.

PubMed

Kane, John M; Leucht, Stefan; Carpenter, Daniel; Docherty, John P

2003-01-01

A growing number of atypical antipsychotics are available for clinicians to choose from in the treatment of psychotic disorders. However, a number of important questions concerning medication selection, dosing and dose equivalence, and the management of inadequate response, compliance problems, and relapse have not been adequately addressed by clinical trials. To aid clinical decision-making, a consensus survey of expert opinion on the pharmacologic treatment of psychotic disorders was undertaken to address questions not definitively answered in the research literature. Based on a literature review, a written survey was developed with 60 questions and 994 options. Approximately half of the options were scored using a modified version of the RAND 9-point scale for rating the appropriateness of medical decisions. For the other options, the experts were asked to write in answers (e.g., average doses) or check a box to indicate their preferred answer. The survey was sent to 50 national experts on the pharmacologic treatment of psychotic disorders, 47 (94%) of whom completed it. In analyzing the responses to items rated on the 9-point scale, consensus on each option was defined as a non random distribution of scores by chi-square "goodness-of-fit"test. We assigned a categorical rank (first line/preferred choice,second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating. Guideline tables indicating preferred treatment strategies were then developed for key clinical situations. The expert panel reached consensus on 88% of the options rated on the 9-point scale. The experts overwhelmingly endorsed the atypical antipsychotics for the treatment of psychotic disorders. Risperidone was the top choice for first-episode and multi-episode patients, with the other newer atypicals rated first line or high second line depending on the clinical situation. Clozapine and a long-acting injectable atypical (when available)were other high second line options for multi-episode patients. The expert's dosing recommendations agreed closely with the package inserts for the drugs, and their estimates of dose equivalence among the antipsychotics followed a linear pattern. The experts considered 3-6 weeks an adequate antipsychotic trial, but would wait a little longer (4-10 weeks) before making a major change in treatment regimen if there is a partial response. The experts recommended trying to improve response by increasing the dose of atypical and depot antipsychotics before switching to a different agent; there was less agreement about increasing the dose of conventional antipsychotics before switching, probably because of concern about side effects at higher doses. If it is decided to switch because of inadequate response, risperidone was the expert's first choice to switch to, no matter what drug was initially tried. Although there was some disparity in the expert's recommendations concerning how many agents to try before switching to clozapine, the expert's responses suggest that switching to clozapine should be Clozapine was also the antipsychotic of choice for patients with suicidal behavior. When switching oral antipsychotics,the experts considered cross-titration the preferred strategy. When switching to an injectable antipsychotic, the experts stressed the importance of continuing the oral antipsychotic until therapeutic levels of the injectable agent are achieved. The experts considered psychosocial interventions the first choice strategy for partially compliant patients, with pharmacologic interventions the first choice for patients with clear evidence of noncompliance. However, because it can be difficult to distinguish partially compliant from noncompliant patients, the editors recommended combining psychosocial and pharmacologic interventions to improve compliance whenever possible. When patients relapse because of compliance problems or if there is any doubt about compliance, the experts recommended the use of a long-acting injectable antipsychotic and would select an injectable atypical when this option becomes available. The experts would also consider using an injectable atypical antipsychotic (when available) in many clinical situations that do not involve compliance problems. The experts stressed the importance of monitoring for health problems-especially obesity, diabetes, cardiovascular problems,HIV risk behaviors, medical complications of substance abuse, heavy smoking and its effects, hypertension, and amenorrhea-in patients being treated with antipsychotics. Although many patients are prescribed adjunctive treatments,multiple antipsychotics, and combinations of different classes of drugs (e.g., antipsychotics plus mood stabilizers or antidepressants) in an effort to enhance response, the experts gave little support to any of these strategies, with the exception of antidepressants for patients with dysphoria/depression, antidepressants or ECT for patients with suicidal behavior, and mood stabilizers for patients with aggression/violence. When asked about indicators of remission and recovery, the experts considered acute improvement in psychotic symptoms the most important indicator of remission, whereas they considered more sustained improvement in multiple outcome domains (e.g., occupational/educational functioning, peer relationships,independent living) important in assessing recovery. The experts reached a high level of consensus on many of the key treatment questions in the survey. Within the limits of expert opinion and with the expectation that future research data will take precedence, these guidelines provide direction for addressing common clinical dilemmas that arise in the pharmacologic treatment of psychotic disorders. They can be used to inform clinicians and educate patients regarding the relative merits of a variety of interventions. Clinicians should keep in mind that no guidelines can address the complexities involved in the care of each individual patient and that sound clinical judgment based on clinical experience should be used in applying these recommendations.

Assistance Focus: Asia/Pacific Region

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

The Clean Energy Solutions Center, an initiative of the Clean Energy Ministerial, helps countries throughout the world create policies and programs that advance the deployment of clean energy technologies. Through the Solutions Center's no-cost 'Ask an Expert' service, a team of international experts has delivered assistance to countries in all regions of the world. High-impact examples from the Asia/Pacific region are featured here.

Biology Teacher and Expert Opinions about Computer Assisted Biology Instruction Materials: A Software Entitled Nucleic Acids and Protein Synthesis

ERIC Educational Resources Information Center

Hasenekoglu, Ismet; Timucin, Melih

2007-01-01

The aim of this study is to collect and evaluate opinions of CAI experts and biology teachers about a high school level Computer Assisted Biology Instruction Material presenting computer-made modelling and simulations. It is a case study. A material covering "Nucleic Acids and Protein Synthesis" topic was developed as the…

An Alternative Expert Knowledge Transfer Model: A Case Study of an Indigenous Storytelling Approach

ERIC Educational Resources Information Center

Spaulding, Roderick Jay

2010-01-01

The increasing complexity of technical work, the demand for highly skilled workers, and the vital challenges facing the world at large have combined to create a need for better ways to transfer knowledge, especially expert knowledge. In this dissertation, I attempted to see if an approach to this process that is more holistic than is typical in…

Professional training in creative writing is associated with enhanced fronto-striatal activity in a literary text continuation task.

PubMed

Erhard, K; Kessler, F; Neumann, N; Ortheil, H-J; Lotze, M

2014-10-15

The aim of the present study was to explore brain activities associated with creativity and expertise in literary writing. Using functional magnetic resonance imaging (fMRI), we applied a real-life neuroscientific setting that consisted of different writing phases (brainstorming and creative writing; reading and copying as control conditions) to well-selected expert writers and to an inexperienced control group. During creative writing, experts showed cerebral activation in a predominantly left-hemispheric fronto-parieto-temporal network. When compared to inexperienced writers, experts showed increased left caudate nucleus and left dorsolateral and superior medial prefrontal cortex activation. In contrast, less experienced participants recruited increasingly bilateral visual areas. During creative writing activation in the right cuneus showed positive association with the creativity index in expert writers. High experience in creative writing seems to be associated with a network of prefrontal (mPFC and DLPFC) and basal ganglia (caudate) activation. In addition, our findings suggest that high verbal creativity specific to literary writing increases activation in the right cuneus associated with increased resources obtained for reading processes. Copyright © 2014 Elsevier Inc. All rights reserved.

Practical interpretation of CYP2D6 haplotypes: Comparison and integration of automated and expert calling.

PubMed

Ruaño, Gualberto; Kocherla, Mohan; Graydon, James S; Holford, Theodore R; Makowski, Gregory S; Goethe, John W

2016-05-01

We describe a population genetic approach to compare samples interpreted with expert calling (EC) versus automated calling (AC) for CYP2D6 haplotyping. The analysis represents 4812 haplotype calls based on signal data generated by the Luminex xMap analyzers from 2406 patients referred to a high-complexity molecular diagnostics laboratory for CYP450 testing. DNA was extracted from buccal swabs. We compared the results of expert calls (EC) and automated calls (AC) with regard to haplotype number and frequency. The ratio of EC to AC was 1:3. Haplotype frequencies from EC and AC samples were convergent across haplotypes, and their distribution was not statistically different between the groups. Most duplications required EC, as only expansions with homozygous or hemizygous haplotypes could be automatedly called. High-complexity laboratories can offer equivalent interpretation to automated calling for non-expanded CYP2D6 loci, and superior interpretation for duplications. We have validated scientific expert calling specified by scoring rules as standard operating procedure integrated with an automated calling algorithm. The integration of EC with AC is a practical strategy for CYP2D6 clinical haplotyping. Copyright © 2016 Elsevier B.V. All rights reserved.

Short-term Forecasting of the Prevalence of Trachoma: Expert Opinion, Statistical Regression, versus Transmission Models

PubMed Central

Liu, Fengchen; Porco, Travis C.; Amza, Abdou; Kadri, Boubacar; Nassirou, Baido; West, Sheila K.; Bailey, Robin L.; Keenan, Jeremy D.; Solomon, Anthony W.; Emerson, Paul M.; Gambhir, Manoj; Lietman, Thomas M.

2015-01-01

Background Trachoma programs rely on guidelines made in large part using expert opinion of what will happen with and without intervention. Large community-randomized trials offer an opportunity to actually compare forecasting methods in a masked fashion. Methods The Program for the Rapid Elimination of Trachoma trials estimated longitudinal prevalence of ocular chlamydial infection from 24 communities treated annually with mass azithromycin. Given antibiotic coverage and biannual assessments from baseline through 30 months, forecasts of the prevalence of infection in each of the 24 communities at 36 months were made by three methods: the sum of 15 experts’ opinion, statistical regression of the square-root-transformed prevalence, and a stochastic hidden Markov model of infection transmission (Susceptible-Infectious-Susceptible, or SIS model). All forecasters were masked to the 36-month results and to the other forecasts. Forecasts of the 24 communities were scored by the likelihood of the observed results and compared using Wilcoxon’s signed-rank statistic. Findings Regression and SIS hidden Markov models had significantly better likelihood than community expert opinion (p = 0.004 and p = 0.01, respectively). All forecasts scored better when perturbed to decrease Fisher’s information. Each individual expert’s forecast was poorer than the sum of experts. Interpretation Regression and SIS models performed significantly better than expert opinion, although all forecasts were overly confident. Further model refinements may score better, although would need to be tested and compared in new masked studies. Construction of guidelines that rely on forecasting future prevalence could consider use of mathematical and statistical models. PMID:26302380

A three-dimensional visualization preoperative treatment planning system for microwave ablation in liver cancer: a simulated experimental study.

PubMed

Liu, Fangyi; Cheng, Zhigang; Han, Zhiyu; Yu, Xiaoling; Yu, Mingan; Liang, Ping

2017-06-01

To evaluate the application value of three-dimensional (3D) visualization preoperative treatment planning system (VPTPS) for microwave ablation (MWA) in liver cancer. The study was a simulated experimental study using the CT imaging data of patients in DICOM format in a model. Three students (who learn to interventional ultrasound for less than 1 year) and three experts (who have more than 5 years of experience in ablation techniques) in MWA performed the preoperative planning for 39 lesions (mean diameter 3.75 ± 1.73 cm) of 32 patients using two-dimensional (2D) image planning method and 3D VPTPS, respectively. The number of planning insertions, planning ablation rate, and damage rate to surrounding structures were compared between2D image planning group and 3D VPTPS group. There were fewer planning insertions, lower ablation rate and higher damage rate to surrounding structures in 2D image planning group than 3D VPTPS group for both students and experts. When using the 2D ultrasound planning method, students could carry out fewer planning insertions and had a lower ablation rate than the experts (p < 0.001). However, there was no significant difference in planning insertions, the ablation rate, and the incidence of damage to the surrounding structures between students and experts using 3D VPTPS. 3DVPTPS enables inexperienced physicians to have similar preoperative planning results to experts, and enhances students' preoperative planning capacity, which may improve the therapeutic efficacy and reduce the complication of MWA.

Qpais: A Web-Based Expert System for Assistedidentification of Quarantine Stored Insect Pests

NASA Astrophysics Data System (ADS)

Huang, Han; Rajotte, Edwin G.; Li, Zhihong; Chen, Ke; Zhang, Shengfang

Stored insect pests can seriously depredate stored products causing worldwide economic losses. Pests enter countries traveling with transported goods. Inspection and Quarantine activities are essential to prevent the invasion and spread of pests. Identification of quarantine stored insect pests is an important component of the China's Inspection and Quarantine procedure, and it is necessary not only to identify whether the species captured is an invasive species, but determine control procedures for stored insect pests. With the development of information technologies, many expert systems that aid in the identification of agricultural pests have been developed. Expert systems for the identification of quarantine stored insect pests are rare and are mainly developed for stand-alone PCs. This paper describes the development of a web-based expert system for identification of quarantine stored insect pests as part of the China 11th Five-Year National Scientific and Technological Support Project (115 Project). Based on user needs, textual knowledge and images were gathered from the literature and expert interviews. ASP.NET, C# and SQL language were used to program the system. Improvement of identification efficiency and flexibility was achieved using a new inference method called characteristic-select-based spatial distance method. The expert system can assist identifying 150 species of quarantine stored insect pests and provide detailed information for each species. The expert system has also been evaluated using two steps: system testing and identification testing. With a 85% rate of correct identification and high efficiency, the system evaluation shows that this expert system can be used in identification work of quarantine stored insect pests.

Identification and detection of anomalies through SSME data analysis

NASA Technical Reports Server (NTRS)

Pereira, Lisa; Ali, Moonis

1990-01-01

The goal of the ongoing research described in this paper is to analyze real-time ground test data in order to identify patterns associated with the anomalous engine behavior, and on the basis of this analysis to develop an expert system which detects anomalous engine behavior in the early stages of fault development. A prototype of the expert system has been developed and tested on the high frequency data of two SSME tests, namely Test #901-0516 and Test #904-044. The comparison of our results with the post-test analyses indicates that the expert system detected the presence of the anomalies in a significantly early stage of fault development.

Layman versus Professional Musician: Who Makes the Better Judge?

PubMed Central

Larrouy-Maestri, Pauline; Magis, David; Grabenhorst, Matthias; Morsomme, Dominique

2015-01-01

The increasing number of casting shows and talent contests in the media over the past years suggests a public interest in rating the quality of vocal performances. In many of these formats, laymen alongside music experts act as judges. Whereas experts' judgments are considered objective and reliable when it comes to evaluating singing voice, little is known about laymen’s ability to evaluate peers. On the one hand, layman listeners–who by definition did not have any formal training or regular musical practice–are known to have internalized the musical rules on which singing accuracy is based. On the other hand, layman listeners’ judgment of their own vocal skills is highly inaccurate. Also, when compared with that of music experts, their level of competence in pitch perception has proven limited. The present study investigates laypersons' ability to objectively evaluate melodies performed by untrained singers. For this purpose, laymen listeners were asked to judge sung melodies. The results were compared with those of music experts who had performed the same task in a previous study. Interestingly, the findings show a high objectivity and reliability in layman listeners. Whereas both the laymen's and experts' definition of pitch accuracy overlap, differences regarding the musical criteria employed in the rating task were evident. The findings suggest that the effect of expertise is circumscribed and limited and supports the view that laypersons make trustworthy judges when evaluating the pitch accuracy of untrained singers. PMID:26308213

[Licensing of Pharmaceuticals and Medical Devices in Germany: Weaknesses and Opportunities].

PubMed

Reinhardt, D; Wildner, M

2016-12-01

The purpose of this study is to describe and compare the licensing of pharmaceuticals and medical devices in Germany. Weaknesses and opportunities of the respective processes are identified. Methods: To describe and compare the two approaches, a systematic literature review was conducted, followed by an archival analysis, guided by experts. Unstructured interviews were conducted with experts (users, financers, surveillants and producers) personally or by telephone to identify weaknesses and opportunities. The data were evaluated by content analysis according to Mayring and MAXQDA 11. The results were critically assessed by comparing them with the current academic literature. Results: A central market authorization for medical devices was mentioned often, but seems politically not viable. However, quality, methodology and depth of the analyses necessary for the licensing of medical devices, especially for high-risk devices, can and should strive for higher standards, comparable to those of pharmaceuticals. With regard to post-market surveillance, the systems for both pharmaceuticals and medical devices should be improved. Innovativeness and competitiveness of European medical device manufacturers should not be promoted by reduced evidence standards and patient safety. Subsidies or easier licensing procedures for small product lines with particular importance for public health, similar to orphan drug regulations, are more desirable. Conclusion: This study helps to identify areas of improvement for licensing of pharmaceuticals and medical devices. Concrete recommendations were developed. Higher evidence standards should be mandatory especially for high-risk devices, comparable to those of pharmaceuticals. Post-marketing surveillance should be improved for pharmaceuticals and medical devices. © Georg Thieme Verlag KG Stuttgart · New York.

Design and Implementation Content Validity Study: Development of an instrument for measuring Patient-Centered Communication

PubMed Central

Zamanzadeh, Vahid; Ghahramanian, Akram; Rassouli, Maryam; Abbaszadeh, Abbas; Alavi-Majd, Hamid; Nikanfar, Ali-Reza

2015-01-01

Introduction: The importance of content validity in the instrument psychometric and its relevance with reliability, have made it an essential step in the instrument development. This article attempts to give an overview of the content validity process and to explain the complexity of this process by introducing an example. Methods: We carried out a methodological study conducted to examine the content validity of the patient-centered communication instrument through a two-step process (development and judgment). At the first step, domain determination, sampling (item generation) and instrument formation and at the second step, content validity ratio, content validity index and modified kappa statistic was performed. Suggestions of expert panel and item impact scores are used to examine the instrument face validity. Results: From a set of 188 items, content validity process identified seven dimensions includes trust building (eight items), informational support (seven items), emotional support (five items), problem solving (seven items), patient activation (10 items), intimacy/friendship (six items) and spirituality strengthening (14 items). Content validity study revealed that this instrument enjoys an appropriate level of content validity. The overall content validity index of the instrument using universal agreement approach was low; however, it can be advocated with respect to the high number of content experts that makes consensus difficult and high value of the S-CVI with the average approach, which was equal to 0.93. Conclusion: This article illustrates acceptable quantities indices for content validity a new instrument and outlines them during design and psychometrics of patient-centered communication measuring instrument. PMID:26161370

The Role of Domain-Specific Practice, Handedness, and Starting Age in Chess

ERIC Educational Resources Information Center

Gobet, Fernand; Campitelli, Guillermo

2007-01-01

The respective roles of the environment and innate talent have been a recurrent question for research into expertise. The authors investigated markers of talent, environment, and critical period for the acquisition of expert performance in chess. Argentinian chess players (N = 104), ranging from weak amateurs to grandmasters, completed a…

The Education Ideal of the Democratic Citizen in Germany: Challenges and Changing Trends

ERIC Educational Resources Information Center

Buck, Alexy; Geissel, Brigitte

2009-01-01

This article draws on exploratory qualitative interviews with German education policy experts. We ask whether, as Germany faces new challenges, changes have occurred in respect of the education ideal of the democratic citizen; perceived implications for civic education and schooling are also drawn out. Interviews were conducted with senior…

The Make Up of Institutional Branding: Who, What, How?

ERIC Educational Resources Information Center

Belanger, Charles H.; Syed, Saadi; Mount, Joan

2007-01-01

The purpose of this paper is to report on who creates branding within institutions of higher learning, and what impact branding has on core institutional activities such as student recruitment and fundraising, as well as on socio-psychological factors such as community respect and national prestige. Eighty-nine tertiary education experts covering…

Eurasian Higher Education Leaders Forum Conference Proceedings (Astana, Kazakhstan, August 20-21, 2012)

ERIC Educational Resources Information Center

Reagan, Timothy, Ed.; Sagintayeva, Aida, Ed.

2013-01-01

This publication presents a diverse collection written by a well-respected group of speakers and authors which includes government leaders, policy makers, education experts and administrators from all over the higher education world. The papers collected hereunder represent the conference proceedings of the Eurasian Higher Education Leaders' Forum…

Not Waiting for a Rainy Day: Professional Development to Promote Informed and Engaged Catchment Communities

ERIC Educational Resources Information Center

Whelan, James; La Rocca, Sam

2004-01-01

Managers and decision-makers are under increasing pressure to engage community members along with experts in considering and resolving environmental degradation. This is especially the case with respect to decisions concerning water quality and quantity in Australia. The commitment of citizens and government to sustainable catchment management and…

Thirteen for Thirteen-Year-Olds

ERIC Educational Resources Information Center

Instructor, 2011

2011-01-01

What does it take to reach a middle school reader? Literacy expert Laura Robb recently shared her top strategies in a webcast for Scholastic fans. This article presents Robb's 13 strategies for thirteen-year-olds. These are: (1) Respect students' search for self; (2) Embrace blogging; (3) Send texts in class; (4) Take words apart; (5) Build…

What Do We Mean by Cyberlearning: Characterizing a Socially Constructed Definition with Experts and Practitioners

ERIC Educational Resources Information Center

Montfort, Devlin B.; Brown, Shane

2013-01-01

The term "cyberlearning" reflects a growing national interest in managing the interactions of technology and education, especially with respect to the use of networking and information technologies. However, there is little agreement about what the term means. Such disagreements reflect underlying differences in beliefs about the purposes of…

29 CFR 18.16 - Supplementation of responses.

Code of Federal Regulations, 2010 CFR

2010-07-01

... responded to a request for discovery with a response that was complete when made is under no duty to... duty to supplement timely his response with respect to any question directly addressed to: (1) The... person expected to be called as an expert witness at the hearing, the subject matter on which he or she...

29 CFR 18.16 - Supplementation of responses.

Code of Federal Regulations, 2011 CFR

2011-07-01

... responded to a request for discovery with a response that was complete when made is under no duty to... duty to supplement timely his response with respect to any question directly addressed to: (1) The... person expected to be called as an expert witness at the hearing, the subject matter on which he or she...

49 CFR 386.40 - Supplementation of responses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... responded to a request for discovery with a response that was complete when made is under no duty to... under a duty to supplement timely his/her response with respect to any question directly addressed to... identity of each person expected to be called as an expert witness at the hearing, the subject matter on...

43 CFR 4.1134 - Supplementation of responses.

Code of Federal Regulations, 2011 CFR

2011-10-01

... complete when made is under no duty to supplement his response to include information thereafter acquired, except as follows— (a) A party is under a duty to supplement timely his response with respect to any... matters; and (2) The identity of each person expected to be called as an expert witness at the hearing...

49 CFR 386.40 - Supplementation of responses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... responded to a request for discovery with a response that was complete when made is under no duty to... under a duty to supplement timely his/her response with respect to any question directly addressed to... identity of each person expected to be called as an expert witness at the hearing, the subject matter on...

43 CFR 4.1134 - Supplementation of responses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... complete when made is under no duty to supplement his response to include information thereafter acquired, except as follows— (a) A party is under a duty to supplement timely his response with respect to any... matters; and (2) The identity of each person expected to be called as an expert witness at the hearing...

Students as Expert Witnesses of Teaching and Learning

ERIC Educational Resources Information Center

Busher, Hugh

2012-01-01

Student voice is a key component in constructing discourses of respect, empowerment and citizenship in schools. It can help schools to become learning communities, rather than knowledge factories, that serve the needs of the majority of their members, the students, as successfully as possible and prepare them for future lives in a wide variety of…

A Structuralist Study of Chinua Achebe's Anthills of the Savannah

ERIC Educational Resources Information Center

Ononiwu, Mark Chitulu; Queen, Njemanze

2015-01-01

Major African writers have never stopped exploring the themes of corruption, radical struggles and political instability in their respective domains. One of these writers and his monumental classic, Chinua Achebe; "Anthills of the Savanna", discusses these themes expertly and with utmost dexterity. The major task of this paper is not to…

The role of interpersonal movement synchronisation in empathic functions: Insights from Tango Argentino and Capoeira.

PubMed

Koehne, Svenja; Schmidt, Mirjam J; Dziobek, Isabel

2016-08-01

Although evidence points to a role for kinesthetic empathy (i.e. spontaneous interpersonal movement imitation and synchronisation) in social interaction, its relationship with emotional and cognitive aspects of empathy is unknown. We compared empathy in Tango and Capoeira experts, which crucially depend on ongoing, mutual interpersonal synchronisation, with empathy in practitioners of Salsa and Breakdance, respectively, which demand less interpersonal synchronisation but are comparable concerning movements and setting. Kinesthetic empathy was increased in the Tango and Capoeira groups. Although no group differences in other aspects of empathy were detected, kinesthetic empathy correlated with emotional and cognitive empathy. Taken together, trait kinesthetic empathy varies in the general population, and appears increased in synchronisation experts. © 2015 International Union of Psychological Science.

[Knowledge, perceptions and practice of dermatologists with respect to Giardia lamblia infection].

PubMed

Iglesias Hernández, Tania; Almannoni, Saleh Ali; Rodríguez, Maria Elena; Sánchez Valdés, Lizet; Pupo, Deisy Martín; Manzur Katrib, Julián; Fonte Galindo, Luis

2010-01-01

to ascertain the level of knowledge, the perceptions and practice of dermatologists in the City of Havana with respect to Giardia lamblia infection. with prior informed consent given by the dermatologists from the City of Havana, 50 dermatologists- a number very close to the universe of these experts in the province- were administered a survey of their knowledge, perceptions and practice about this parasitosis. The survey was prepared in 4 phases; that is, interviews to physicians on diagnosis, treatment and control of giardiasis; drafting of a preliminary questionnaire based on the interview results; submission of this instruments to the experts, and finally its validation through its application to a small group of physicians. it was evinced that the dermatologists in the City of Havana had poor knowledge about giardiasis, particularly its cutaneous manifestations (out of 19 questions on cognitive aspects, the correct answer mean was 10,18), inadequate perceptions on this disease and practice was not good. with the aim of mitigating these difficulties, some academic intervention is needed to make emphasis on the formative aspects related to parasitic diseases in general and giardiasis in particular

Recommendations for Promoting Physical Activity for Children and Adolescents in Germany. A Consensus Statement

PubMed Central

Graf, Christine; Beneke, Ralph; Bloch, Wilhelm; Bucksch, Jens; Dordel, Sigrid; Eiser, Stefanie; Ferrari, Nina; Koch, Benjamin; Krug, Susanne; Lawrenz, Wolfgang; Manz, Kristin; Naul, Roland; Oberhoffer, Renate; Quilling, Eike; Schulz, Henry; Stemper, Theo; Stibbe, Günter; Tokarski, Walter; Völker, Klaus; Woll, Alexander

2014-01-01

Increasing physical activity and reduction of sedentary behaviour play important roles in health promotion and prevention of lifestyle-related diseases in children and adolescents. However, the question of how much physical activity is useful for which target group is still a matter of debate. International guidelines (World Health Organization; European Association for the Study of Obesity), which are mainly based on expert opinions, recommend 60 min of physical activity every day. Age- and sex-specific features and regional differences are not taken into account. Therefore, expert consensus recommendations for promoting physical activity of children and adolescents in Germany were developed with special respect to national data, but also with respect to aspects of specific target groups, e.g., children with a lower socio-economic status (SES) or with migration background. They propose 90 min/day of physical activity, or at least 12,000 steps daily. Additionally, lifestyle factors, especially restriction of media consumption, were integrated. The recommendations provide orientation for parents and caregivers, for institutions such as schools and kindergartens as well as for communities and stakeholders. PMID:24821136

Evaluation of Nine Consensus Indices in Delphi Foresight Research and Their Dependency on Delphi Survey Characteristics: A Simulation Study and Debate on Delphi Design and Interpretation.

PubMed

Birko, Stanislav; Dove, Edward S; Özdemir, Vural

2015-01-01

The extent of consensus (or the lack thereof) among experts in emerging fields of innovation can serve as antecedents of scientific, societal, investor and stakeholder synergy or conflict. Naturally, how we measure consensus is of great importance to science and technology strategic foresight. The Delphi methodology is a widely used anonymous survey technique to evaluate consensus among a panel of experts. Surprisingly, there is little guidance on how indices of consensus can be influenced by parameters of the Delphi survey itself. We simulated a classic three-round Delphi survey building on the concept of clustered consensus/dissensus. We evaluated three study characteristics that are pertinent for design of Delphi foresight research: (1) the number of survey questions, (2) the sample size, and (3) the extent to which experts conform to group opinion (the Group Conformity Index) in a Delphi study. Their impacts on the following nine Delphi consensus indices were then examined in 1000 simulations: Clustered Mode, Clustered Pairwise Agreement, Conger's Kappa, De Moivre index, Extremities Version of the Clustered Pairwise Agreement, Fleiss' Kappa, Mode, the Interquartile Range and Pairwise Agreement. The dependency of a consensus index on the Delphi survey characteristics was expressed from 0.000 (no dependency) to 1.000 (full dependency). The number of questions (range: 6 to 40) in a survey did not have a notable impact whereby the dependency values remained below 0.030. The variation in sample size (range: 6 to 50) displayed the top three impacts for the Interquartile Range, the Clustered Mode and the Mode (dependency = 0.396, 0.130, 0.116, respectively). The Group Conformity Index, a construct akin to measuring stubbornness/flexibility of experts' opinions, greatly impacted all nine Delphi consensus indices (dependency = 0.200 to 0.504), except the Extremity CPWA and the Interquartile Range that were impacted only beyond the first decimal point (dependency = 0.087 and 0.083, respectively). Scholars in technology design, foresight research and future(s) studies might consider these new findings in strategic planning of Delphi studies, for example, in rational choice of consensus indices and sample size, or accounting for confounding factors such as experts' variable degrees of conformity (stubbornness/flexibility) in modifying their opinions.