Multicriteria hierarchical iterative interactive algorithm for organizing operational modes of large heat supply systems

NASA Astrophysics Data System (ADS)

Korotkova, T. I.; Popova, V. I.

2017-11-01

The generalized mathematical model of decision-making in the problem of planning and mode selection providing required heat loads in a large heat supply system is considered. The system is multilevel, decomposed into levels of main and distribution heating networks with intermediate control stages. Evaluation of the effectiveness, reliability and safety of such a complex system is carried out immediately according to several indicators, in particular pressure, flow, temperature. This global multicriteria optimization problem with constraints is decomposed into a number of local optimization problems and the coordination problem. An agreed solution of local problems provides a solution to the global multicriterion problem of decision making in a complex system. The choice of the optimum operational mode of operation of a complex heat supply system is made on the basis of the iterative coordination process, which converges to the coordinated solution of local optimization tasks. The interactive principle of multicriteria task decision-making includes, in particular, periodic adjustment adjustments, if necessary, guaranteeing optimal safety, reliability and efficiency of the system as a whole in the process of operation. The degree of accuracy of the solution, for example, the degree of deviation of the internal air temperature from the required value, can also be changed interactively. This allows to carry out adjustment activities in the best way and to improve the quality of heat supply to consumers. At the same time, an energy-saving task is being solved to determine the minimum required values of heads at sources and pumping stations.

A hedging point strategy--balancing effluent quality, economy and robustness in the control of wastewater treatment plants.

PubMed

Ingildsen, P; Olsson, G; Yuan, Z

2002-01-01

An operational space map is an efficient tool to compare a large number of operational strategies to find an optimal choice of setpoints based on a multicriterion. Typically, such a multicriterion includes a weighted sum of cost of operation and effluent quality. Due to the relative high cost of aeration such a definition of optimality result in a relatively high fraction of the effluent total nitrogen in the form of ammonium. Such a strategy may however introduce a risk into operation because a low degree of ammonium removal leads to a low amount of nitrifiers. This in turn leads to a reduced ability to reject event disturbances, such as large variations in the ammonium load, drop in temperature, the presence of toxic/inhibitory compounds in the influent etc. Hedging is a risk minimisation tool, with the aim to "reduce one's risk of loss on a bet or speculation by compensating transactions on the other side" (The Concise Oxford Dictionary (1995)). In wastewater treatment plant operation hedging can be applied by choosing a higher level of ammonium removal to increase the amount of nitrifiers. This is a sensible way to introduce disturbance rejection ability into the multi criterion. In practice, this is done by deciding upon an internal effluent ammonium criterion. In some countries such as Germany, a separate criterion already applies to the level of ammonium in the effluent. However, in most countries the effluent criterion applies to total nitrogen only. In these cases, an internal effluent ammonium criterion should be selected in order to secure proper disturbance rejection ability.

A Critical Evaluation of Waste Incineration Plants in Wuhan (China) Based on Site Selection, Environmental Influence, Public Health and Public Participation

PubMed Central

Hu, Hui; Li, Xiang; Nguyen, Anh Dung; Kavan, Philip

2015-01-01

With the rapid development of the waste incineration industry in China, top priority has been given to the problem of pollution caused by waste incineration. This study is the first attempt to assess all the waste incineration plants in Wuhan, the only national key city in central China, in terms of environmental impact, site selection, public health and public participation. By using a multi-criterion assessment model for economic, social, public health and environmental effects, this study indicates these incineration plants are established without much consideration of the local residents’ health and environment. A location analysis is also applied and some influences of waste incineration plants are illustrated. This study further introduces a signaling game model to prove that public participation is a necessary condition for improving the environmental impact assessment and increasing total welfare of different interest groups in China. This study finally offers some corresponding recommendations for improving the environmental impact assessments of waste incineration projects. PMID:26184242

A Critical Evaluation of Waste Incineration Plants in Wuhan (China) Based on Site Selection, Environmental Influence, Public Health and Public Participation.

PubMed

Hu, Hui; Li, Xiang; Nguyen, Anh Dung; Kavan, Philip

2015-07-08

With the rapid development of the waste incineration industry in China, top priority has been given to the problem of pollution caused by waste incineration. This study is the first attempt to assess all the waste incineration plants in Wuhan, the only national key city in central China, in terms of environmental impact, site selection, public health and public participation. By using a multi-criterion assessment model for economic, social, public health and environmental effects, this study indicates these incineration plants are established without much consideration of the local residents' health and environment. A location analysis is also applied and some influences of waste incineration plants are illustrated. This study further introduces a signaling game model to prove that public participation is a necessary condition for improving the environmental impact assessment and increasing total welfare of different interest groups in China. This study finally offers some corresponding recommendations for improving the environmental impact assessments of waste incineration projects.

Multimodal Perception and Multicriterion Control of Nested Systems. 1; Coordination of Postural Control and Vehicular Control

NASA Technical Reports Server (NTRS)

Riccio, Gary E.; McDonald, P. Vernon

1998-01-01

The purpose of this report is to identify the essential characteristics of goal-directed whole-body motion. The report is organized into three major sections (Sections 2, 3, and 4). Section 2 reviews general themes from ecological psychology and control-systems engineering that are relevant to the perception and control of whole-body motion. These themes provide an organizational framework for analyzing the complex and interrelated phenomena that are the defining characteristics of whole-body motion. Section 3 of this report applies the organization framework from the first section to the problem of perception and control of aircraft motion. This is a familiar problem in control-systems engineering and ecological psychology. Section 4 examines an essential but generally neglected aspect of vehicular control: coordination of postural control and vehicular control. To facilitate presentation of this new idea, postural control and its coordination with vehicular control are analyzed in terms of conceptual categories that are familiar in the analysis of vehicular control.

Air protection programmes in Poland in the context of the low emission.

PubMed

Adamczyk, Janusz; Piwowar, Arkadiusz; Dzikuć, Maciej

2017-07-01

The protection of the air against pollutants from individual boiler plants is a big challenge in Poland. It results mainly from the preference for coal, the national energy carrier, the use of old low-efficiency boilers and the location of Poland in a temperate climate where the heating period lasts at least 5 months. This article presents a wide range of activities aimed at the reduction of the environmental impact of the emissions of pollutants from individual heat sources-the so-called low emission. The article presents the extent of the national legislation resulting from the European Union regulations. It discusses the assumptions of the air protection programmes (APPs) and the low emission reduction programmes (LERPs). The assumptions mentioned above are analysed as part of a life cycle assessment (LCA) analysis and a multi-criterion analysis. An important result of these analyses (in the Polish conditions) is the conclusion that a boiler fired with large pieces of wood is an optimal solution from the economic and ecological points of view. The article proposes systemic, organisational and legislative solutions whose implementation could contribute to raising the effectiveness of the protection of the atmosphere.

System analysis of vehicle active safety problem

NASA Astrophysics Data System (ADS)

Buznikov, S. E.

2018-02-01

The problem of the road transport safety affects the vital interests of the most of the population and is characterized by a global level of significance. The system analysis of problem of creation of competitive active vehicle safety systems is presented as an interrelated complex of tasks of multi-criterion optimization and dynamic stabilization of the state variables of a controlled object. Solving them requires generation of all possible variants of technical solutions within the software and hardware domains and synthesis of the control, which is close to optimum. For implementing the task of the system analysis the Zwicky “morphological box” method is used. Creation of comprehensive active safety systems involves solution of the problem of preventing typical collisions. For solving it, a structured set of collisions is introduced with its elements being generated also using the Zwicky “morphological box” method. The obstacle speed, the longitudinal acceleration of the controlled object and the unpredictable changes in its movement direction due to certain faults, the road surface condition and the control errors are taken as structure variables that characterize the conditions of collisions. The conditions for preventing typical collisions are presented as inequalities for physical variables that define the state vector of the object and its dynamic limits.

Using a fuzzy DEMATEL method for analyzing the factors influencing subcontractors selection

NASA Astrophysics Data System (ADS)

Kozik, Renata

2016-06-01

Subcontracting is a long-standing practice in the construction industry. This form of project organization, if manage properly, could provide the better quality, reduction in project time and costs. Subcontractors selection is a multi-criterion problem and can be determined by many factors. Identifying the importance of each of them as well as the direction of cause-effect relations between various types of factors can improve the management process. Their values could be evaluated on the basis of the available expert opinions with the application of a fuzzy multi-stage grading scale. In this paper it is recommended to use fuzzy DEMATEL method to analyze the relationship between factors affecting subcontractors selection.

A predictive model for assistive technology adoption for people with dementia.

PubMed

Zhang, Shuai; McClean, Sally I; Nugent, Chris D; Donnelly, Mark P; Galway, Leo; Scotney, Bryan W; Cleland, Ian

2014-01-01

Assistive technology has the potential to enhance the level of independence of people with dementia, thereby increasing the possibility of supporting home-based care. In general, people with dementia are reluctant to change; therefore, it is important that suitable assistive technologies are selected for them. Consequently, the development of predictive models that are able to determine a person's potential to adopt a particular technology is desirable. In this paper, a predictive adoption model for a mobile phone-based video streaming system, developed for people with dementia, is presented. Taking into consideration characteristics related to a person's ability, living arrangements, and preferences, this paper discusses the development of predictive models, which were based on a number of carefully selected data mining algorithms for classification. For each, the learning on different relevant features for technology adoption has been tested, in conjunction with handling the imbalance of available data for output classes. Given our focus on providing predictive tools that could be used and interpreted by healthcare professionals, models with ease-of-use, intuitive understanding, and clear decision making processes are preferred. Predictive models have, therefore, been evaluated on a multi-criterion basis: in terms of their prediction performance, robustness, bias with regard to two types of errors and usability. Overall, the model derived from incorporating a k-Nearest-Neighbour algorithm using seven features was found to be the optimal classifier of assistive technology adoption for people with dementia (prediction accuracy 0.84 ± 0.0242).

Restoring Natural Streamflow Variability by Modifying Multi-purpose Reservoir Operation

NASA Astrophysics Data System (ADS)

Shiau, J.

2010-12-01

Multi-purpose reservoirs typically provide benefits of water supply, hydroelectric power, and flood mitigation. Hydroelectric power generations generally do not consume water. However, temporal distribution of downstream flows is highly changed due to hydro-peaking effects. Associated with offstream diversion of water supplies for municipal, industrial, and agricultural requirements, natural streamflow characteristics of magnitude, duration, frequency, timing, and rate of change is significantly altered by multi-purpose reservoir operation. Natural flow regime has long been recognized a master factor for ecosystem health and biodiversity. Restoration of altered flow regime caused by multi-purpose reservoir operation is the main objective of this study. This study presents an optimization framework that modifying reservoir operation to seeking balance between human and environmental needs. The methodology presented in this study is applied to the Feitsui Reservoir, located in northern Taiwan, with main purpose of providing stable water-supply and auxiliary purpose of electricity generation and flood-peak attenuation. Reservoir releases are dominated by two decision variables, i.e., duration of water releases for each day and percentage of daily required releases within the duration. The current releasing policy of the Feitsui Reservoir releases water for water-supply and hydropower purposes during 8:00 am to 16:00 pm each day and no environmental flows releases. Although greater power generation is obtained by 100% releases distributed within 8-hour period, severe temporal alteration of streamflow is observed downstream of the reservoir. Modifying reservoir operation by relaxing these two variables and reserve certain ratio of streamflow as environmental flow to maintain downstream natural variability. The optimal reservoir releasing policy is searched by the multi-criterion decision making technique for considering reservoir performance in terms of shortage ratio and power generation and downstream hydrologic alterations in terms of ecological relevant indicators. The results show that the proposed methodology can mitigate hydro-peaking effects on natural variability, while maintains efficient reservoir operation.

Techniques for designing rotorcraft control systems

NASA Technical Reports Server (NTRS)

Yudilevitch, Gil; Levine, William S.

1994-01-01

Over the last two and a half years we have been demonstrating a new methodology for the design of rotorcraft flight control systems (FCS) to meet handling qualities requirements. This method is based on multicriterion optimization as implemented in the optimization package CONSOL-OPTCAD (C-O). This package has been developed at the Institute for Systems Research (ISR) at the University of Maryland at College Park. This design methodology has been applied to the design of a FCS for the UH-60A helicopter in hover having the ADOCS control structure. The controller parameters have been optimized to meet the ADS-33C specifications. Furthermore, using this approach, an optimal (minimum control energy) controller has been obtained and trade-off studies have been performed.

The Use of Geographic Information Technologies in Environmental Decision-Making in the State of Michoacan, Mexico

NASA Astrophysics Data System (ADS)

Teodoro, Silva García José; Gustavo, Cruz Cárdenas; Salvador, Ochoa Estrada; Franciso, Estrada Godoy; Fabian, Villalpando Barragán

2008-05-01

One of the most urgent issues facing the human environment, a result of current human evolution is the increase in the production of Urban Solid Waste (USW). The State of Michoacán is no exception; the presence of waste facilities in the area is a very big problem and one with a strong geographical content (Mena et al., 2006). SIGs are one tool for addressing this kind of need. A model which has been commonly used for selecting areas for the final deposit of USW, and which has obtained good results, is so-called multicriterion decision-making. It has been applied in the context of integral USW management, and has generated both a methodology for the determination of safe places for final waste deposit and an Environmental Risk Index (ERI), which fulfills the requirements indicated by the Official Mexican Norm (NOM-083-SEMARNAT-2003). The methodology consists of a quadrant analysis of 25 ha of five factors. A rank was assigned to each of the factors, and this rank was standardized according to a scale from 0 to 10 and subsequently multiplied by a weight (W) which numerically represents the degree of importance and influence of each factor in the environment. Five represented the largest impact, and two represented the smallest impact. The ERI is the sum of the five factors considered and it is represented by means of the following equation: ERI = VVw+UsUsw+FrFrw+ln lnw+Zi Ziw, where ERI is the Environmental Risk Index, V Vw is the aquifer vulnerability, Us Usw represents the use of the soil, Fr Frw refers to the fracturing density, ln lnw represents the domain of the urban and industrial infrastructure, and Zi Ziw refers to flood zones. This was shown to be successful in different regions of Michoacán State, such as the Bajío area, the Paísde la Mariposa Monarca and Tierra Caliente. Another example is its application in the hydrogeologic context, which generated the Aquifer Veda index (a restriction diagram for the opening of new exploitations), and which is intended to regulate and give advice about the design of wells, their depth and optimum slot interval, their appropriate location and caudal, in those cases in which well-drilling is permitted. The above-mentioned approach is fundamental to the sustainable operating schemes for the handling of the underground water in the Ciénega de Chapala. This approach is intended to influence the scientific handling of the hydro resource, promoting sustainable politics and rules of operation.

Multimodal Perception and Multicriterion Control of Nested Systems. 2; Constraints on Crew Members During Space Vehicle Abort, Entry, and Landing

NASA Technical Reports Server (NTRS)

Riccio, Gary E.; McDonald, P. Vernon; Irvin, Gregg E.; Bloomberg, Jacob J.

1998-01-01

This report reviews the operational demands made of a Shuttle pilot or commander within the context of a proven empirical methodology for describing human sensorimotor performance and whole-body coordination in mechanically and perceptually complex environments. The conclusions of this review pertain to a) methods for improving our understanding of the psychophysics and biomechanics of visual/manual control and whole-body coordination in space vehicle cockpits; b) the application of scientific knowledge about human perception and performance in dynamic inertial conditions to the development of technology, procedures, and training for personnel in space vehicle cockpits; c) recommendations for mitigation of safety and reliability concerns about human performance in space vehicle cockpits; and d) in-flight evaluation of flight crew performance during nominal and off-nominal launch and reentry scenarios.

Global Design Optimization for Fluid Machinery Applications

NASA Technical Reports Server (NTRS)

Shyy, Wei; Papila, Nilay; Tucker, Kevin; Vaidyanathan, Raj; Griffin, Lisa

2000-01-01

Recent experiences in utilizing the global optimization methodology, based on polynomial and neural network techniques for fluid machinery design are summarized. Global optimization methods can utilize the information collected from various sources and by different tools. These methods offer multi-criterion optimization, handle the existence of multiple design points and trade-offs via insight into the entire design space can easily perform tasks in parallel, and are often effective in filtering the noise intrinsic to numerical and experimental data. Another advantage is that these methods do not need to calculate the sensitivity of each design variable locally. However, a successful application of the global optimization method needs to address issues related to data requirements with an increase in the number of design variables and methods for predicting the model performance. Examples of applications selected from rocket propulsion components including a supersonic turbine and an injector element and a turbulent flow diffuser are used to illustrate the usefulness of the global optimization method.

Contributions of cultural services to the ecosystem services agenda

PubMed Central

Daniel, Terry C.; Muhar, Andreas; Arnberger, Arne; Aznar, Olivier; Boyd, James W.; Chan, Kai M. A.; Costanza, Robert; Elmqvist, Thomas; Flint, Courtney G.; Gobster, Paul H.; Grêt-Regamey, Adrienne; Lave, Rebecca; Muhar, Susanne; Penker, Marianne; Ribe, Robert G.; Schauppenlehner, Thomas; Sikor, Thomas; Soloviy, Ihor; Spierenburg, Marja; Taczanowska, Karolina; Tam, Jordan; von der Dunk, Andreas

2012-01-01

Cultural ecosystem services (ES) are consistently recognized but not yet adequately defined or integrated within the ES framework. A substantial body of models, methods, and data relevant to cultural services has been developed within the social and behavioral sciences before and outside of the ES approach. A selective review of work in landscape aesthetics, cultural heritage, outdoor recreation, and spiritual significance demonstrates opportunities for operationally defining cultural services in terms of socioecological models, consistent with the larger set of ES. Such models explicitly link ecological structures and functions with cultural values and benefits, facilitating communication between scientists and stakeholders and enabling economic, multicriterion, deliberative evaluation and other methods that can clarify tradeoffs and synergies involving cultural ES. Based on this approach, a common representation is offered that frames cultural services, along with all ES, by the relative contribution of relevant ecological structures and functions and by applicable social evaluation approaches. This perspective provides a foundation for merging ecological and social science epistemologies to define and integrate cultural services better within the broader ES framework. PMID:22615401

Thermodynamic criteria for estimating the kinetic parameters of catalytic reactions

NASA Astrophysics Data System (ADS)

Mitrichev, I. I.; Zhensa, A. V.; Kol'tsova, E. M.

2017-01-01

Kinetic parameters are estimated using two criteria in addition to the traditional criterion that considers the consistency between experimental and modeled conversion data: thermodynamic consistency and the consistency with entropy production (i.e., the absolute rate of the change in entropy due to exchange with the environment is consistent with the rate of entropy production in the steady state). A special procedure is developed and executed on a computer to achieve the thermodynamic consistency of a set of kinetic parameters with respect to both the standard entropy of a reaction and the standard enthalpy of a reaction. A problem of multi-criterion optimization, reduced to a single-criterion problem by summing weighted values of the three criteria listed above, is solved. Using the reaction of NO reduction with CO on a platinum catalyst as an example, it is shown that the set of parameters proposed by D.B. Mantri and P. Aghalayam gives much worse agreement with experimental values than the set obtained on the basis of three criteria: the sum of the squares of deviations for conversion, the thermodynamic consistency, and the consistency with entropy production.

Technology adoption and prediction tools for everyday technologies aimed at people with dementia.

PubMed

Chaurasia, Priyanka; McClean, Sally I; Nugent, Chris D; Cleland, Ian; Shuai Zhang; Donnelly, Mark P; Scotney, Bryan W; Sanders, Chelsea; Smith, Ken; Norton, Maria C; Tschanz, JoAnn

2016-08-01

A wide range of assistive technologies have been developed to support the elderly population with the goal of promoting independent living. The adoption of these technology based solutions is, however, critical to their overarching success. In our previous research we addressed the significance of modelling user adoption to reminding technologies based on a range of physical, environmental and social factors. In our current work we build upon our initial modeling through considering a wider range of computational approaches and identify a reduced set of relevant features that can aid the medical professionals to make an informed choice of whether to recommend the technology or not. The adoption models produced were evaluated on a multi-criterion basis: in terms of prediction performance, robustness and bias in relation to two types of errors. The effects of data imbalance on prediction performance was also considered. With handling the imbalance in the dataset, a 16 feature-subset was evaluated consisting of 173 instances, resulting in the ability to differentiate between adopters and non-adopters with an overall accuracy of 99.42 %.

Geographical Analysis for Detecting High-Risk Areas for Bovine/Human Rabies Transmitted by the Common Hematophagous Bat in the Amazon Region, Brazil

PubMed Central

Begot, Alberto L.; Ramos, Ofir de S.

2016-01-01

Background The common hematophagous bat, Desmodus rotundus, is one of the main wild reservoirs of rabies virus in several regions in Latin America. New production practices and changed land use have provided environmental features that have been very favorable for D. rotundus bat populations, making this species the main transmitter of rabies in the cycle that involves humans and herbivores. In the Amazon region, these features include a mosaic of environmental, social, and economic components, which together creates areas with different levels of risk for human and bovine infections, as presented in this work in the eastern Brazilian Amazon. Methodology We geo-referenced a total of 175 cases of rabies, of which 88% occurred in bovines and 12% in humans, respectively, and related these cases to a number of different geographical and biological variables. The spatial distribution was analyzed using the Kernel function, while the association with independent variables was assessed using a multi-criterion Analytical Hierarchy Process (AHP) technique. Findings The spatiotemporal analysis of the occurrence of rabies in bovines and humans found reduction in the number of cases in the eastern state of Pará, where no more cases were recorded in humans, whereas high infection rates were recorded in bovines in the northeastern part of the state, and low rates in the southeast. The areas of highest risk for bovine rabies are found in the proximity of rivers and highways. In the case of human rabies, the highest concentration of high-risk areas was found where the highway network coincides with high densities of rural and indigenous populations. Conclusion The high-risk areas for human and bovine rabies are patchily distributed, and related to extensive deforested areas, large herds of cattle, and the presence of highways. These findings provide an important database for the generation of epidemiological models that could support the development of effective prevention measures and controls. PMID:27388498

A modelling methodology to assess the effect of insect pest control on agro-ecosystems.

PubMed

Wan, Nian-Feng; Ji, Xiang-Yun; Jiang, Jie-Xian; Li, Bo

2015-04-23

The extensive use of chemical pesticides for pest management in agricultural systems can entail risks to the complex ecosystems consisting of economic, ecological and social subsystems. To analyze the negative and positive effects of external or internal disturbances on complex ecosystems, we proposed an ecological two-sidedness approach which has been applied to the design of pest-controlling strategies for pesticide pollution management. However, catastrophe theory has not been initially applied to this approach. Thus, we used an approach of integrating ecological two-sidedness with a multi-criterion evaluation method of catastrophe theory to analyze the complexity of agro-ecosystems disturbed by the insecticides and screen out the best insect pest-controlling strategy in cabbage production. The results showed that the order of the values of evaluation index (RCC/CP) for three strategies in cabbage production was "applying frequency vibration lamps and environment-friendly insecticides 8 times" (0.80) < "applying trap devices and environment-friendly insecticides 9 times" (0.83) < "applying common insecticides 14 times" (1.08). The treatment "applying frequency vibration lamps and environment-friendly insecticides 8 times" was considered as the best insect pest-controlling strategy in cabbage production in Shanghai, China.

A modelling methodology to assess the effect of insect pest control on agro-ecosystems

PubMed Central

Wan, Nian-Feng; Ji, Xiang-Yun; Jiang, Jie-Xian; Li, Bo

2015-01-01

The extensive use of chemical pesticides for pest management in agricultural systems can entail risks to the complex ecosystems consisting of economic, ecological and social subsystems. To analyze the negative and positive effects of external or internal disturbances on complex ecosystems, we proposed an ecological two-sidedness approach which has been applied to the design of pest-controlling strategies for pesticide pollution management. However, catastrophe theory has not been initially applied to this approach. Thus, we used an approach of integrating ecological two-sidedness with a multi-criterion evaluation method of catastrophe theory to analyze the complexity of agro-ecosystems disturbed by the insecticides and screen out the best insect pest-controlling strategy in cabbage production. The results showed that the order of the values of evaluation index (RCC/CP) for three strategies in cabbage production was “applying frequency vibration lamps and environment-friendly insecticides 8 times” (0.80) < “applying trap devices and environment-friendly insecticides 9 times” (0.83) < “applying common insecticides 14 times” (1.08). The treatment “applying frequency vibration lamps and environment-friendly insecticides 8 times” was considered as the best insect pest-controlling strategy in cabbage production in Shanghai, China. PMID:25906199

Further Development, Support and Enhancement of CONDUIT

NASA Technical Reports Server (NTRS)

Veronica, Moldoveanu; Levine, William S.

1999-01-01

From the first airplanes steered by handles, wheels, and pedals to today's advanced aircraft, there has been a century of revolutionary inventions, all of them contributing to flight quality. The stability and controllability of aircraft as they appear to a pilot are called flying or handling qualities. Many years after the first airplanes flew, flying qualities were identified and ranked from desirable to unsatisfactory. Later on engineers developed design methods to satisfy these practical criteria. CONDUIT, which stands for Control Designer's Unified Interface, is a modern software package that provides a methodology for optimization of flight control systems in order to improve the flying qualities. CONDUIT is dependent on an the optimization engine called CONSOL-OPTCAD (C-O). C-O performs multicriterion parametric optimization. C-O was successfully tested on a variety of control problems. The optimization-based computational system, C-O, requires a particular control system description as a MATLAB file and possesses the ability to modify the vector of design parameters in an attempt to satisfy performance objectives and constraints specified by the designer, in a C-type file. After the first optimization attempts on the UH-60A control system, an early interface system, named GIFCORCODE (Graphical Interface for CONSOL-OPTCAD for Rotorcraft Controller Design) was created.

Demographics of reintroduced populations: estimation, modeling, and decision analysis

USGS Publications Warehouse

Converse, Sarah J.; Moore, Clinton T.; Armstrong, Doug P.

2013-01-01

Reintroduction can be necessary for recovering populations of threatened species. However, the success of reintroduction efforts has been poorer than many biologists and managers would hope. To increase the benefits gained from reintroduction, management decision making should be couched within formal decision-analytic frameworks. Decision analysis is a structured process for informing decision making that recognizes that all decisions have a set of components—objectives, alternative management actions, predictive models, and optimization methods—that can be decomposed, analyzed, and recomposed to facilitate optimal, transparent decisions. Because the outcome of interest in reintroduction efforts is typically population viability or related metrics, models used in decision analysis efforts for reintroductions will need to include population models. In this special section of the Journal of Wildlife Management, we highlight examples of the construction and use of models for informing management decisions in reintroduced populations. In this introductory contribution, we review concepts in decision analysis, population modeling for analysis of decisions in reintroduction settings, and future directions. Increased use of formal decision analysis, including adaptive management, has great potential to inform reintroduction efforts. Adopting these practices will require close collaboration among managers, decision analysts, population modelers, and field biologists.

Thermal power systems small power systems applications project. Decision analysis for evaluating and ranking small solar thermal power system technologies. Volume 1: A brief introduction to multiattribute decision analysis. [explanation of multiattribute decision analysis methods used in evaluating alternatives for small powered systems

NASA Technical Reports Server (NTRS)

Feinberg, A.; Miles, R. F., Jr.

1978-01-01

The principal concepts of the Keeney and Raiffa approach to multiattribute decision analysis are described. Topics discussed include the concepts of decision alternatives, outcomes, objectives, attributes and their states, attribute utility functions, and the necessary independence properties for the attribute states to be aggregated into a numerical representation of the preferences of the decision maker for the outcomes and decision alternatives.

Understanding The Decision Context: DPSIR, Decision Landscape, And Social Network Analysis

EPA Science Inventory

Establishing the decision context for a management problem is the critical first step for effective decision analysis. Understanding the decision context allow stakeholders and decision-makers to integrate the societal, environmental, and economic considerations that must be con...

Advancing Alternative Analysis: Integration of Decision Science.

PubMed

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

2017-06-13

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

Understanding medical decision making in hand surgery.

PubMed

Myers, John; McCabe, Steven J

2005-10-01

The practice of medicine takes place in an environment of uncertainty. Expected value decision making, prospect theory, and regret theory are three theories of decision making under uncertainty that may be used to help us learn how patients and physicians make decisions. These theories form the underpinnings of decision analysis and provide the opportunity to introduce the broad discipline of decision science. Because decision analysis and economic analysis are underrepresented in upper extremity surgery, the authors believe these are important areas for future research.

Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers

PubMed Central

Vickers, Andrew J; Cronin, Angel M; Elkin, Elena B; Gonen, Mithat

2008-01-01

Background Decision curve analysis is a novel method for evaluating diagnostic tests, prediction models and molecular markers. It combines the mathematical simplicity of accuracy measures, such as sensitivity and specificity, with the clinical applicability of decision analytic approaches. Most critically, decision curve analysis can be applied directly to a data set, and does not require the sort of external data on costs, benefits and preferences typically required by traditional decision analytic techniques. Methods In this paper we present several extensions to decision curve analysis including correction for overfit, confidence intervals, application to censored data (including competing risk) and calculation of decision curves directly from predicted probabilities. All of these extensions are based on straightforward methods that have previously been described in the literature for application to analogous statistical techniques. Results Simulation studies showed that repeated 10-fold crossvalidation provided the best method for correcting a decision curve for overfit. The method for applying decision curves to censored data had little bias and coverage was excellent; for competing risk, decision curves were appropriately affected by the incidence of the competing risk and the association between the competing risk and the predictor of interest. Calculation of decision curves directly from predicted probabilities led to a smoothing of the decision curve. Conclusion Decision curve analysis can be easily extended to many of the applications common to performance measures for prediction models. Software to implement decision curve analysis is provided. PMID:19036144

Extensions to decision curve analysis, a novel method for evaluating diagnostic tests, prediction models and molecular markers.

PubMed

Vickers, Andrew J; Cronin, Angel M; Elkin, Elena B; Gonen, Mithat

2008-11-26

Decision curve analysis is a novel method for evaluating diagnostic tests, prediction models and molecular markers. It combines the mathematical simplicity of accuracy measures, such as sensitivity and specificity, with the clinical applicability of decision analytic approaches. Most critically, decision curve analysis can be applied directly to a data set, and does not require the sort of external data on costs, benefits and preferences typically required by traditional decision analytic techniques. In this paper we present several extensions to decision curve analysis including correction for overfit, confidence intervals, application to censored data (including competing risk) and calculation of decision curves directly from predicted probabilities. All of these extensions are based on straightforward methods that have previously been described in the literature for application to analogous statistical techniques. Simulation studies showed that repeated 10-fold crossvalidation provided the best method for correcting a decision curve for overfit. The method for applying decision curves to censored data had little bias and coverage was excellent; for competing risk, decision curves were appropriately affected by the incidence of the competing risk and the association between the competing risk and the predictor of interest. Calculation of decision curves directly from predicted probabilities led to a smoothing of the decision curve. Decision curve analysis can be easily extended to many of the applications common to performance measures for prediction models. Software to implement decision curve analysis is provided.

The potential for meta-analysis to support decision analysis in ecology.

PubMed

Mengersen, Kerrie; MacNeil, M Aaron; Caley, M Julian

2015-06-01

Meta-analysis and decision analysis are underpinned by well-developed methods that are commonly applied to a variety of problems and disciplines. While these two fields have been closely linked in some disciplines such as medicine, comparatively little attention has been paid to the potential benefits of linking them in ecology, despite reasonable expectations that benefits would be derived from doing so. Meta-analysis combines information from multiple studies to provide more accurate parameter estimates and to reduce the uncertainty surrounding them. Decision analysis involves selecting among alternative choices using statistical information that helps to shed light on the uncertainties involved. By linking meta-analysis to decision analysis, improved decisions can be made, with quantification of the costs and benefits of alternate decisions supported by a greater density of information. Here, we briefly review concepts of both meta-analysis and decision analysis, illustrating the natural linkage between them and the benefits from explicitly linking one to the other. We discuss some examples in which this linkage has been exploited in the medical arena and how improvements in precision and reduction of structural uncertainty inherent in a meta-analysis can provide substantive improvements to decision analysis outcomes by reducing uncertainty in expected loss and maximising information from across studies. We then argue that these significant benefits could be translated to ecology, in particular to the problem of making optimal ecological decisions in the face of uncertainty. Copyright © 2013 John Wiley & Sons, Ltd.

Assessment of Surface Air Temperature over China Using Multi-criterion Model Ensemble Framework

NASA Astrophysics Data System (ADS)

Li, J.; Zhu, Q.; Su, L.; He, X.; Zhang, X.

2017-12-01

The General Circulation Models (GCMs) are designed to simulate the present climate and project future trends. It has been noticed that the performances of GCMs are not always in agreement with each other over different regions. Model ensemble techniques have been developed to post-process the GCMs' outputs and improve their prediction reliabilities. To evaluate the performances of GCMs, root-mean-square error, correlation coefficient, and uncertainty are commonly used statistical measures. However, the simultaneous achievements of these satisfactory statistics cannot be guaranteed when using many model ensemble techniques. Meanwhile, uncertainties and future scenarios are critical for Water-Energy management and operation. In this study, a new multi-model ensemble framework was proposed. It uses a state-of-art evolutionary multi-objective optimization algorithm, termed Multi-Objective Complex Evolution Global Optimization with Principle Component Analysis and Crowding Distance (MOSPD), to derive optimal GCM ensembles and demonstrate the trade-offs among various solutions. Such trade-off information was further analyzed with a robust Pareto front with respect to different statistical measures. A case study was conducted to optimize the surface air temperature (SAT) ensemble solutions over seven geographical regions of China for the historical period (1900-2005) and future projection (2006-2100). The results showed that the ensemble solutions derived with MOSPD algorithm are superior over the simple model average and any single model output during the historical simulation period. For the future prediction, the proposed ensemble framework identified that the largest SAT change would occur in the South Central China under RCP 2.6 scenario, North Eastern China under RCP 4.5 scenario, and North Western China under RCP 8.5 scenario, while the smallest SAT change would occur in the Inner Mongolia under RCP 2.6 scenario, South Central China under RCP 4.5 scenario, and South Central China under RCP 8.5 scenario.

Advancing Alternative Analysis: Integration of Decision Science

PubMed Central

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

2017-01-01

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

Walking the Fine Line: Political Decision Making with or without Data.

ERIC Educational Resources Information Center

Merkel-Keller, Claudia

The stages of the policy process are examined and explained in terms of the decision making framework. The policy process is comprised of four stages; policy analysis, policy formation, policy decision, and political analysis. Political analysis is the performance of the market analysis needed for a decision. The political weight, rather than the…

Decision fatigue: A conceptual analysis.

PubMed

Pignatiello, Grant A; Martin, Richard J; Hickman, Ronald L

2018-03-01

Decision fatigue is an applicable concept to healthcare psychology. Due to a lack of conceptual clarity, we present a concept analysis of decision fatigue. A search of the term "decision fatigue" was conducted across seven research databases, which yielded 17 relevant articles. The authors identified three antecedent themes (decisional, self-regulatory, and situational) and three attributional themes (behavioral, cognitive, and physiological) of decision fatigue. However, the extant literature failed to adequately describe consequences of decision fatigue. This concept analysis provides needed conceptual clarity for decision fatigue, a concept possessing relevance to nursing and allied health sciences.

Teleeducation and telepathology for open and distance education.

PubMed

Szymas, J

2000-01-01

Our experience in creating and using telepathology system and multimedia database for education is described. This program packet currently works in the Department of Pathology of University Medical School in Poznan. It is used for self-education, tests, services and for the examinations in pathology, i.e., for dental students and for medical students in terms of self-education and individual examination services. The system is implemented on microcomputers compatible with IBM PC and works in the network system Netware 5.1. Some modules are available through the Internet. The program packet described here accomplishes the TELEMIC system for telepathology, ASSISTANT, which is the administrator for the databases, and EXAMINATOR, which is the executive program. The realization of multi-user module allows students to work on several working areas, on random be chosen different sets of problems contemporary. The possibility to work in the exercise mode will image files and questions is an attractive way for self-education. The standard format of the notation files enables to elaborate the results by commercial statistic packets in order to estimate the scale of answers and to find correlation between the obtained results. The method of multi-criterion grading excludes unlimited mutual compensation of the criteria, differentiates the importance of particular courses and introduces the quality criteria. The packet is part of the integrated management information system of the department of pathology. Applications for other telepathological systems are presented.

Applications of decision analysis and related techniques to industrial engineering problems at KSC

NASA Technical Reports Server (NTRS)

Evans, Gerald W.

1995-01-01

This report provides: (1) a discussion of the origination of decision analysis problems (well-structured problems) from ill-structured problems; (2) a review of the various methodologies and software packages for decision analysis and related problem areas; (3) a discussion of how the characteristics of a decision analysis problem affect the choice of modeling methodologies, thus providing a guide as to when to choose a particular methodology; and (4) examples of applications of decision analysis to particular problems encountered by the IE Group at KSC. With respect to the specific applications at KSC, particular emphasis is placed on the use of the Demos software package (Lumina Decision Systems, 1993).

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

EPA Science Inventory

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

The Risky Shift in Policy Decision Making: A Comparative Analysis

ERIC Educational Resources Information Center

Wilpert, B.; And Others

1976-01-01

Based on analysis of data on 432 decision-makers from around the world, this study examines the decision-making phenomenon that individuals tend to move toward riskier decisions after group discussion. Findings of the analysis contradicted earlier studies, showing a consistent shift toward greater risk avoidance. Available from Elsevier Scientific…

Decision analysis in clinical cardiology: When is coronary angiography required in aortic stenosis

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

Georgeson, S.; Meyer, K.B.; Pauker, S.G.

1990-03-15

Decision analysis offers a reproducible, explicit approach to complex clinical decisions. It consists of developing a model, typically a decision tree, that separates choices from chances and that specifies and assigns relative values to outcomes. Sensitivity analysis allows exploration of alternative assumptions. Cost-effectiveness analysis shows the relation between dollars spent and improved health outcomes achieved. In a tutorial format, this approach is applied to the decision whether to perform coronary angiography in a patient who requires aortic valve replacement for critical aortic stenosis.

Considering Risk and Resilience in Decision-Making

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2015-01-01

This paper examines the concepts of decision-making, risk analysis, uncertainty and resilience analysis. The relation between risk, vulnerability, and resilience is analyzed. The paper describes how complexity, uncertainty, and ambiguity are the most critical factors in the definition of the approach and criteria for decision-making. Uncertainty in its various forms is what limits our ability to offer definitive answers to questions about the outcomes of alternatives in a decision-making process. It is shown that, although resilience-informed decision-making would seem fundamentally different from risk-informed decision-making, this is not the case as resilience-analysis can be easily incorporated within existing analytic-deliberative decision-making frameworks.

Trusted Advisors, Decision Models and Other Keys to Communicating Science to Decision Makers

NASA Astrophysics Data System (ADS)

Webb, E.

2006-12-01

Water resource management decisions often involve multiple parties engaged in contentious negotiations that try to navigate through complex combinations of legal, social, hydrologic, financial, and engineering considerations. The standard approach for resolving these issues is some form of multi-party negotiation, a formal court decision, or a combination of the two. In all these cases, the role of the decision maker(s) is to choose and implement the best option that fits the needs and wants of the community. However, each path to a decision carries the risk of technical and/or financial infeasibility as well as the possibility of unintended consequences. To help reduce this risk, decision makers often rely on some type of predictive analysis from which they can evaluate the projected consequences of their decisions. Typically, decision makers are supported in the analysis process by trusted advisors who engage in the analysis as well as the day to day tasks associated with multi-party negotiations. In the case of water resource management, the analysis is frequently a numerical model or set of models that can simulate various management decisions across multiple systems and output results that illustrate the impact on areas of concern. Thus, in order to communicate scientific knowledge to the decision makers, the quality of the communication between the analysts, the trusted advisor, and the decision maker must be clear and direct. To illustrate this concept, a multi-attribute decision analysis matrix will be used to outline the value of computer model-based collaborative negotiation approaches to guide water resources decision making and communication with decision makers. In addition, the critical role of the trusted advisor and other secondary participants in the decision process will be discussed using examples from recent water negotiations.

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

EPA Science Inventory

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

Applicability of risk-based management and the need for risk-based economic decision analysis at hazardous waste contaminated sites.

PubMed

Khadam, Ibrahim; Kaluarachchi, Jagath J

2003-07-01

Decision analysis in subsurface contamination management is generally carried out through a traditional engineering economic viewpoint. However, new advances in human health risk assessment, namely, the probabilistic risk assessment, and the growing awareness of the importance of soft data in the decision-making process, require decision analysis methodologies that are capable of accommodating non-technical and politically biased qualitative information. In this work, we discuss the major limitations of the currently practiced decision analysis framework, which evolves around the definition of risk and cost of risk, and its poor ability to communicate risk-related information. A demonstration using a numerical example was conducted to provide insight on these limitations of the current decision analysis framework. The results from this simple ground water contamination and remediation scenario were identical to those obtained from studies carried out on existing Superfund sites, which suggests serious flaws in the current risk management framework. In order to provide a perspective on how these limitations may be avoided in future formulation of the management framework, more matured and well-accepted approaches to decision analysis in dam safety and the utility industry, where public health and public investment are of great concern, are presented and their applicability in subsurface remediation management is discussed. Finally, in light of the success of the application of risk-based decision analysis in dam safety and the utility industry, potential options for decision analysis in subsurface contamination management are discussed.

The need for consumer behavior analysis in health care coverage decisions.

PubMed

Thompson, A M; Rao, C P

1990-01-01

Demographic analysis has been the primary form of analysis connected with health care coverage decisions. This paper reviews past demographic research and shows the need to use behavioral analyses for health care coverage policy decisions. A behavioral model based research study is presented and a case is made for integrated study into why consumers make health care coverage decisions.

Toward Reflective Judgment in Exploratory Factor Analysis Decisions: Determining the Extraction Method and Number of Factors To Retain.

ERIC Educational Resources Information Center

Knight, Jennifer L.

This paper considers some decisions that must be made by the researcher conducting an exploratory factor analysis. The primary purpose is to aid the researcher in making informed decisions during the factor analysis instead of relying on defaults in statistical programs or traditions of previous researchers. Three decision areas are addressed.…

Do violations of the axioms of expected utility theory threaten decision analysis?

PubMed

Nease, R F

1996-01-01

Research demonstrates that people violate the independence principle of expected utility theory, raising the question of whether expected utility theory is normative for medical decision making. The author provides three arguments that violations of the independence principle are less problematic than they might first appear. First, the independence principle follows from other more fundamental axioms whose appeal may be more readily apparent than that of the independence principle. Second, the axioms need not be descriptive to be normative, and they need not be attractive to all decision makers for expected utility theory to be useful for some. Finally, by providing a metaphor of decision analysis as a conversation between the actual decision maker and a model decision maker, the author argues that expected utility theory need not be purely normative for decision analysis to be useful. In short, violations of the independence principle do not necessarily represent direct violations of the axioms of expected utility theory; behavioral violations of the axioms of expected utility theory do not necessarily imply that decision analysis is not normative; and full normativeness is not necessary for decision analysis to generate valuable insights.

Distinction between Externally vs. Internally Guided Decision-Making: Operational Differences, Meta-Analytical Comparisons and Their Theoretical Implications

PubMed Central

Nakao, Takashi; Ohira, Hideki; Northoff, Georg

2012-01-01

Most experimental studies of decision-making have specifically examined situations in which a single less-predictable correct answer exists (externally guided decision-making under uncertainty). Along with such externally guided decision-making, there are instances of decision-making in which no correct answer based on external circumstances is available for the subject (internally guided decision-making). Such decisions are usually made in the context of moral decision-making as well as in preference judgment, where the answer depends on the subject’s own, i.e., internal, preferences rather than on external, i.e., circumstantial, criteria. The neuronal and psychological mechanisms that allow guidance of decisions based on more internally oriented criteria in the absence of external ones remain unclear. This study was undertaken to compare decision-making of these two kinds empirically and theoretically. First, we reviewed studies of decision-making to clarify experimental–operational differences between externally guided and internally guided decision-making. Second, using multi-level kernel density analysis, a whole-brain-based quantitative meta-analysis of neuroimaging studies was performed. Our meta-analysis revealed that the neural network used predominantly for internally guided decision-making differs from that for externally guided decision-making under uncertainty. This result suggests that studying only externally guided decision-making under uncertainty is insufficient to account for decision-making processes in the brain. Finally, based on the review and results of the meta-analysis, we discuss the differences and relations between decision-making of these two types in terms of their operational, neuronal, and theoretical characteristics. PMID:22403525

Multiple Criteria Decision Analysis for Health Care Decision Making--An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force.

PubMed

Thokala, Praveen; Devlin, Nancy; Marsh, Kevin; Baltussen, Rob; Boysen, Meindert; Kalo, Zoltan; Longrenn, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Ijzerman, Maarten

2016-01-01

Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting, objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making and a set of techniques, known under the collective heading multiple criteria decision analysis (MCDA), are useful for this purpose. MCDA methods are widely used in other sectors, and recently there has been an increase in health care applications. In 2014, ISPOR established an MCDA Emerging Good Practices Task Force. It was charged with establishing a common definition for MCDA in health care decision making and developing good practice guidelines for conducting MCDA to aid health care decision making. This initial ISPOR MCDA task force report provides an introduction to MCDA - it defines MCDA; provides examples of its use in different kinds of decision making in health care (including benefit risk analysis, health technology assessment, resource allocation, portfolio decision analysis, shared patient clinician decision making and prioritizing patients' access to services); provides an overview of the principal methods of MCDA; and describes the key steps involved. Upon reviewing this report, readers should have a solid overview of MCDA methods and their potential for supporting health care decision making. Copyright © 2016. Published by Elsevier Inc.

DECISION ANALYSIS OF INCINERATION COSTS IN SUPERFUND SITE REMEDIATION

EPA Science Inventory

This study examines the decision-making process of the remedial design (RD) phase of on-site incineration projects conducted at Superfund sites. Decisions made during RD affect the cost and schedule of remedial action (RA). Decision analysis techniques are used to determine the...

Issue a Boil-Water Advisory or Wait for Definitive Information? A Decision Analysis

PubMed Central

Wagner, Michael M.; Wallstrom, Garrick L.; Onisko, Agnieszka

2005-01-01

Objective Study the decision to issue a boil-water advisory in response to a spike in sales of diarrhea remedies or wait 72 hours for the results of definitive testing of water and people. Methods Decision analysis. Results In the base-case analysis, the optimal decision is test-and-wait. If the cost of issuing a boil-water advisory is less than 13.92 cents per person per day, the optimal decision is to issue the boil-water advisory immediately. Conclusions Decisions based on surveillance data that are suggestive but not conclusive about the existence of a disease outbreak can be modeled. PMID:16779145

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-22

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

Multicriteria decision analysis: Overview and implications for environmental decision making

USGS Publications Warehouse

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

2007-01-01

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

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

NASA Astrophysics Data System (ADS)

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

2012-12-01

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

Development of Automated Aids for Decision Analysis

DTIC Science & Technology

1976-05-01

21 7. Resources Affected by a Decision .. ................... 22 8. Scope of Decision ..................................... 22 9. Urgency...24 t . Resources Available for Analysis . . . .. . . . 26 Expeiene anTrininginAayigDcsos2 C. Chrceisiso heDcso Poes2 -I. II TYPES OF DECISION...Assessment . . . . . . . . . ......... . 62 a. Assessing State Variables .... ........... ... 63 b. Assessing Dependencics .. . .. ... . 65 c. Assessing

Helping decision makers frame, analyze, and implement decisions

USGS Publications Warehouse

Runge, Michael C.; McDonald-Madden, Eve

2018-01-01

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

Economic evaluation of the DiAMOND randomized trial: cost and outcomes of 2 decision aids for mode of delivery among women with a previous cesarean section.

PubMed

Hollinghurst, Sandra; Emmett, Clare; Peters, Tim J; Watson, Helen; Fahey, Tom; Murphy, Deirdre J; Montgomery, Alan

2010-01-01

Maternal preferences should be considered in decisions about mode of delivery following a previous cesarean, but risks and benefits are unclear. Decision aids can help decision making, although few studies have assessed costs in conjunction with effectiveness. Economic evaluation of 2 decision aids for women with 1 previous cesarean. Cost-consequences analysis. Data sources were self-reported resource use and outcome and published national unit costs. The target population was women with 1 previous cesarean. The time horizon was 37 weeks' gestation and 6 weeks postnatal. The perspective was health care delivery system. The interventions were usual care, usual care plus an information program, and usual care plus a decision analysis program. The outcome measures were costs to the National Health Service (NHS) in the United Kingdom (UK), score on the Decisional Conflict Scale, and mode of delivery. RESULTS OF MAIN ANALYSIS: Cost of delivery represented 84% of the total cost; mode of delivery was the most important determinant of cost differences across the groups. Mean (SD) total cost per mother and baby: 2033 (677) for usual care, 2069 (738) for information program, and 2019 (741) for decision analysis program. Decision aids reduced decisional conflict. Women using the decision analysis program had fewest cesarean deliveries. Applying a cost premium to emergency cesareans over electives had little effect on group comparisons. Conclusions were unaffected. Disparity in timing of outcomes and costs, data completeness, and quality. Decision aids can reduce decisional conflict in women with a previous cesarean section when deciding on mode of delivery. The information program could be implemented at no extra cost to the NHS. The decision analysis program might reduce the rate of cesarean sections without any increase in costs.

Characterizing uncertain sea-level rise projections to support investment decisions.

PubMed

Sriver, Ryan L; Lempert, Robert J; Wikman-Svahn, Per; Keller, Klaus

2018-01-01

Many institutions worldwide are considering how to include uncertainty about future changes in sea-levels and storm surges into their investment decisions regarding large capital infrastructures. Here we examine how to characterize deeply uncertain climate change projections to support such decisions using Robust Decision Making analysis. We address questions regarding how to confront the potential for future changes in low probability but large impact flooding events due to changes in sea-levels and storm surges. Such extreme events can affect investments in infrastructure but have proved difficult to consider in such decisions because of the deep uncertainty surrounding them. This study utilizes Robust Decision Making methods to address two questions applied to investment decisions at the Port of Los Angeles: (1) Under what future conditions would a Port of Los Angeles decision to harden its facilities against extreme flood scenarios at the next upgrade pass a cost-benefit test, and (2) Do sea-level rise projections and other information suggest such conditions are sufficiently likely to justify such an investment? We also compare and contrast the Robust Decision Making methods with a full probabilistic analysis. These two analysis frameworks result in similar investment recommendations for different idealized future sea-level projections, but provide different information to decision makers and envision different types of engagement with stakeholders. In particular, the full probabilistic analysis begins by aggregating the best scientific information into a single set of joint probability distributions, while the Robust Decision Making analysis identifies scenarios where a decision to invest in near-term response to extreme sea-level rise passes a cost-benefit test, and then assembles scientific information of differing levels of confidence to help decision makers judge whether or not these scenarios are sufficiently likely to justify making such investments. Results highlight the highly-localized and context dependent nature of applying Robust Decision Making methods to inform investment decisions.

Characterizing uncertain sea-level rise projections to support investment decisions

PubMed Central

Lempert, Robert J.; Wikman-Svahn, Per; Keller, Klaus

2018-01-01

Many institutions worldwide are considering how to include uncertainty about future changes in sea-levels and storm surges into their investment decisions regarding large capital infrastructures. Here we examine how to characterize deeply uncertain climate change projections to support such decisions using Robust Decision Making analysis. We address questions regarding how to confront the potential for future changes in low probability but large impact flooding events due to changes in sea-levels and storm surges. Such extreme events can affect investments in infrastructure but have proved difficult to consider in such decisions because of the deep uncertainty surrounding them. This study utilizes Robust Decision Making methods to address two questions applied to investment decisions at the Port of Los Angeles: (1) Under what future conditions would a Port of Los Angeles decision to harden its facilities against extreme flood scenarios at the next upgrade pass a cost-benefit test, and (2) Do sea-level rise projections and other information suggest such conditions are sufficiently likely to justify such an investment? We also compare and contrast the Robust Decision Making methods with a full probabilistic analysis. These two analysis frameworks result in similar investment recommendations for different idealized future sea-level projections, but provide different information to decision makers and envision different types of engagement with stakeholders. In particular, the full probabilistic analysis begins by aggregating the best scientific information into a single set of joint probability distributions, while the Robust Decision Making analysis identifies scenarios where a decision to invest in near-term response to extreme sea-level rise passes a cost-benefit test, and then assembles scientific information of differing levels of confidence to help decision makers judge whether or not these scenarios are sufficiently likely to justify making such investments. Results highlight the highly-localized and context dependent nature of applying Robust Decision Making methods to inform investment decisions. PMID:29414978

Data for Renewable Energy Planning, Policy, and Investment

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

Cox, Sarah L

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

The value of decision tree analysis in planning anaesthetic care in obstetrics.

PubMed

Bamber, J H; Evans, S A

2016-08-01

The use of decision tree analysis is discussed in the context of the anaesthetic and obstetric management of a young pregnant woman with joint hypermobility syndrome with a history of insensitivity to local anaesthesia and a previous difficult intubation due to a tongue tumour. The multidisciplinary clinical decision process resulted in the woman being delivered without complication by elective caesarean section under general anaesthesia after an awake fibreoptic intubation. The decision process used is reviewed and compared retrospectively to a decision tree analytical approach. The benefits and limitations of using decision tree analysis are reviewed and its application in obstetric anaesthesia is discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Naturalistic Decision Making: Implications for Design

DTIC Science & Technology

1993-04-01

Cognitive Task Analysis Decision Making Design Engineer Design System Human-Computer Interface System Development 15. NUMBER OF PAGES 182 16...people use to select a course of action. The SOAR explains how stress affects the decision making of both individuals and teams. COGNITIVE TASK ANALYSIS : This...procedures for Cognitive Task Analysis , contrasting the strengths and weaknesses of each, and showing how a Cognitive Task Analysis

Impact of model structure on flow simulation and hydrological realism: from a lumped to a semi-distributed approach

NASA Astrophysics Data System (ADS)

Garavaglia, Federico; Le Lay, Matthieu; Gottardi, Fréderic; Garçon, Rémy; Gailhard, Joël; Paquet, Emmanuel; Mathevet, Thibault

2017-08-01

Model intercomparison experiments are widely used to investigate and improve hydrological model performance. However, a study based only on runoff simulation is not sufficient to discriminate between different model structures. Hence, there is a need to improve hydrological models for specific streamflow signatures (e.g., low and high flow) and multi-variable predictions (e.g., soil moisture, snow and groundwater). This study assesses the impact of model structure on flow simulation and hydrological realism using three versions of a hydrological model called MORDOR: the historical lumped structure and a revisited formulation available in both lumped and semi-distributed structures. In particular, the main goal of this paper is to investigate the relative impact of model equations and spatial discretization on flow simulation, snowpack representation and evapotranspiration estimation. Comparison of the models is based on an extensive dataset composed of 50 catchments located in French mountainous regions. The evaluation framework is founded on a multi-criterion split-sample strategy. All models were calibrated using an automatic optimization method based on an efficient genetic algorithm. The evaluation framework is enriched by the assessment of snow and evapotranspiration modeling against in situ and satellite data. The results showed that the new model formulations perform significantly better than the initial one in terms of the various streamflow signatures, snow and evapotranspiration predictions. The semi-distributed approach provides better calibration-validation performance for the snow cover area, snow water equivalent and runoff simulation, especially for nival catchments.

GIS-based landslide susceptibility mapping for the 2005 Kashmir earthquake region

NASA Astrophysics Data System (ADS)

Kamp, Ulrich; Growley, Benjamin J.; Khattak, Ghazanfar A.; Owen, Lewis A.

2008-11-01

The Mw 7.6 October 8, 2005 Kashmir earthquake triggered several thousand landslides throughout the Himalaya of northern Pakistan and India. These were concentrated in six different geomorphic-geologic-anthropogenic settings. A spatial database, which included 2252 landslides, was developed and analyzed using ASTER satellite imagery and geographical information system (GIS) technology. A multi-criterion evaluation was applied to determine the significance of event-controlling parameters in triggering the landslides. The parameters included lithology, faults, slope gradient, slope aspect, elevation, land cover, rivers and roads. The results showed four classes of landslide susceptibility. Furthermore, they indicated that lithology had the strongest influence on landsliding, particularly when the rock is highly fractured, such as in shale, slate, clastic sediments, and limestone and dolomite. Moreover, the proximity of the landslides to faults, rivers, and roads was also an important factor in helping to initiate failures. In addition, landslides occurred particularly in moderate elevations on south facing slopes. Shrub land, grassland, and also agricultural land were highly susceptible to failures, while forested slopes had few landslides. One-third of the study area was highly or very highly susceptible to future landsliding and requires immediate mitigation action. The rest of the region had a low or moderate susceptibility to landsliding and remains relatively stable. This study supports the view that (1) earthquake-triggered landslides are concentrated in specific zones associated with event-controlling parameters; and (2) in the western Himalaya deforestation and road construction contributed significantly to landsliding during and shortly after earthquakes.

Decision curve analysis for assessing the usefulness of tests for making decisions to treat: an application to tests for prodromal psychosis.

PubMed

Pulleyblank, Ryan; Chuma, Jefter; Gilbody, Simon M; Thompson, Carl

2013-09-01

For a test to be considered useful for making treatment decisions, it is necessary that making treatment decisions based on the results of the test be a preferable strategy to making treatment decisions without the test. Decision curve analysis is a framework for assessing when a test would be expected to be useful, which integrates evidence of a test's performance characteristics (sensitivity and specificity), condition prevalence among at-risk patients, and patient preferences for treatment. We describe decision curve analysis generally and illustrate its potential through an application to tests for prodromal psychosis. Clinical psychosis is often preceded by a prodromal phase, but not all those with prodromal symptoms proceed to develop full psychosis. Patients identified as at risk for developing psychosis may be considered for proactive treatment to mitigate development of clinically defined psychosis. Tests exist to help identify those at-risk patients most likely to develop psychosis, but it is uncertain when these tests would be considered useful for making proactive treatment decisions. We apply decision curve analysis to results from a systematic review of studies investigating clinical tests for predicting the development of psychosis in at-risk populations, and present resulting decision curves that illustrate when the tests may be expected to be useful for making proactive treatment decisions.

An Analysis of Factors that Influence Enlistment Decisions in the U.S. Army

DTIC Science & Technology

1998-03-01

NAVAL POSTGRADUATE SCHOOL Monterey, California CM THESIS AN ANALYSIS OF FACTORS THAT INFLUENCE ENLISTMENT DECISIONS IN THE U.S. ARMY by Young...TITLE AND SUBTITLE : AN ANALYSIS OF FACTORS THAT INFLUENCE ENLISTMENT DECISIONS IN THE U.S. ARMY 6. AUTHOR(S) Oh, Young Yeol 7...200 words) The purpose of this thesis is to analyze factors that influence decisions to enlist in the U.S. Army. This thesis uses 1997 New Recruit

To analyse a trace or not? Evaluating the decision-making process in the criminal investigation.

PubMed

Bitzer, Sonja; Ribaux, Olivier; Albertini, Nicola; Delémont, Olivier

2016-05-01

In order to broaden our knowledge and understanding of the decision steps in the criminal investigation process, we started by evaluating the decision to analyse a trace and the factors involved in this decision step. This decision step is embedded in the complete criminal investigation process, involving multiple decision and triaging steps. Considering robbery cases occurring in a geographic region during a 2-year-period, we have studied the factors influencing the decision to submit biological traces, directly sampled on the scene of the robbery or on collected objects, for analysis. The factors were categorised into five knowledge dimensions: strategic, immediate, physical, criminal and utility and decision tree analysis was carried out. Factors in each category played a role in the decision to analyse a biological trace. Interestingly, factors involving information available prior to the analysis are of importance, such as the fact that a positive result (a profile suitable for comparison) is already available in the case, or that a suspect has been identified through traditional police work before analysis. One factor that was taken into account, but was not significant, is the matrix of the trace. Hence, the decision to analyse a trace is not influenced by this variable. The decision to analyse a trace first is very complex and many of the tested variables were taken into account. The decisions are often made on a case-by-case basis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Evaluation of on-line concentration coupled to liquid chromatography tandem mass spectrometry for the quantification of neonicotinoids and fipronil in surface water and tap water.

PubMed

Montiel-León, Juan Manuel; Duy, Sung Vo; Munoz, Gabriel; Amyot, Marc; Sauvé, Sébastien

2018-04-01

A study was initiated to investigate a fast and reliable method for the determination of selected systemic insecticides in water matrixes and to evaluate potential sources of bias in their analysis. Acetamiprid, clothianidin, desnitro-imidacloprid, dinotefuran, fipronil, imidacloprid, nitenpyram, thiacloprid, and thiamethoxam were amenable to analysis via on-line sample enrichment hyphenated to ultra-high-performance liquid chromatography tandem mass spectrometry. The selection of on-line solid-phase extraction parameters was dictated by a multicriterion desirability approach. A 2-mL on-line injection volume with a 1500 μL min -1 loading flow rate met the objectives sought in terms of chromatographic requirements, extraction efficiency, sensitivity, and precision. A total analysis time of 8 min per sample was obtained with method limits of detection in the range of 0.1-5 ng L -1 for the scope of targeted analytes. Automation at the sample concentration step yielded intraday and interday precisions in the range of 1-23 and 2-26%, respectively. Factors that could affect the whole method accuracy were further evaluated in matrix-specific experiments. The impact of the initial filtration step on analyte recovery was evaluated in ultra-pure water, tap water, and surface water. Out of the nine membranes tested, glass fiber filters and polyester filters appeared as the most appropriate materials. Sample storage stability was also investigated across the three matrix types; the targeted analytes displayed suitable stability during 28 days at either 4 °C or - 20 °C, with little deviations (± 10%) with respect to the initial T 0 concentration. Method applicability was demonstrated in a range of tap water and surface water samples from the province of Québec, Canada. Results from the present survey indicated a predominance of thiamethoxam (< 0.5-10 and 3-61 ng L -1 in tap water and river water, respectively), clothianidin (< 0.5-6 and 2-88 ng L -1 in tap water and river water, respectively), and imidacloprid (< 0.1-1 and 0.8-38 ng L -1 in tap water and river water, respectively) among the targeted analytes. Graphical abstract ᅟ Development of solid-phase extraction coupled on-line to UHPLC-MS/MS for the rapid screening of systemic insecticides in water.

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

PubMed

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

2017-01-01

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

An Overview of R in Health Decision Sciences.

PubMed

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

2017-10-01

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

Models for Rational Decision Making. Analysis of Literature and Selected Bibliography. Analysis and Bibliography Series, No. 6.

ERIC Educational Resources Information Center

Hall, John S.

This review analyzes the trend in educational decision making to replace hierarchical authority structures with more rational models for decision making drawn from management science. Emphasis is also placed on alternatives to a hierarchical decision-making model, including governing models, union models, and influence models. A 54-item…

NASA program decisions using reliability analysis.

NASA Technical Reports Server (NTRS)

Steinberg, A.

1972-01-01

NASA made use of the analytical outputs of reliability people to make management decisions on the Apollo program. Such decisions affected the amount of the incentive fees, how much acceptance testing was necessary, how to optimize development testing, whether to approve engineering changes, and certification of flight readiness. Examples of such analysis are discussed and related to programmatic decisions.-

75 FR 18205 - Notice of Peer Review Meeting for the External Peer Review Drafts of Two Documents on Using...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... Role of Risk Analysis in Decision-Making AGENCY: Environmental Protection Agency (EPA). ACTION: Notice... documents entitled, ``Using Probabilistic Methods to Enhance the Role of Risk Analysis in Decision- Making... Probabilistic Methods to Enhance the Role of Risk Analysis in Decision-Making, with Case Study Examples'' and...

A preliminary study applying decision analysis to the treatment of caries in primary teeth.

PubMed

Tamošiūnas, Vytautas; Kay, Elizabeth; Craven, Rebecca

2013-01-01

To determine an optimal treatment strategy for carious deciduous teeth. Manchester Dental Hospital. Decision analysis. The likelihoods of each of the sequelae of caries in deciduous teeth were determined from the literature. The utility of the outcomes from non-treatment and treatment was then measured in 100 parents of children with caries, using a visual analogue scale. Decision analysis was performed which weighted the value of each potential outcome by the probability of its occurrence. A decision tree "fold-back" and sensitivity analysis then determined which treatment strategies, under which circumstances, offered the maximum expected utilities. The decision to leave a carious deciduous tooth unrestored attracted a maximum utility of 76.65 and the overall expected utility for the decision "restore" was 73.27 The decision to restore or not restore carious deciduous teeth are therefore of almost equal value. The decision is however highly sensitive to the utility value assigned to the advent of pain by the patient. There is no clear advantage to be gained by restoring deciduous teeth if patients' evaluations of outcomes are taken into account. Avoidance of pain and avoidance of procedures which are viewed as unpleasant by parents should be key determinants of clinical decision making about carious deciduous teeth.

When is enough evidence enough? - Using systematic decision analysis and value-of-information analysis to determine the need for further evidence.

PubMed

Siebert, Uwe; Rochau, Ursula; Claxton, Karl

2013-01-01

Decision analysis (DA) and value-of-information (VOI) analysis provide a systematic, quantitative methodological framework that explicitly considers the uncertainty surrounding the currently available evidence to guide healthcare decisions. In medical decision making under uncertainty, there are two fundamental questions: 1) What decision should be made now given the best available evidence (and its uncertainty)?; 2) Subsequent to the current decision and given the magnitude of the remaining uncertainty, should we gather further evidence (i.e., perform additional studies), and if yes, which studies should be undertaken (e.g., efficacy, side effects, quality of life, costs), and what sample sizes are needed? Using the currently best available evidence, VoI analysis focuses on the likelihood of making a wrong decision if the new intervention is adopted. The value of performing further studies and gathering additional evidence is based on the extent to which the additional information will reduce this uncertainty. A quantitative framework allows for the valuation of the additional information that is generated by further research, and considers the decision maker's objectives and resource constraints. Claxton et al. summarise: "Value of information analysis can be used to inform a range of policy questions including whether a new technology should be approved based on existing evidence, whether it should be approved but additional research conducted or whether approval should be withheld until the additional evidence becomes available." [Claxton K. Value of information entry in Encyclopaedia of Health Economics, Elsevier, forthcoming 2014.] The purpose of this tutorial is to introduce the framework of systematic VoI analysis to guide further research. In our tutorial article, we explain the theoretical foundations and practical methods of decision analysis and value-of-information analysis. To illustrate, we use a simple case example of a foot ulcer (e.g., with diabetes) as well as key references from the literature, including examples for the use of the decision-analytic VoI framework by health technology assessment agencies to guide further research. These concepts may guide stakeholders involved or interested in how to determine whether or not and, if so, which additional evidence is needed to make decisions. Copyright © 2013. Published by Elsevier GmbH.

Decision Modeling for Socio-Cultural Data

DTIC Science & Technology

2011-02-01

REFERENCES [1] Malczewski, J. (1999) GIS and Multicriteria Decision Analysis . John Wiley and Sons, New York. [2] Ehrgott, M., and Gandibleux, X. (Eds...up, nonexclusive, irrevocable worldwide license to use , modify, reproduce, release, perform, display, or disclose the work by or on behalf of the...criteria decision analysis (MCDA), into a geospatial environment to support decision making for campaign management. Our development approach supports

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

PubMed

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

2014-06-01

Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially.

Development of a Decision Support System for Analysis and Solutions of Prolonged Standing in the Workplace

PubMed Central

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

2014-01-01

Background Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing. Methods The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system. Results Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results. Conclusion The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially. PMID:25180141

A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Multiple Myeloma.

PubMed

Raju, G K; Gurumurthi, Karthik; Domike, Reuben; Kazandjian, Dickran; Landgren, Ola; Blumenthal, Gideon M; Farrell, Ann; Pazdur, Richard; Woodcock, Janet

2018-01-01

Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analysis. In this work, a quantitative benefit-risk analysis approach captures regulatory decision-making about new drugs to treat multiple myeloma (MM). MM assessments have been based on endpoints such as time to progression (TTP), progression-free survival (PFS), and objective response rate (ORR) which are different than benefit-risk analysis based on overall survival (OS). Twenty-three FDA decisions on MM drugs submitted to FDA between 2003 and 2016 were identified and analyzed. The benefits and risks were quantified relative to comparators (typically the control arm of the clinical trial) to estimate whether the median benefit-risk was positive or negative. A sensitivity analysis was demonstrated using ixazomib to explore the magnitude of uncertainty. FDA approval decision outcomes were consistent and logical using this benefit-risk framework. © 2017 American Society for Clinical Pharmacology and Therapeutics.

Analysis of the decision-making process of nurse managers: a collective reflection.

PubMed

Eduardo, Elizabete Araujo; Peres, Aida Maris; de Almeida, Maria de Lourdes; Roglio, Karina de Dea; Bernardino, Elizabeth

2015-01-01

to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories. qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis. data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model. the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that influence and determine right decisions.

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

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

Booth, Steven Richard

2016-04-04

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

Decision analysis framing study; in-valley drainage management strategies for the western San Joaquin Valley, California

USGS Publications Warehouse

Presser, Theresa S.; Jenni, Karen E.; Nieman, Timothy; Coleman, James

2010-01-01

Constraints on drainage management in the western San Joaquin Valley and implications of proposed approaches to management were recently evaluated by the U.S. Geological Survey (USGS). The USGS found that a significant amount of data for relevant technical issues was available and that a structured, analytical decision support tool could help optimize combinations of specific in-valley drainage management strategies, address uncertainties, and document underlying data analysis for future use. To follow-up on USGS's technical analysis and to help define a scientific basis for decisionmaking in implementing in-valley drainage management strategies, this report describes the first step (that is, a framing study) in a Decision Analysis process. In general, a Decision Analysis process includes four steps: (1) problem framing to establish the scope of the decision problem(s) and a set of fundamental objectives to evaluate potential solutions, (2) generation of strategies to address identified decision problem(s), (3) identification of uncertainties and their relationships, and (4) construction of a decision support model. Participation in such a systematic approach can help to promote consensus and to build a record of qualified supporting data for planning and implementation. In December 2008, a Decision Analysis framing study was initiated with a series of meetings designed to obtain preliminary input from key stakeholder groups on the scope of decisions relevant to drainage management that were of interest to them, and on the fundamental objectives each group considered relevant to those decisions. Two key findings of this framing study are: (1) participating stakeholders have many drainage management objectives in common; and (2) understanding the links between drainage management and water management is necessary both for sound science-based decisionmaking and for resolving stakeholder differences about the value of proposed drainage management solutions. Citing ongoing legal processes associated with drainage management in the western San Joaquin Valley, the U.S. Bureau of Reclamation (USBR) withdrew from the Decision Analysis process early in the proceedings. Without the involvement of the USBR, the USGS discontinued further development of this study.

Decision curve analysis revisited: overall net benefit, relationships to ROC curve analysis, and application to case-control studies.

PubMed

Rousson, Valentin; Zumbrunn, Thomas

2011-06-22

Decision curve analysis has been introduced as a method to evaluate prediction models in terms of their clinical consequences if used for a binary classification of subjects into a group who should and into a group who should not be treated. The key concept for this type of evaluation is the "net benefit", a concept borrowed from utility theory. We recall the foundations of decision curve analysis and discuss some new aspects. First, we stress the formal distinction between the net benefit for the treated and for the untreated and define the concept of the "overall net benefit". Next, we revisit the important distinction between the concept of accuracy, as typically assessed using the Youden index and a receiver operating characteristic (ROC) analysis, and the concept of utility of a prediction model, as assessed using decision curve analysis. Finally, we provide an explicit implementation of decision curve analysis to be applied in the context of case-control studies. We show that the overall net benefit, which combines the net benefit for the treated and the untreated, is a natural alternative to the benefit achieved by a model, being invariant with respect to the coding of the outcome, and conveying a more comprehensive picture of the situation. Further, within the framework of decision curve analysis, we illustrate the important difference between the accuracy and the utility of a model, demonstrating how poor an accurate model may be in terms of its net benefit. Eventually, we expose that the application of decision curve analysis to case-control studies, where an accurate estimate of the true prevalence of a disease cannot be obtained from the data, is achieved with a few modifications to the original calculation procedure. We present several interrelated extensions to decision curve analysis that will both facilitate its interpretation and broaden its potential area of application.

Decision curve analysis revisited: overall net benefit, relationships to ROC curve analysis, and application to case-control studies

PubMed Central

2011-01-01

Background Decision curve analysis has been introduced as a method to evaluate prediction models in terms of their clinical consequences if used for a binary classification of subjects into a group who should and into a group who should not be treated. The key concept for this type of evaluation is the "net benefit", a concept borrowed from utility theory. Methods We recall the foundations of decision curve analysis and discuss some new aspects. First, we stress the formal distinction between the net benefit for the treated and for the untreated and define the concept of the "overall net benefit". Next, we revisit the important distinction between the concept of accuracy, as typically assessed using the Youden index and a receiver operating characteristic (ROC) analysis, and the concept of utility of a prediction model, as assessed using decision curve analysis. Finally, we provide an explicit implementation of decision curve analysis to be applied in the context of case-control studies. Results We show that the overall net benefit, which combines the net benefit for the treated and the untreated, is a natural alternative to the benefit achieved by a model, being invariant with respect to the coding of the outcome, and conveying a more comprehensive picture of the situation. Further, within the framework of decision curve analysis, we illustrate the important difference between the accuracy and the utility of a model, demonstrating how poor an accurate model may be in terms of its net benefit. Eventually, we expose that the application of decision curve analysis to case-control studies, where an accurate estimate of the true prevalence of a disease cannot be obtained from the data, is achieved with a few modifications to the original calculation procedure. Conclusions We present several interrelated extensions to decision curve analysis that will both facilitate its interpretation and broaden its potential area of application. PMID:21696604

Training in Decision-making Strategies: An approach to enhance students' competence to deal with socio-scientific issues

NASA Astrophysics Data System (ADS)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2013-10-01

Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based programme was developed that trains secondary school students (grades 11-13) in decision-making strategies. The main research question is: does training students to use these strategies foster decision-making competence? In addition, the influence of meta-decision aids was examined. Students conducted a task analysis to select an appropriate strategy prior to the decision-making process. Hence, the second research question is: does combining decision-making training with a task analysis enhance decision-making competence at a higher rate? To answer these questions, 386 students were tested in a pre-post-follow-up control-group design that included two training groups (decision-making strategies/decision-making strategies combined with a task analysis) and a control group (decision-making with additional ecological information instead of strategic training). An open-ended questionnaire was used to assess decision-making competence in situations related to sustainable development. The decision-making training led to a significant improvement in the post-test and the follow-up, which was administered three months after the training. Long-term effects on the quality of the students' decisions were evident for both training groups. Gains in competence when reflecting upon the decision-making processes of others were found, to a lesser extent, in the training group that received the additional meta-decision training. In conclusion, training in decision-making strategies is a promising approach to deal with socio-scientific issues related to sustainable development.

Fuzzy rationality and parameter elicitation in decision analysis

NASA Astrophysics Data System (ADS)

Nikolova, Natalia D.; Tenekedjiev, Kiril I.

2010-07-01

It is widely recognised by decision analysts that real decision-makers always make estimates in an interval form. An overview of techniques to find an optimal alternative among such with imprecise and interval probabilities is presented. Scalarisation methods are outlined as most appropriate. A proper continuation of such techniques is fuzzy rational (FR) decision analysis. A detailed representation of the elicitation process influenced by fuzzy rationality is given. The interval character of probabilities leads to the introduction of ribbon functions, whose general form and special cases are compared with the p-boxes. As demonstrated, approximation of utilities in FR decision analysis does not depend on the probabilities, but the approximation of probabilities is dependent on preferences.

A decision analysis approach for risk management of near-earth objects

NASA Astrophysics Data System (ADS)

Lee, Robert C.; Jones, Thomas D.; Chapman, Clark R.

2014-10-01

Risk management of near-Earth objects (NEOs; e.g., asteroids and comets) that can potentially impact Earth is an important issue that took on added urgency with the Chelyabinsk event of February 2013. Thousands of NEOs large enough to cause substantial damage are known to exist, although only a small fraction of these have the potential to impact Earth in the next few centuries. The probability and location of a NEO impact are subject to complex physics and great uncertainty, and consequences can range from minimal to devastating, depending upon the size of the NEO and location of impact. Deflecting a potential NEO impactor would be complex and expensive, and inter-agency and international cooperation would be necessary. Such deflection campaigns may be risky in themselves, and mission failure may result in unintended consequences. The benefits, risks, and costs of different potential NEO risk management strategies have not been compared in a systematic fashion. We present a decision analysis framework addressing this hazard. Decision analysis is the science of informing difficult decisions. It is inherently multi-disciplinary, especially with regard to managing catastrophic risks. Note that risk analysis clarifies the nature and magnitude of risks, whereas decision analysis guides rational risk management. Decision analysis can be used to inform strategic, policy, or resource allocation decisions. First, a problem is defined, including the decision situation and context. Second, objectives are defined, based upon what the different decision-makers and stakeholders (i.e., participants in the decision) value as important. Third, quantitative measures or scales for the objectives are determined. Fourth, alternative choices or strategies are defined. Fifth, the problem is then quantitatively modeled, including probabilistic risk analysis, and the alternatives are ranked in terms of how well they satisfy the objectives. Sixth, sensitivity analyses are performed in order to examine the impact of uncertainties. Finally, the need for further analysis, data collection, or refinement is determined. The first steps of defining the problem and the objectives are critical to constructing an informative decision analysis. Such steps must be undertaken with participation from experts, decision-makers, and stakeholders (defined here as "decision participants"). The basic problem here can be framed as: “What is the best strategy to manage risk associated with NEOs?” Some high-level objectives might be to minimize: mortality and injuries, damage to critical infrastructure (e.g., power, communications and food distribution), ecosystem damage, property damage, ungrounded media and public speculation, resources expended, and overall cost. Another valuable objective would be to maximize inter-agency/government coordination. Some of these objectives (e.g., “minimize mortality”) are readily quantified (e.g., deaths and injuries averted). Others are less so (e.g., “maximize inter-agency/government coordination”), but these can be scaled. Objectives may be inversely related: e.g., a strategy that minimizes mortality may cost more. They are also unlikely to be weighted equally. Defining objectives and assessing their relative weight and interactions requires early engagement with decision participants. High-level decisions include whether to deflect a NEO, when to deflect, what is the best alternative for deflection/destruction, and disaster management strategies if an impact occurs. Important influences include, for example: NEO characteristics (orbital characteristics, diameter, mass, spin and composition), impact probability and location, interval between discovery and projected impact date, interval between discovery and deflection target date, costs of information collection, costs and technological feasibility of deflection alternatives, risks of deflection campaigns, requirements for inter-agency and international cooperation, and timing of informing the public. The analytical aspects of decision analysis center on estimation of the expected value (i.e. utility) of different alternatives. The expected value of an alternative is a function of the probability-weighted consequences, estimated using Bayesian calculations in a decision tree or influence diagram model. The result is a set of expected-value estimates for all alternatives evaluated that enables a ranking; the higher the expected value, the more preferred the alternative. A common way to include resource limitations is by framing the decision analysis in the context of economics (e.g., cost-effectiveness analysis). An important aspect of decision analysis in the NEO risk management case is the ability, known as sensitivity analysis, to examine the effect of parameter uncertainty upon decisions. The simplest way to evaluate uncertainty associated with the information used in a decision analysis is to adjust the input values one at a time (or simultaneously) to examine how the results change. Monte Carlo simulations can be used to adjust the inputs over ranges or distributions of values; statistical means then are used to determine the most influential variables. These techniques yield a measure known as the expected value of imperfect information. This value is highly informative, because it allows the decision-maker with imperfect information to evaluate the impact of using experiments, tests, or data collection (e.g. Earth-based observations, space-based remote sensing, etc.) to refine judgments; and indeed to estimate how much should be spent to reduce uncertainty.

Decision Trajectories in Dementia Care Networks: Decisions and Related Key Events.

PubMed

Groen-van de Ven, Leontine; Smits, Carolien; Oldewarris, Karen; Span, Marijke; Jukema, Jan; Eefsting, Jan; Vernooij-Dassen, Myrra

2017-10-01

This prospective multiperspective study provides insight into the decision trajectories of people with dementia by studying the decisions made and related key events. This study includes three waves of interviews, conducted between July 2010 and July 2012, with 113 purposefully selected respondents (people with beginning to advanced stages of dementia and their informal and professional caregivers) completed in 12 months (285 interviews). Our multilayered qualitative analysis consists of content analysis, timeline methods, and constant comparison. Four decision themes emerged-managing daily life, arranging support, community living, and preparing for the future. Eight key events delineate the decision trajectories of people with dementia. Decisions and key events differ between people with dementia living alone and living with a caregiver. Our study clarifies that decisions relate not only to the disease but to living with the dementia. Individual differences in decision content and sequence may effect shared decision-making and advance care planning.

Group decision making with the analytic hierarchy process in benefit-risk assessment: a tutorial.

PubMed

Hummel, J Marjan; Bridges, John F P; IJzerman, Maarten J

2014-01-01

The analytic hierarchy process (AHP) has been increasingly applied as a technique for multi-criteria decision analysis in healthcare. The AHP can aid decision makers in selecting the most valuable technology for patients, while taking into account multiple, and even conflicting, decision criteria. This tutorial illustrates the procedural steps of the AHP in supporting group decision making about new healthcare technology, including (1) identifying the decision goal, decision criteria, and alternative healthcare technologies to compare, (2) structuring the decision criteria, (3) judging the value of the alternative technologies on each decision criterion, (4) judging the importance of the decision criteria, (5) calculating group judgments, (6) analyzing the inconsistency in judgments, (7) calculating the overall value of the technologies, and (8) conducting sensitivity analyses. The AHP is illustrated via a hypothetical example, adapted from an empirical AHP analysis on the benefits and risks of tissue regeneration to repair small cartilage lesions in the knee.

Conceptualizing surrogate decision making at end of life in the intensive care unit using cognitive task analysis.

PubMed

Dionne-Odom, J Nicholas; Willis, Danny G; Bakitas, Marie; Crandall, Beth; Grace, Pamela J

2015-01-01

Surrogate decision makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. To identify and describe the underlying psychological processes of surrogate decision making for adults at EOL in the ICU. Qualitative case study design using a cognitive task analysis interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical center's ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semistructured cognitive task analysis interviews. The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions (gist impressions, distressing emotions, and moral intuitions) impact an SDM's judgment about the acceptability of either the patient's medical treatments or his or her condition. The framework offers initial insights about the underlying psychological processes of surrogate decision making and may facilitate enhanced decision support for SDMs. Copyright © 2015 Elsevier Inc. All rights reserved.

Rational selection of experimental readout and intervention sites for reducing uncertainties in computational model predictions.

PubMed

Flassig, Robert J; Migal, Iryna; der Zalm, Esther van; Rihko-Struckmann, Liisa; Sundmacher, Kai

2015-01-16

Understanding the dynamics of biological processes can substantially be supported by computational models in the form of nonlinear ordinary differential equations (ODE). Typically, this model class contains many unknown parameters, which are estimated from inadequate and noisy data. Depending on the ODE structure, predictions based on unmeasured states and associated parameters are highly uncertain, even undetermined. For given data, profile likelihood analysis has been proven to be one of the most practically relevant approaches for analyzing the identifiability of an ODE structure, and thus model predictions. In case of highly uncertain or non-identifiable parameters, rational experimental design based on various approaches has shown to significantly reduce parameter uncertainties with minimal amount of effort. In this work we illustrate how to use profile likelihood samples for quantifying the individual contribution of parameter uncertainty to prediction uncertainty. For the uncertainty quantification we introduce the profile likelihood sensitivity (PLS) index. Additionally, for the case of several uncertain parameters, we introduce the PLS entropy to quantify individual contributions to the overall prediction uncertainty. We show how to use these two criteria as an experimental design objective for selecting new, informative readouts in combination with intervention site identification. The characteristics of the proposed multi-criterion objective are illustrated with an in silico example. We further illustrate how an existing practically non-identifiable model for the chlorophyll fluorescence induction in a photosynthetic organism, D. salina, can be rendered identifiable by additional experiments with new readouts. Having data and profile likelihood samples at hand, the here proposed uncertainty quantification based on prediction samples from the profile likelihood provides a simple way for determining individual contributions of parameter uncertainties to uncertainties in model predictions. The uncertainty quantification of specific model predictions allows identifying regions, where model predictions have to be considered with care. Such uncertain regions can be used for a rational experimental design to render initially highly uncertain model predictions into certainty. Finally, our uncertainty quantification directly accounts for parameter interdependencies and parameter sensitivities of the specific prediction.

Incorporating uncertainty regarding applicability of evidence from meta-analyses into clinical decision making.

PubMed

Kriston, Levente; Meister, Ramona

2014-03-01

Judging applicability (relevance) of meta-analytical findings to particular clinical decision-making situations remains challenging. We aimed to describe an evidence synthesis method that accounts for possible uncertainty regarding applicability of the evidence. We conceptualized uncertainty regarding applicability of the meta-analytical estimates to a decision-making situation as the result of uncertainty regarding applicability of the findings of the trials that were included in the meta-analysis. This trial-level applicability uncertainty can be directly assessed by the decision maker and allows for the definition of trial inclusion probabilities, which can be used to perform a probabilistic meta-analysis with unequal probability resampling of trials (adaptive meta-analysis). A case study with several fictitious decision-making scenarios was performed to demonstrate the method in practice. We present options to elicit trial inclusion probabilities and perform the calculations. The result of an adaptive meta-analysis is a frequency distribution of the estimated parameters from traditional meta-analysis that provides individually tailored information according to the specific needs and uncertainty of the decision maker. The proposed method offers a direct and formalized combination of research evidence with individual clinical expertise and may aid clinicians in specific decision-making situations. Copyright © 2014 Elsevier Inc. All rights reserved.

Three-class ROC analysis--the equal error utility assumption and the optimality of three-class ROC surface using the ideal observer.

PubMed

He, Xin; Frey, Eric C

2006-08-01

Previously, we have developed a decision model for three-class receiver operating characteristic (ROC) analysis based on decision theory. The proposed decision model maximizes the expected decision utility under the assumption that incorrect decisions have equal utilities under the same hypothesis (equal error utility assumption). This assumption reduced the dimensionality of the "general" three-class ROC analysis and provided a practical figure-of-merit to evaluate the three-class task performance. However, it also limits the generality of the resulting model because the equal error utility assumption will not apply for all clinical three-class decision tasks. The goal of this study was to investigate the optimality of the proposed three-class decision model with respect to several other decision criteria. In particular, besides the maximum expected utility (MEU) criterion used in the previous study, we investigated the maximum-correctness (MC) (or minimum-error), maximum likelihood (ML), and Nyman-Pearson (N-P) criteria. We found that by making assumptions for both MEU and N-P criteria, all decision criteria lead to the previously-proposed three-class decision model. As a result, this model maximizes the expected utility under the equal error utility assumption, maximizes the probability of making correct decisions, satisfies the N-P criterion in the sense that it maximizes the sensitivity of one class given the sensitivities of the other two classes, and the resulting ROC surface contains the maximum likelihood decision operating point. While the proposed three-class ROC analysis model is not optimal in the general sense due to the use of the equal error utility assumption, the range of criteria for which it is optimal increases its applicability for evaluating and comparing a range of diagnostic systems.

Decision-Making in National Security Affairs: Toward a Typology.

DTIC Science & Technology

1985-06-07

decisional model, and thus provide the necessary linkage between observation and application of theory in explaining and/or predicting policy decisions . r...examines theories and models of decision -making processes from an interdisciplinary perspective, with a view toward deriving means by which the behavior of...processes, game theory , linear programming, network and graph theory , time series analysis, and the like. The discipline of decision analysis is a relatively

Gender and internet consumers' decision-making.

PubMed

Yang, Chyan; Wu, Chia-Chun

2007-02-01

The purpose of this research is to provide managers of shopping websites information regarding consumer purchasing decisions based on the Consumer Styles Inventory (CSI). According to the CSI, one can capture what decision-making styles online shoppers use. Furthermore, this research also discusses the gender differences among online shoppers. Exploratory factor analysis (EFA) was used to understand the decision-making styles and discriminant analysis was used to distinguish the differences between female and male shoppers. The result shows that there are differences in purchasing decisions between online female and male Internet users.

Non-monetary valuation using Multi-Criteria Decision Analysis: Sensitivity of additive aggregation methods to scaling and compensation assumptions

EPA Science Inventory

Analytical methods for Multi-Criteria Decision Analysis (MCDA) support the non-monetary valuation of ecosystem services for environmental decision making. Many published case studies transform ecosystem service outcomes into a common metric and aggregate the outcomes to set land ...

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

EPA Science Inventory

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

Decision Analysis Techniques for Adult Learners: Application to Leadership

ERIC Educational Resources Information Center

Toosi, Farah

2017-01-01

Most decision analysis techniques are not taught at higher education institutions. Leaders, project managers and procurement agents in industry have strong technical knowledge, and it is crucial for them to apply this knowledge at the right time to make critical decisions. There are uncertainties, problems, and risks involved in business…

Assessing the Impact of Financial Aid Offers on Enrollment Decisions.

ERIC Educational Resources Information Center

Somers, Patricia A.; St. John, Edward P.

1993-01-01

A study tested a model for assessing the impact of financial aid offers on 2,558 accepted students' college enrollment decisions. The analysis demonstrates that financial aid strategies have a substantial influence on enrollment and the systematic analysis of student enrollment decisions can help institutional administrators refine their financing…

An Evaluation on Factors Influencing Decision making for Malaysia Disaster Management: The Confirmatory Factor Analysis Approach

NASA Astrophysics Data System (ADS)

Zubir, S. N. A.; Thiruchelvam, S.; Mustapha, K. N. M.; Che Muda, Z.; Ghazali, A.; Hakimie, H.

2017-12-01

For the past few years, natural disaster has been the subject of debate in disaster management especially in flood disaster. Each year, natural disaster results in significant loss of life, destruction of homes and public infrastructure, and economic hardship. Hence, an effective and efficient flood disaster management would assure non-futile efforts for life saving. The aim of this article is to examine the relationship between approach, decision maker, influence factor, result, and ethic to decision making for flood disaster management in Malaysia. The key elements of decision making in the disaster management were studied based on the literature. Questionnaire surveys were administered among lead agencies at East Coast of Malaysia in the state of Kelantan and Pahang. A total of 307 valid responses had been obtained for further analysis. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were carried out to analyse the measurement model involved in the study. The CFA for second-order reflective and first-order reflective measurement model indicates that approach, decision maker, influence factor, result, and ethic have a significant and direct effect on decision making during disaster. The results from this study showed that decision- making during disaster is an important element for disaster management to necessitate a successful collaborative decision making. The measurement model is accepted to proceed with further analysis known as Structural Equation Modeling (SEM) and can be assessed for the future research.

A Benefit-Risk Analysis Approach to Capture Regulatory Decision-Making: Non-Small Cell Lung Cancer.

PubMed

Raju, G K; Gurumurthi, K; Domike, R; Kazandjian, D; Blumenthal, G; Pazdur, R; Woodcock, J

2016-12-01

Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analyses. There is much interest in quantifying regulatory approaches to benefit and risk. In this work the use of a quantitative benefit-risk analysis was applied to regulatory decision-making about new drugs to treat advanced non-small cell lung cancer (NSCLC). Benefits and risks associated with 20 US Food and Drug Administration (FDA) decisions associated with a set of candidate treatments submitted between 2003 and 2015 were analyzed. For benefit analysis, the median overall survival (OS) was used where available. When not available, OS was estimated based on overall response rate (ORR) or progression-free survival (PFS). Risks were analyzed based on magnitude (or severity) of harm and likelihood of occurrence. Additionally, a sensitivity analysis was explored to demonstrate analysis of systematic uncertainty. FDA approval decision outcomes considered were found to be consistent with the benefit-risk logic. © 2016 American Society for Clinical Pharmacology and Therapeutics.

How Expert Pilots Think Cognitive Processes in Expert Decision Making

DTIC Science & Technology

1993-02-01

Management (CRM) This document is available to the public Advanced Qualification Program (AQP) through the National Technical Information Cognitive Task Analysis (CTA...8217 Selecting realistic EDM scenarios with critical events and performing a cognitive task analysis of novice vs. expert decision making for these events...scenarios with critical events and performing a cognitive task analysis of novice vs. expert decision making for these events is a basic requirement for

Multi-Metric Sustainability Analysis

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

Cowlin, Shannon; Heimiller, Donna; Macknick, Jordan

2014-12-01

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

Toward an Extension of Decision Analysis to Competitive Situations.

DTIC Science & Technology

1985-12-01

order to deal with competition may ease the use of non- von Neumann-Morgenstern utility. This leads to our secondary goal of questioning expected...While von WInterfeldt [1980] attempted a 5 (more detailed analysis using three separate decision trees, one for each side In the dispute, he felt that...rationality generally used In game theory derives from the same roots as the calculated rationality of Decision Analysis, von Neumann and

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

PubMed

Diaby, Vakaramoko; Goeree, Ron

2014-02-01

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

Determining the Best Treatment for Coronal Angular Deformity of the Knee Joint in Growing Children: A Decision Analysis

PubMed Central

Sung, Ki Hyuk; Chung, Chin Youb; Lee, Kyoung Min; Lee, Seung Yeol; Choi, In Ho; Cho, Tae-Joon; Yoo, Won Joon; Park, Moon Seok

2014-01-01

This study aimed to determine the best treatment modality for coronal angular deformity of the knee joint in growing children using decision analysis. A decision tree was created to evaluate 3 treatment modalities for coronal angular deformity in growing children: temporary hemiepiphysiodesis using staples, percutaneous screws, or a tension band plate. A decision analysis model was constructed containing the final outcome score, probability of metal failure, and incomplete correction of deformity. The final outcome was defined as health-related quality of life and was used as a utility in the decision tree. The probabilities associated with each case were obtained by literature review, and health-related quality of life was evaluated by a questionnaire completed by 25 pediatric orthopedic experts. Our decision analysis model favored temporary hemiepiphysiodesis using a tension band plate over temporary hemiepiphysiodesis using percutaneous screws or stapling, with utilities of 0.969, 0.957, and 0.962, respectively. One-way sensitivity analysis showed that hemiepiphysiodesis using a tension band plate was better than temporary hemiepiphysiodesis using percutaneous screws, when the overall complication rate of hemiepiphysiodesis using a tension band plate was lower than 15.7%. Two-way sensitivity analysis showed that hemiepiphysiodesis using a tension band plate was more beneficial than temporary hemiepiphysiodesis using percutaneous screws. PMID:25276801

[Comparison of Discriminant Analysis and Decision Trees for the Detection of Subclinical Keratoconus].

PubMed

Kleinhans, Sonja; Herrmann, Eva; Kohnen, Thomas; Bühren, Jens

2017-08-15

Background Iatrogenic keratectasia is one of the most dreaded complications of refractive surgery. In most cases, keratectasia develops after refractive surgery of eyes suffering from subclinical stages of keratoconus with few or no signs. Unfortunately, there has been no reliable procedure for the early detection of keratoconus. In this study, we used binary decision trees (recursive partitioning) to assess their suitability for discrimination between normal eyes and eyes with subclinical keratoconus. Patients and Methods The method of decision tree analysis was compared with discriminant analysis which has shown good results in previous studies. Input data were 32 eyes of 32 patients with newly diagnosed keratoconus in the contralateral eye and preoperative data of 10 eyes of 5 patients with keratectasia after laser in-situ keratomileusis (LASIK). The control group was made up of 245 normal eyes after LASIK and 12-month follow-up without any signs of iatrogenic keratectasia. Results Decision trees gave better accuracy and specificity than did discriminant analysis. The sensitivity of decision trees was lower than the sensitivity of discriminant analysis. Conclusion On the basis of the patient population of this study, decision trees did not prove to be superior to linear discriminant analysis for the detection of subclinical keratoconus. Georg Thieme Verlag KG Stuttgart · New York.

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

PubMed

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

2014-06-01

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

Joint Intelligence Analysis Complex: DOD Partially Used Best Practices for Analyzing Alternatives and Should Do So Fully for Future Military Construction Decisions

DTIC Science & Technology

2016-09-01

Military Construction Decisions Report to Congressional Requesters September 2016 GAO-16-853 United States Government Accountability Office...ANALYSIS COMPLEX DOD Partially Used Best Practices for Analyzing Alternatives and Should Do So Fully for Future Military Construction Decisions What...a set of AOA best practices for military construction decisions. Without guidance for using AOA best practices during certain military construction

Escalation research: Providing new frontiers for applying behavior analysis to organizational behavior

PubMed Central

Goltz, Sonia M.

2000-01-01

Decision fiascoes such as escalation of commitment, the tendency of decision makers to “throw good money after bad,” can have serious consequences for organizations and are therefore of great interest in applied research. This paper discusses the use of behavior analysis in organizational behavior research on escalation. Among the most significant aspects of behavior-analytic research on escalation is that it has indicated that both the patterns of outcomes that decision makers have experienced for past decisions and the patterns of responses that they make are critical for understanding escalation. This research has also stimulated the refinement of methods by researchers to better assess decision making and the role reinforcement plays in it. Finally, behavior-analytic escalation research has not only indicated the utility of reinforcement principles for predicting more complex human behavior but has also suggested some additional areas for future exploration of decision making using behavior analysis. PMID:22478347

Improving IT Portfolio Management Decision Confidence Using Multi-Criteria Decision Making and Hypervariate Display Techniques

ERIC Educational Resources Information Center

Landmesser, John Andrew

2014-01-01

Information technology (IT) investment decision makers are required to process large volumes of complex data. An existing body of knowledge relevant to IT portfolio management (PfM), decision analysis, visual comprehension of large volumes of information, and IT investment decision making suggest Multi-Criteria Decision Making (MCDM) and…

Modeling Adversaries in Counterterrorism Decisions Using Prospect Theory.

PubMed

Merrick, Jason R W; Leclerc, Philip

2016-04-01

Counterterrorism decisions have been an intense area of research in recent years. Both decision analysis and game theory have been used to model such decisions, and more recently approaches have been developed that combine the techniques of the two disciplines. However, each of these approaches assumes that the attacker is maximizing its utility. Experimental research shows that human beings do not make decisions by maximizing expected utility without aid, but instead deviate in specific ways such as loss aversion or likelihood insensitivity. In this article, we modify existing methods for counterterrorism decisions. We keep expected utility as the defender's paradigm to seek for the rational decision, but we use prospect theory to solve for the attacker's decision to descriptively model the attacker's loss aversion and likelihood insensitivity. We study the effects of this approach in a critical decision, whether to screen containers entering the United States for radioactive materials. We find that the defender's optimal decision is sensitive to the attacker's levels of loss aversion and likelihood insensitivity, meaning that understanding such descriptive decision effects is important in making such decisions. © 2014 Society for Risk Analysis.

Workshop on Aeronautical Decision Making (ADM). Volume 1. Executive Summary

DTIC Science & Technology

1992-08-01

expert and novice pilots when a real decision was required. Aeronautical Decision Making (ADM), Crew Resource Management (CRM), Advanced Qualification Program (AQP), Cognitive Task Analysis (CTA), Expert Decision Making (EDM)

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

PubMed

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

2008-11-01

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

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

NASA Astrophysics Data System (ADS)

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

2016-03-01

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

Structured decision making: Chapter 5

USGS Publications Warehouse

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

2013-01-01

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

Benefit-Risk Analysis for Decision-Making: An Approach.

PubMed

Raju, G K; Gurumurthi, K; Domike, R

2016-12-01

The analysis of benefit and risk is an important aspect of decision-making throughout the drug lifecycle. In this work, the use of a benefit-risk analysis approach to support decision-making was explored. The proposed approach builds on the qualitative US Food and Drug Administration (FDA) approach to include a more explicit analysis based on international standards and guidance that enables aggregation and comparison of benefit and risk on a common basis and a lifecycle focus. The approach is demonstrated on six decisions over the lifecycle (e.g., accelerated approval, withdrawal, and traditional approval) using two case studies: natalizumab for multiple sclerosis (MS) and bedaquiline for multidrug-resistant tuberculosis (MDR-TB). © 2016 American Society for Clinical Pharmacology and Therapeutics.

Analyses of S-Box in Image Encryption Applications Based on Fuzzy Decision Making Criterion

NASA Astrophysics Data System (ADS)

Rehman, Inayatur; Shah, Tariq; Hussain, Iqtadar

2014-06-01

In this manuscript, we put forward a standard based on fuzzy decision making criterion to examine the current substitution boxes and study their strengths and weaknesses in order to decide their appropriateness in image encryption applications. The proposed standard utilizes the results of correlation analysis, entropy analysis, contrast analysis, homogeneity analysis, energy analysis, and mean of absolute deviation analysis. These analyses are applied to well-known substitution boxes. The outcome of these analyses are additional observed and a fuzzy soft set decision making criterion is used to decide the suitability of an S-box to image encryption applications.

Methods for Conducting Cognitive Task Analysis for a Decision Making Task.

DTIC Science & Technology

1996-01-01

Cognitive task analysis (CTA) improves traditional task analysis procedures by analyzing the thought processes of performers while they complete a...for using these methods to conduct a CTA for domains which involve critical decision making tasks in naturalistic settings. The cognitive task analysis methods

An Environmental Decision Support System for Spatial Assessment and Selective Remediation

EPA Science Inventory

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

Path Analysis Examining Self-Efficacy and Decision-Making Performance on a Simulated Baseball Task

ERIC Educational Resources Information Center

Hepler, Teri J.; Feltz, Deborah L.

2012-01-01

The purpose of this study was to examine the relationship between decision-making self-efficacy and decision-making performance in sport. Undergraduate students (N = 78) performed 10 trials of a decision-making task in baseball. Self-efficacy was measured before performing each trial. Decision-making performance was assessed by decision speed and…

Decision Styles and Rationality: An Analysis of the Predictive Validity of the General Decision-Making Style Inventory

ERIC Educational Resources Information Center

Curseu, Petru Lucian; Schruijer, Sandra G. L.

2012-01-01

This study investigates the relationship between the five decision-making styles evaluated by the General Decision-Making Style Inventory, indecisiveness, and rationality in decision making. Using a sample of 102 middle-level managers, the results show that the rational style positively predicts rationality in decision making and negatively…

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

ERIC Educational Resources Information Center

Erskine, Michael A.

2013-01-01

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

Decision-Making Phenomena Described by Expert Nurses Working in Urban Community Health Settings.

ERIC Educational Resources Information Center

Watkins, Mary P.

1998-01-01

Expert community health nurses (n=28) described crucial clinical situations. Content analysis revealed that decision making was both rational and intuitive. Eight themes were identified: decision-making focus, type, purpose, decision-maker characteristics, sequencing of events, data collection methods, facilitators/barriers, and decision-making…

Patient participation in palliative care decisions: An ethnographic discourse analysis

PubMed Central

Bélanger, Emmanuelle; Rodríguez, Charo; Groleau, Danielle; Légaré, France; MacDonald, Mary Ellen; Marchand, Robert

2016-01-01

The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team. This qualitative study combined ethnographic observations of a palliative care team with discourse analysis. Eighteen palliative care patients with cancer diagnoses, six family physicians, and two nurses were involved in the study. Multiple interactions were observed between each patient and health care providers over the course of 1 year, for a total of 101 consultations, 24 of which were audio-recorded. The analysis consisted in looking for the interpretive repertoires (i.e., familiar lines of argument used to justify actions) that were used to justify patient participation in decision-making during clinical interactions, as well as exploring their implications for decision roles and end-of-life care. Patients and their health care providers seldom addressed their decision-making roles explicitly. Rather, they constructed patient participation in palliative care decisions in a covert manner. Four interpretive repertoires were used to justify patient participation: (1) exposing uncertainty, (2) co-constructing patient preferences, (3) affirming patient autonomy, and finally (4) upholding the authority of health care providers. The results demonstrate how patients and health care providers used these arguments to negotiate their respective roles in decision-making. In conclusion, patients and health care providers used a variety of interpretive repertoires to covertly negotiate their roles in decision-making, and to legitimize decisions that shaped patients’ dying trajectories. Discourse analysis encourages awareness of the role of language in either promoting or hindering patient participation in decision-making. PMID:27882864

Patient participation in palliative care decisions: An ethnographic discourse analysis.

PubMed

Bélanger, Emmanuelle; Rodríguez, Charo; Groleau, Danielle; Légaré, France; MacDonald, Mary Ellen; Marchand, Robert

2016-01-01

The participation of patients in making decisions about their care is especially important towards the end of life because palliative care decisions involve extensive uncertainty and are heavily influenced by personal values. Yet, there is a scarcity of studies directly observing clinical interactions between palliative patients and their health care providers. In this study, we aimed to understand how patient participation in palliative care decisions is constructed through discourse in a community hospital-based palliative care team. This qualitative study combined ethnographic observations of a palliative care team with discourse analysis. Eighteen palliative care patients with cancer diagnoses, six family physicians, and two nurses were involved in the study. Multiple interactions were observed between each patient and health care providers over the course of 1 year, for a total of 101 consultations, 24 of which were audio-recorded. The analysis consisted in looking for the interpretive repertoires (i.e., familiar lines of argument used to justify actions) that were used to justify patient participation in decision-making during clinical interactions, as well as exploring their implications for decision roles and end-of-life care. Patients and their health care providers seldom addressed their decision-making roles explicitly. Rather, they constructed patient participation in palliative care decisions in a covert manner. Four interpretive repertoires were used to justify patient participation: (1) exposing uncertainty, (2) co-constructing patient preferences, (3) affirming patient autonomy, and finally (4) upholding the authority of health care providers. The results demonstrate how patients and health care providers used these arguments to negotiate their respective roles in decision-making. In conclusion, patients and health care providers used a variety of interpretive repertoires to covertly negotiate their roles in decision-making, and to legitimize decisions that shaped patients' dying trajectories. Discourse analysis encourages awareness of the role of language in either promoting or hindering patient participation in decision-making.

Application of risk analysis in water resourses management

NASA Astrophysics Data System (ADS)

Varouchakis, Emmanouil; Palogos, Ioannis

2017-04-01

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

Beyond utilitarianism: a method for analyzing competing ethical principles in a decision analysis of liver transplantation.

PubMed

Volk, Michael L; Lok, Anna S F; Ubel, Peter A; Vijan, Sandeep

2008-01-01

The utilitarian foundation of decision analysis limits its usefulness for many social policy decisions. In this study, the authors examine a method to incorporate competing ethical principles in a decision analysis of liver transplantation for a patient with acute liver failure (ALF). A Markov model was constructed to compare the benefit of transplantation for a patient with ALF versus the harm caused to other patients on the waiting list and to determine the lowest acceptable 5-y posttransplant survival for the ALF patient. The weighting of the ALF patient and other patients was then adjusted using a multiattribute variable incorporating utilitarianism, urgency, and other principles such as fair chances. In the base-case analysis, the strategy of transplanting the ALF patient resulted in a 0.8% increase in the risk of death and a utility loss of 7.8 quality-adjusted days of life for each of the other patients on the waiting list. These harms cumulatively outweighed the benefit of transplantation for an ALF patient having a posttransplant survival of less than 48% at 5 y. However, the threshold for an acceptable posttransplant survival for the ALF patient ranged from 25% to 56% at 5 y, depending on the ethical principles involved. The results of the decision analysis vary depending on the ethical perspective. This study demonstrates how competing ethical principles can be numerically incorporated in a decision analysis.

Shaping Strategy: An Institutional Analysis of Decision Making in the Middle Tier

ERIC Educational Resources Information Center

Vasquez, Alejandro

2017-01-01

The intent of this single-case study was to explore the effects of a competitive environment on organizational decision making. The study examines the decision making processes that resulted in the adoption of an undergraduate business major at a traditional, middle-tier Liberal Arts College and offers an analysis of academic leaders' perspectives…

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

EPA Science Inventory

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

Decision modeling for fire incident analysis

Treesearch

Donald G. MacGregor; Armando González-Cabán

2009-01-01

This paper reports on methods for representing and modeling fire incidents based on concepts and models from the decision and risk sciences. A set of modeling techniques are used to characterize key fire management decision processes and provide a basis for incident analysis. The results of these methods can be used to provide insights into the structure of fire...

ALTERNATIVE FUTURES ANALYSIS: A FRAMEWORK FOR COMMUNITY DECISION-MAKING

EPA Science Inventory

Alternative futures analysis is an assessment approach designed to inform community decisions about land and water use. We conducted an alternative futures analysis in Oregon's Willamette River Basin. Three alternative future landscapes for the year 2050 were depicted and compare...

End-of-Life Decision Making in Palliative Care and Recommendations of the Council of Europe: Qualitative Secondary Analysis of Interviews and Observation Field Notes.

PubMed

Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo

2018-05-01

End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.

The BCD of response time analysis in experimental economics.

PubMed

Spiliopoulos, Leonidas; Ortmann, Andreas

2018-01-01

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

Using Cluster Analysis to Examine Husband-Wife Decision Making

ERIC Educational Resources Information Center

Bonds-Raacke, Jennifer M.

2006-01-01

Cluster analysis has a rich history in many disciplines and although cluster analysis has been used in clinical psychology to identify types of disorders, its use in other areas of psychology has been less popular. The purpose of the current experiments was to use cluster analysis to investigate husband-wife decision making. Cluster analysis was…

Development of Decision Making in School-Aged Children and Adolescents: Evidence from Heart Rate and Skin Conductance Analysis

ERIC Educational Resources Information Center

Crone, Eveline A.; van der Molen, Maurits W.

2007-01-01

Age differences in decision making indicate that children fail to anticipate outcomes of their decisions. Using heart rate and skin conductance analyses, we tested whether developmental changes in decision making are associated with (a) a failure to process outcomes of decisions, or (b) a failure to anticipate future outcomes of decisions.…

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

NASA Technical Reports Server (NTRS)

Ballin, Mark G.

1994-01-01

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

Using Decision Analysis to Improve Malaria Control Policy Making

PubMed Central

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

2013-01-01

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

A framework for sensitivity analysis of decision trees.

PubMed

Kamiński, Bogumił; Jakubczyk, Michał; Szufel, Przemysław

2018-01-01

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

Risk analysis theory applied to fishing operations: A new approach on the decision-making problem

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

Cunha, J.C.S.

1994-12-31

In the past the decisions concerning whether to continue or interrupt a fishing operation were based primarily on the operator`s previous experience. This procedure often led to wrong decisions and unnecessary loss of money and time. This paper describes a decision-making method based on risk analysis theory and previous operation results from a field under study. The method leads to more accurate decisions on a daily basis allowing the operator to verify each day of the operation if the decision being carried out is the one with the highest probability to conduct to the best economical result. An example ofmore » the method application is provided at the end of the paper.« less

Analysis And Assistant Planning System Ofregional Agricultural Economic Inform

NASA Astrophysics Data System (ADS)

Han, Jie; Zhang, Junfeng

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

Factors influencing decision regret regarding placement of a PEG among substitute decision-makers of older persons in Japan: a prospective study.

PubMed

Kuraoka, Yumiko; Nakayama, Kazuhiro

2017-06-28

A tube feeding decision aid designed at the Ottawa Health Research Institute was specifically created for substitute decision-makers who must decide whether to allow placement of a percutaneous endoscopic gastrostomy (PEG) tube in a cognitively impaired older person. We developed a Japanese version and found that the decision aid promoted the decision-making process of substitute decision-makers to decrease decisional conflict and increase knowledge. However, the factors that influence decision regret among substitute decision-makers were not measured after the decision was made. The objective of this study was to explore the factors that influence decision regret among substitute decision-makers 6 months after using a decision aid for PEG placement. In this prospective study, participants comprised substitute decision-makers for 45 inpatients aged 65 years and older who were being considered for placement of a PEG tube in hospitals, nursing homes and patients' homes in Japan. The Decisional Conflict Scale (DCS) was used to evaluate decisional conflict among substitute decision-makers immediately after deciding whether to introduce tube feeding and the Decision Regret Scale (DRS) was used to evaluate decisional regret among substitute decision-makers 6 months after they made their decision. Normalized scores were evaluated and analysis of variance was used to compare groups. The results of the multiple regression analysis suggest that PEG placement (P < .01) and decision conflict (P < .001) are explanatory factors of decision regret regarding placement of a PEG among substitute decision-makers. PEG placement and decision conflict immediately after deciding whether to allow PEG placement have an influence on decision regret among substitute decision-makers after 6 months.

The use of decision analysis to evaluate the economic effects of heat mount detectors in two dairy herds.

PubMed

Williamson, N B

1975-03-01

This paper reports a decrease in the interval from calving to conception in two commercial dairy herds, associated with the use of KaMaR Heat Mount Detectors. An economic analysis of the results uses a neoclassical decision theory approach to demonstrate that the use of heat mount detectors is likely to be profitable, with an expected net return of $154.18 per 100 calvings. The analysis demonstrates the suitability of a decision-theoretic approach to the analysis of applied research, and illustrates some of the weaknesses of "Classical" statistical analysis in such circumstances.

Decision strategies to reduce teenage and young adult deaths in the United States.

PubMed

Keeney, Ralph L; Palley, Asa B

2013-09-01

This article uses decision analysis concepts and techniques to address an extremely important problem to any family with children, namely, how to avoid the tragic death of a child during the high-risk ages of 15-24. Descriptively, our analysis indicates that of the 35,000 annual deaths among this age group in the United States, approximately 20,000 could be avoided if individuals chose readily available alternatives for decisions relating to these deaths. Prescriptively, we develop a decision framework for parents and a child to both identify and proactively pursue decisions that can lower that child's exposure to life-threatening risks and positively alter decisions when facing such risks. Applying this framework for parents and the youth themselves, we illustrate the logic and process of generating proactive alternatives with numerous examples that each could pursue to lower these life-threatening risks and possibly avoid a tragic premature death, and discuss some public policy implications of our findings. © 2013 Society for Risk Analysis.

Conceptualizing Surrogate Decision-Making at End of Life in the Intensive Care Unit using Cognitive Task Analysis

PubMed Central

Dionne-Odom, J. Nicholas; Willis, Danny G.; Bakitas, Marie; Crandall, Beth; Grace, Pamela J.

2014-01-01

Background Surrogate decision-makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. Purpose Identify and describe the underlying psychological processes of surrogate decision-making for adults at EOL in the ICU. Method Qualitative case study design using a cognitive task analysis (CTA) interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical center’s ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semi-structured CTA interviews. Discussion The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions: gist impressions, distressing emotions, and moral intuitions impact a SDM’s judgment about the acceptability of either the patient’s medical treatments or his or her condition. Conclusion The framework offers initial insights about the underlying psychological processes of surrogate decision-making and may facilitate enhanced decision support for SDMs. PMID:25982772

Neural systems analysis of decision making during goal-directed navigation.

PubMed

Penner, Marsha R; Mizumori, Sheri J Y

2012-01-01

The ability to make adaptive decisions during goal-directed navigation is a fundamental and highly evolved behavior that requires continual coordination of perceptions, learning and memory processes, and the planning of behaviors. Here, a neurobiological account for such coordination is provided by integrating current literatures on spatial context analysis and decision-making. This integration includes discussions of our current understanding of the role of the hippocampal system in experience-dependent navigation, how hippocampal information comes to impact midbrain and striatal decision making systems, and finally the role of the striatum in the implementation of behaviors based on recent decisions. These discussions extend across cellular to neural systems levels of analysis. Not only are key findings described, but also fundamental organizing principles within and across neural systems, as well as between neural systems functions and behavior, are emphasized. It is suggested that studying decision making during goal-directed navigation is a powerful model for studying interactive brain systems and their mediation of complex behaviors. Copyright © 2011. Published by Elsevier Ltd.

Defining the optimal therapy sequence in synchronous resectable liver metastases from colorectal cancer: a decision analysis approach.

PubMed

Van Dessel, E; Fierens, K; Pattyn, P; Van Nieuwenhove, Y; Berrevoet, F; Troisi, R; Ceelen, W

2009-01-01

Approximately 5%-20% of colorectal cancer (CRC) patients present with synchronous potentially resectable liver metastatic disease. Preclinical and clinical studies suggest a benefit of the 'liver first' approach, i.e. resection of the liver metastasis followed by resection of the primary tumour. A formal decision analysis may support a rational choice between several therapy options. Survival and morbidity data were retrieved from relevant clinical studies identified by a Web of Science search. Data were entered into decision analysis software (TreeAge Pro 2009, Williamstown, MA, USA). Transition probabilities including the risk of death from complications or disease progression associated with individual therapy options were entered into the model. Sensitivity analysis was performed to evaluate the model's validity under a variety of assumptions. The result of the decision analysis confirms the superiority of the 'liver first' approach. Sensitivity analysis demonstrated that this assumption is valid on condition that the mortality associated with the hepatectomy first is < 4.5%, and that the mortality of colectomy performed after hepatectomy is < 3.2%. The results of this decision analysis suggest that, in patients with synchronous resectable colorectal liver metastases, the 'liver first' approach is to be preferred. Randomized trials will be needed to confirm the results of this simulation based outcome.

The decision tree classifier - Design and potential. [for Landsat-1 data

NASA Technical Reports Server (NTRS)

Hauska, H.; Swain, P. H.

1975-01-01

A new classifier has been developed for the computerized analysis of remote sensor data. The decision tree classifier is essentially a maximum likelihood classifier using multistage decision logic. It is characterized by the fact that an unknown sample can be classified into a class using one or several decision functions in a successive manner. The classifier is applied to the analysis of data sensed by Landsat-1 over Kenosha Pass, Colorado. The classifier is illustrated by a tree diagram which for processing purposes is encoded as a string of symbols such that there is a unique one-to-one relationship between string and decision tree.

The application of natural science data to land management decision-making

NASA Technical Reports Server (NTRS)

Williams, D. L.; Sharpe, C. P.; Rowe, P. G.

1974-01-01

A natural environmental analysis process which allows the decision maker to know the probable consequences of a decision prior to the act is developed. Emphasis is placed on the fit between the natural environment and the social, economic, and functional attributes of man's communities and the transition from nature in its present state to various forms and intensities of development. Applications of the analysis are examined. It is concluded that the analysis is a workable system for land use management.

Decision Analysis in the U.S. Army’s Capabilties Needs Analysis: Applications of Decision Analysis Methods to Capabilities Resource Allocation and Capabilities Development Decisions

DTIC Science & Technology

2015-10-01

capability to meet the task to the standard under the condition, nothing more or less, else the funding is wasted . Also, that funding for the...bin to segregate gaps qualitatively before the gap value model determined preference among gaps within the bins. Computation of a gap’s...for communication, interpretation, or processing by humans or by automatic means (as it pertains to modeling and simulation). Delphi Method -- a

Decisions, decisions: analysis of age, cohort, and time of testing on framing of risky decision options.

PubMed

Mayhorn, Christopher B; Fisk, Arthur D; Whittle, Justin D

2002-01-01

Decision making in uncertain environments is a daily challenge faced by adults of all ages. Framing decision options as either gains or losses is a common method of altering decision-making behavior. In the experiment reported here, benchmark decision-making data collected in the 1970s by Tversky and Kahneman (1981, 1988) were compared with data collected from current samples of young and older adults to determine whether behavior was consistent across time. Although differences did emerge between the benchmark and the present samples, the effect of framing on decision behavior was relatively stable. The present findings suggest that adults of all ages are susceptible to framing effects. Results also indicated that apparent age differences might be better explained by an analysis of cohort and time-of-testing effects. Actual or potential applications of this research include an understanding of how framing might influence the decision-making behavior of people of all ages in a number of applied contexts, such as product warning interactions and medical decision scenarios.

Comparative Analysis of Enrollment and Financial Strength of Private Institutions. AIR 1989 Annual Forum Paper.

ERIC Educational Resources Information Center

Glover, Robert H.; Mills, Michael R.

A research design, decision support system, and results of a comparative analysis of enrollment and financial strength (of private institutions granting masters and doctoral degrees) are presented. Cluster analysis, discriminant analysis, multiple regression, and an interactive decision support system are used to compare the enrollment and…

Decision analysis in formulary decision making.

PubMed

Schechter, C B

1993-06-01

Although decision making about what drugs to include in an institutional formulary appears to lend itself readily to quantitative techniques such as decision analysis and cost-benefit analysis, a review of the literature reveals that very little has been published in this area. Several of the published decision analyses use non-standard techniques that are, at best, of unproved validity, and may seriously distort the underlying issues through covert under-counting or double-counting of various drug attributes. Well executed decision analyses have contributed to establishing that drug acquisition costs are not an adequate measure of the total economic impact of formulary decisions and that costs of labour and materials associated with drug administration must be calculated on an institution-specific basis to reflect unique staffing patterns, bulk purchasing practices, and the availability of surplus capacity within the institution which might be mobilised at little marginal cost. Clinical studies of newly introduced drugs frequently fail to answer the questions that weigh most heavily on the structuring of a formal assessment of a proposed formulary acquisition. Studies comparing a full spectrum of therapeutically equivalent drugs are rarely done, and individual studies of particular pairs of drugs can rarely be used together because of differences in methodology or patient populations studied. Gathering of institution-specific economic and clinical data is a daunting, labour-intensive task. In many institutions, incentive and reward structures discourage behaviour that takes the broad institutional perspective that is intrinsic to a good decision analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Using real options analysis to support strategic management decisions

NASA Astrophysics Data System (ADS)

Kabaivanov, Stanimir; Markovska, Veneta; Milev, Mariyan

2013-12-01

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

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

PubMed

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

1985-04-01

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

Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

PubMed

Gillespie, Mary

2010-11-01

Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA.

PubMed

Mühlbacher, Axel C; Kaczynski, Anika

2016-02-01

Healthcare decision making is usually characterized by a low degree of transparency. The demand for transparent decision processes can be fulfilled only when assessment, appraisal and decisions about health technologies are performed under a systematic construct of benefit assessment. The benefit of an intervention is often multidimensional and, thus, must be represented by several decision criteria. Complex decision problems require an assessment and appraisal of various criteria; therefore, a decision process that systematically identifies the best available alternative and enables an optimal and transparent decision is needed. For that reason, decision criteria must be weighted and goal achievement must be scored for all alternatives. Methods of multi-criteria decision analysis (MCDA) are available to analyse and appraise multiple clinical endpoints and structure complex decision problems in healthcare decision making. By means of MCDA, value judgments, priorities and preferences of patients, insurees and experts can be integrated systematically and transparently into the decision-making process. This article describes the MCDA framework and identifies potential areas where MCDA can be of use (e.g. approval, guidelines and reimbursement/pricing of health technologies). A literature search was performed to identify current research in healthcare. The results showed that healthcare decision making is addressing the problem of multiple decision criteria and is focusing on the future development and use of techniques to weight and score different decision criteria. This article emphasizes the use and future benefit of MCDA.

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

PubMed

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

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

Accuracy of intuition in clinical decision-making among novice clinicians.

PubMed

Price, Amanda; Zulkosky, Kristen; White, Krista; Pretz, Jean

2017-05-01

To assess the reliance on intuitive and analytical approaches during clinical decision-making among novice clinicians and whether that reliance is associated with accurate decision-making. Nurse educators and managers tend to emphasize analysis over intuition during clinical decision-making though nurses typically report some reliance on intuition in their practice. We hypothesized that under certain conditions, reliance on intuition would support accurate decision-making, even among novices. This study utilized an experimental design with clinical complication (familiar vs. novel) and decision phase (cue acquisition, diagnosis and action) as within-subjects' factors, and simulation role (observer, family, auxiliary nurse and primary nurse) as between-subjects' factor. We examined clinical decision-making accuracy among final semester pre-licensure nursing students in a simulation experience. Students recorded their reasoning about emerging clinical complications with their patient during two distinct points in the simulation; one point involved a familiar complication and the other a relatively novel complication. All data were collected during Spring 2015. Although most participants relied more heavily on analysis than on intuition, use of intuition during the familiar complication was associated with more accurate decision-making, particularly in guiding attention to relevant cues. With the novel complication, use of intuition appeared to hamper decision-making, particularly for those in an observer role. Novice clinicians should be supported by educators and nurse managers to note when their intuitions are likely to be valid. Our findings emphasize the integrated nature of intuition and analysis in clinical decision-making. © 2016 John Wiley & Sons Ltd.

My Lived Experiences Are More Important Than Your Probabilities: The Role of Individualized Risk Estimates for Decision Making about Participation in the Study of Tamoxifen and Raloxifene (STAR).

PubMed

Holmberg, Christine; Waters, Erika A; Whitehouse, Katie; Daly, Mary; McCaskill-Stevens, Worta

2015-11-01

Decision-making experts emphasize that understanding and using probabilistic information are important for making informed decisions about medical treatments involving complex risk-benefit tradeoffs. Yet empirical research demonstrates that individuals may not use probabilities when making decisions. To explore decision making and the use of probabilities for decision making from the perspective of women who were risk-eligible to enroll in the Study of Tamoxifen and Raloxifene (STAR). We conducted narrative interviews with 20 women who agreed to participate in STAR and 20 women who declined. The project was based on a narrative approach. Analysis included the development of summaries of each narrative, and thematic analysis with developing a coding scheme inductively to code all transcripts to identify emerging themes. Interviewees explained and embedded their STAR decisions within experiences encountered throughout their lives. Such lived experiences included but were not limited to breast cancer family history, a personal history of breast biopsies, and experiences or assumptions about taking tamoxifen or medicines more generally. Women's explanations of their decisions about participating in a breast cancer chemoprevention trial were more complex than decision strategies that rely solely on a quantitative risk-benefit analysis of probabilities derived from populations In addition to precise risk information, clinicians and risk communicators should recognize the importance and legitimacy of lived experience in individual decision making. © The Author(s) 2015.

Fast Image Texture Classification Using Decision Trees

NASA Technical Reports Server (NTRS)

Thompson, David R.

2011-01-01

Texture analysis would permit improved autonomous, onboard science data interpretation for adaptive navigation, sampling, and downlink decisions. These analyses would assist with terrain analysis and instrument placement in both macroscopic and microscopic image data products. Unfortunately, most state-of-the-art texture analysis demands computationally expensive convolutions of filters involving many floating-point operations. This makes them infeasible for radiation- hardened computers and spaceflight hardware. A new method approximates traditional texture classification of each image pixel with a fast decision-tree classifier. The classifier uses image features derived from simple filtering operations involving integer arithmetic. The texture analysis method is therefore amenable to implementation on FPGA (field-programmable gate array) hardware. Image features based on the "integral image" transform produce descriptive and efficient texture descriptors. Training the decision tree on a set of training data yields a classification scheme that produces reasonable approximations of optimal "texton" analysis at a fraction of the computational cost. A decision-tree learning algorithm employing the traditional k-means criterion of inter-cluster variance is used to learn tree structure from training data. The result is an efficient and accurate summary of surface morphology in images. This work is an evolutionary advance that unites several previous algorithms (k-means clustering, integral images, decision trees) and applies them to a new problem domain (morphology analysis for autonomous science during remote exploration). Advantages include order-of-magnitude improvements in runtime, feasibility for FPGA hardware, and significant improvements in texture classification accuracy.

A pilot level decision analysis of thermionic reactor development strategy for nuclear electric propulsion

NASA Technical Reports Server (NTRS)

Menke, M. M.; Judd, B. R.

1973-01-01

The development policy for thermionic reactors to provide electric propulsion and power for space exploration was analyzed to develop a logical procedure for selecting development alternatives that reflect the technical feasibility, JPL/NASA project objectives, and the economic environment of the project. The partial evolution of a decision model from the underlying philosophy of decision analysis to a deterministic pilot phase is presented, and the general manner in which this decision model can be employed to examine propulsion development alternatives is illustrated.

Decision Analysis for Multicandidate Voting Systems. Applications of Elementary Decision Analysis to Political Science. [and] An Application of Voting Theory to Congress. Applications of Decision Theory and Game Theory to American Politics. Modules and Monographs in Undergraduate Mathematics and Its Applications Project. UMAP Units 384 and 386.

ERIC Educational Resources Information Center

Merrill, Samuel, III; Enelow, James M.

This document consists of two modules. The first studies a variety of multicandidate voting systems, including approval, Borda, and cumulative voting, using a model which takes account of a voter's intensity of preference for candidates. The voter's optimal strategy is investigated for each voting system using decision criteria under uncertainty…

The role of risk-based prioritization in total quality management

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

Bennett, C.T.

1994-10-01

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

The Process of Life Cycle Cost Analysis: Projecting Economic Consequences of Design Decisions

ERIC Educational Resources Information Center

AIA Journal, 1976

1976-01-01

Life-cycle cost analysis deals with both present and future costs and attempts to relate the two as a basis for making decisions. This article lays the groundwork for a better understanding of the techniques of life-cycle cost analysis. (Author/MLF)

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-24

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

Decision analysis of shoreline protection under climate change uncertainty

NASA Astrophysics Data System (ADS)

Chao, Philip T.; Hobbs, Benjamin F.

1997-04-01

If global warming occurs, it could significantly affect water resource distribution and availability. Yet it is unclear whether the prospect of such change is relevant to water resources management decisions being made today. We model a shoreline protection decision problem with a stochastic dynamic program (SDP) to determine whether consideration of the possibility of climate change would alter the decision. Three questions are addressed with the SDP: (l) How important is climate change compared to other uncertainties?, (2) What is the economic loss if climate change uncertainty is ignored?, and (3) How does belief in climate change affect the timing of the decision? In the case study, sensitivity analysis shows that uncertainty in real discount rates has a stronger effect upon the decision than belief in climate change. Nevertheless, a strong belief in climate change makes the shoreline protection project less attractive and often alters the decision to build it.

Leadership Style, Decision Context, and the Poliheuristic Theory of Decision Making: An Experimental Analysis

ERIC Educational Resources Information Center

Keller, Jonathan W.; Yang, Yi Edward

2008-01-01

The poliheuristic (PH) theory of decision making has made important contributions to our understanding of political decision making but remains silent about certain key aspects of the decision process. Specifically, PH theory contends that leaders screen out politically unacceptable options, but it provides no guidance on (1) the crucial threshold…

Why, When, and How to Take into Account the Uncertainty Involved in Career Decisions.

ERIC Educational Resources Information Center

Gati, Itamar

1990-01-01

Theoretically analyzes career decisions under uncertainty, when career decision maker ranks options rather than choosing best one. Found that how decisions were framed affected ranking of options and quality of decisions. Analysis showed that the rank order of options in optimal ranking always coincided with the rank order of the options by their…

Patient and provider perceptions of decision making about use of epidural analgesia during childbirth: a thematic analysis.

PubMed

Goldberg, Holly Bianca; Shorten, Allison

2014-01-01

This study examines the nature of differences in perceptions of decision making between patients and providers about use of epidural analgesia during labor. Thematic analysis was used to identify patterns in written survey responses from 14 patients, 13 labor nurses, and 7 obstetrician-gynecologists. Results revealed patients attempted to place themselves in an informed role in decision making and sought respect for their decisions. Some providers demonstrated paternalism and a tendency to steer patients in the direction of their own preferences. Nurses observed various pressures on decision making, reinforcing the importance of patients being supported to make an informed choice. Differences in perceptions suggest need for improvement in communication and shared decision-making practices related to epidural analgesia use in labor.

Decision-making impairments in Parkinson's disease as a by-product of defective cost-benefit analysis and feedback processing.

PubMed

Ryterska, Agata; Jahanshahi, Marjan; Osman, Magda

2014-01-01

Studies examining decision-making in people with Parkinson's disease (PD) show impaired performance on a variety of tasks. However, there are also demonstrations that patients with PD can make optimal decisions just like healthy age-matched controls. We propose that the reason for these mixed findings is that PD does not produce a generalized impairment of decision-making, but rather affects sub-components of this process. In this review we evaluate this hypothesis by considering the empirical evidence examining decision-making in PD. We suggest that of the various stages of the decision-making process, the most affected in PD are (1) the cost-benefit analysis stage and (2) the outcome evaluation stage. We consider the implications of this proposal for research in this area.

When do cancer patients regret their treatment decision? A path analysis of the influence of clinicians' communication styles and the match of decision-making styles on decision regret.

PubMed

Nicolai, Jennifer; Buchholz, Angela; Seefried, Nathalie; Reuter, Katrin; Härter, Martin; Eich, Wolfgang; Bieber, Christiane

2016-05-01

To test the influence of physician empathy (PE), shared decision making (SDM), and the match between patients' preferred and perceived decision-making styles on patients' decision regret. Patients with breast or colon cancer (n=71) completed questionnaires immediately following (T1) and three months after a consultation (T2). Path analysis was used to examine the relationships among patient demographics, patient reports of PE, SDM, the match between preferred and perceived decision-making styles, and patient decision regret at T2. After controlling for clinician clusters, higher PE was directly associated with more SDM (β=0.43, p<0.01) and lower decision regret (β=-0.28, p<0.01). The match between patients' preferred and perceived roles was negatively associated with decision regret (β=-0.33, p<0.01). Patients who participated less than desired reported more decision regret at T2. There was no significant association between SDM and decision regret (β=0.03, p=0.74). PE and the match between patients' preferred and perceived roles in medical decision making are essential for patient-centered cancer consultations and treatment decisions. Ways to enhance PE and matching the consultation style to patients' expectations should be encouraged. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Human-computer interface for the study of information fusion concepts in situation analysis and command decision support systems

NASA Astrophysics Data System (ADS)

Roy, Jean; Breton, Richard; Paradis, Stephane

2001-08-01

Situation Awareness (SAW) is essential for commanders to conduct decision-making (DM) activities. Situation Analysis (SA) is defined as a process, the examination of a situation, its elements, and their relations, to provide and maintain a product, i.e., a state of SAW for the decision maker. Operational trends in warfare put the situation analysis process under pressure. This emphasizes the need for a real-time computer-based Situation analysis Support System (SASS) to aid commanders in achieving the appropriate situation awareness, thereby supporting their response to actual or anticipated threats. Data fusion is clearly a key enabler for SA and a SASS. Since data fusion is used for SA in support of dynamic human decision-making, the exploration of the SA concepts and the design of data fusion techniques must take into account human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight human factor aspects in order to ensure a cognitive fit of the fusion system with the decision-maker. Indeed, the tight integration of the human element with the SA technology is essential. Regarding these issues, this paper provides a description of CODSI (Command Decision Support Interface), and operational- like human machine interface prototype for investigations in computer-based SA and command decision support. With CODSI, one objective was to apply recent developments in SA theory and information display technology to the problem of enhancing SAW quality. It thus provides a capability to adequately convey tactical information to command decision makers. It also supports the study of human-computer interactions for SA, and methodologies for SAW measurement.

Robustness Regions for Dichotomous Decisions.

ERIC Educational Resources Information Center

Vijn, Pieter; Molenaar, Ivo W.

1981-01-01

In the case of dichotomous decisions, the total set of all assumptions/specifications for which the decision would have been the same is the robustness region. Inspection of this (data-dependent) region is a form of sensitivity analysis which may lead to improved decision making. (Author/BW)

Dynamics of individual perceptual decisions

PubMed Central

Clark, Torin K.; Lu, Yue M.; Karmali, Faisal

2015-01-01

Perceptual decision making is fundamental to a broad range of fields including neurophysiology, economics, medicine, advertising, law, etc. Although recent findings have yielded major advances in our understanding of perceptual decision making, decision making as a function of time and frequency (i.e., decision-making dynamics) is not well understood. To limit the review length, we focus most of this review on human findings. Animal findings, which are extensively reviewed elsewhere, are included when beneficial or necessary. We attempt to put these various findings and data sets, which can appear to be unrelated in the absence of a formal dynamic analysis, into context using published models. Specifically, by adding appropriate dynamic mechanisms (e.g., high-pass filters) to existing models, it appears that a number of otherwise seemingly disparate findings from the literature might be explained. One hypothesis that arises through this dynamic analysis is that decision making includes phasic (high pass) neural mechanisms, an evidence accumulator and/or some sort of midtrial decision-making mechanism (e.g., peak detector and/or decision boundary). PMID:26467513

The Potential for Meta-Analysis to Support Decision Analysis in Ecology

ERIC Educational Resources Information Center

Mengersen, Kerrie; MacNeil, M. Aaron; Caley, M. Julian

2015-01-01

Meta-analysis and decision analysis are underpinned by well-developed methods that are commonly applied to a variety of problems and disciplines. While these two fields have been closely linked in some disciplines such as medicine, comparatively little attention has been paid to the potential benefits of linking them in ecology, despite reasonable…

Documentation of Decision-Aiding Software: Introductory Guide

DTIC Science & Technology

1980-02-01

for the Manager ( New York: Holt, ’ 6 ( Simply put, the discipline assists planners and deci- sion makers in choosing between alternative courses of...con- ducting international negotiations on tanker safety; g. use by Headquarters, U.S. Marine Corps as an orga- nizing vehicle for the preparation of...literature on decision analysis. For an introductory treatment the reader should refer to Howard Raiffa, Decision Analysis (Reading, Massachusetts

Signal Detection Analysis of Computer Enhanced Group Decision Making Strategies

DTIC Science & Technology

2007-11-01

group decision making. 20 References American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American... Creelman , C. D. (2005). Detection theory: A user’s guide (2nd ed.). Mahwah, NJ: Lawrence Erlbaum. Sorkin, R. D. (1998). Group performance depends on...the majority rule. Psychological Science, 9, 456-463. Sorkin, R. D. (2001). Signal-detection analysis of group decision making. Psychological

The impact of management science on political decision making

NASA Technical Reports Server (NTRS)

White, M. J.

1971-01-01

The possible impact on public policy and organizational decision making of operations research/management science (OR/MS) is discussed. Criticisms based on the assumption that OR/MS will have influence on decision making and criticisms based on the assumption that it will have no influence are described. New directions in the analysis of analysis and in thinking about policy making are also considered.

Safety Assessment of Dangerous Goods Transport Enterprise Based on the Relative Entropy Aggregation in Group Decision Making Model

PubMed Central

Wu, Jun; Li, Chengbing; Huo, Yueying

2014-01-01

Safety of dangerous goods transport is directly related to the operation safety of dangerous goods transport enterprise. Aiming at the problem of the high accident rate and large harm in dangerous goods logistics transportation, this paper took the group decision making problem based on integration and coordination thought into a multiagent multiobjective group decision making problem; a secondary decision model was established and applied to the safety assessment of dangerous goods transport enterprise. First of all, we used dynamic multivalue background and entropy theory building the first level multiobjective decision model. Secondly, experts were to empower according to the principle of clustering analysis, and combining with the relative entropy theory to establish a secondary rally optimization model based on relative entropy in group decision making, and discuss the solution of the model. Then, after investigation and analysis, we establish the dangerous goods transport enterprise safety evaluation index system. Finally, case analysis to five dangerous goods transport enterprises in the Inner Mongolia Autonomous Region validates the feasibility and effectiveness of this model for dangerous goods transport enterprise recognition, which provides vital decision making basis for recognizing the dangerous goods transport enterprises. PMID:25477954

Safety assessment of dangerous goods transport enterprise based on the relative entropy aggregation in group decision making model.

PubMed

Wu, Jun; Li, Chengbing; Huo, Yueying

2014-01-01

Safety of dangerous goods transport is directly related to the operation safety of dangerous goods transport enterprise. Aiming at the problem of the high accident rate and large harm in dangerous goods logistics transportation, this paper took the group decision making problem based on integration and coordination thought into a multiagent multiobjective group decision making problem; a secondary decision model was established and applied to the safety assessment of dangerous goods transport enterprise. First of all, we used dynamic multivalue background and entropy theory building the first level multiobjective decision model. Secondly, experts were to empower according to the principle of clustering analysis, and combining with the relative entropy theory to establish a secondary rally optimization model based on relative entropy in group decision making, and discuss the solution of the model. Then, after investigation and analysis, we establish the dangerous goods transport enterprise safety evaluation index system. Finally, case analysis to five dangerous goods transport enterprises in the Inner Mongolia Autonomous Region validates the feasibility and effectiveness of this model for dangerous goods transport enterprise recognition, which provides vital decision making basis for recognizing the dangerous goods transport enterprises.

Decision-problem state analysis methodology

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A methodology for analyzing a decision-problem state is presented. The methodology is based on the analysis of an incident in terms of the set of decision-problem conditions encountered. By decomposing the events that preceded an unwanted outcome, such as an accident, into the set of decision-problem conditions that were resolved, a more comprehensive understanding is possible. All human-error accidents are not caused by faulty decision-problem resolutions, but it appears to be one of the major areas of accidents cited in the literature. A three-phase methodology is presented which accommodates a wide spectrum of events. It allows for a systems content analysis of the available data to establish: (1) the resolutions made, (2) alternatives not considered, (3) resolutions missed, and (4) possible conditions not considered. The product is a map of the decision-problem conditions that were encountered as well as a projected, assumed set of conditions that should have been considered. The application of this methodology introduces a systematic approach to decomposing the events that transpired prior to the accident. The initial emphasis is on decision and problem resolution. The technique allows for a standardized method of accident into a scenario which may used for review or the development of a training simulation.

Real options analysis for land use management: Methods, application, and implications for policy.

PubMed

Regan, Courtney M; Bryan, Brett A; Connor, Jeffery D; Meyer, Wayne S; Ostendorf, Bertram; Zhu, Zili; Bao, Chenming

2015-09-15

Discounted cash flow analysis, including net present value is an established way to value land use and management investments which accounts for the time-value of money. However, it provides a static view and assumes passive commitment to an investment strategy when real world land use and management investment decisions are characterised by uncertainty, irreversibility, change, and adaptation. Real options analysis has been proposed as a better valuation method under uncertainty and where the opportunity exists to delay investment decisions, pending more information. We briefly review the use of discounted cash flow methods in land use and management and discuss their benefits and limitations. We then provide an overview of real options analysis, describe the main analytical methods, and summarize its application to land use investment decisions. Real options analysis is largely underutilized in evaluating land use decisions, despite uncertainty in policy and economic drivers, the irreversibility and sunk costs involved. New simulation methods offer the potential for overcoming current technical challenges to implementation as demonstrated with a real options simulation model used to evaluate an agricultural land use decision in South Australia. We conclude that considering option values in future policy design will provide a more realistic assessment of landholder investment decision making and provide insights for improved policy performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Uncertainty

USGS Publications Warehouse

Hunt, Randall J.

2012-01-01

Management decisions will often be directly informed by model predictions. However, we now know there can be no expectation of a single ‘true’ model; thus, model results are uncertain. Understandable reporting of underlying uncertainty provides necessary context to decision-makers, as model results are used for management decisions. This, in turn, forms a mechanism by which groundwater models inform a risk-management framework because uncertainty around a prediction provides the basis for estimating the probability or likelihood of some event occurring. Given that the consequences of management decisions vary, it follows that the extent of and resources devoted to an uncertainty analysis may depend on the consequences. For events with low impact, a qualitative, limited uncertainty analysis may be sufficient for informing a decision. For events with a high impact, on the other hand, the risks might be better assessed and associated decisions made using a more robust and comprehensive uncertainty analysis. The purpose of this chapter is to provide guidance on uncertainty analysis through discussion of concepts and approaches, which can vary from heuristic (i.e. the modeller’s assessment of prediction uncertainty based on trial and error and experience) to a comprehensive, sophisticated, statistics-based uncertainty analysis. Most of the material presented here is taken from Doherty et al. (2010) if not otherwise cited. Although the treatment here is necessarily brief, the reader can find citations for the source material and additional references within this chapter.

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

PubMed

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

2016-01-01

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

Decision analysis with cumulative prospect theory.

PubMed

Bayoumi, A M; Redelmeier, D A

2000-01-01

Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

Development of a Shared Decision Making coding system for analysis of patient-healthcare provider encounters

PubMed Central

Clayman, Marla L.; Makoul, Gregory; Harper, Maya M.; Koby, Danielle G.; Williams, Adam R.

2012-01-01

Objectives Describe the development and refinement of a scheme, Detail of Essential Elements and Participants in Shared Decision Making (DEEP-SDM), for coding Shared Decision Making (SDM) while reporting on the characteristics of decisions in a sample of patients with metastatic breast cancer. Methods The Evidence-Based Patient Choice instrument was modified to reflect Makoul and Clayman’s Integrative Model of SDM. Coding was conducted on video recordings of 20 women at the first visit with their medical oncologists after suspicion of disease progression. Noldus Observer XT v.8, a video coding software platform, was used for coding. Results The sample contained 80 decisions (range: 1-11), divided into 150 decision making segments. Most decisions were physician-led, although patients and physicians initiated similar numbers of decision-making conversations. Conclusion DEEP-SDM facilitates content analysis of encounters between women with metastatic breast cancer and their medical oncologists. Despite the fractured nature of decision making, it is possible to identify decision points and to code each of the Essential Elements of Shared Decision Making. Further work should include application of DEEP-SDM to non-cancer encounters. Practice Implications: A better understanding of how decisions unfold in the medical encounter can help inform the relationship of SDM to patient-reported outcomes. PMID:22784391

Hierarchical Task Analysis and Training Decisions.

ERIC Educational Resources Information Center

Shepherd, A.

1985-01-01

Hierarchical task analysis (HTA), which requires description of a task in terms of a hierarchy of operations and plans, is reviewed and examined as a basis for making training decisions. Benefits of HTA in terms of economy of analysis and as a means of accounting for complex performance are outlined. (Author/MBR)

Applying Recursive Sensitivity Analysis to Multi-Criteria Decision Models to Reduce Bias in Defense Cyber Engineering Analysis

DTIC Science & Technology

2015-10-28

techniques such as regression analysis, correlation, and multicollinearity assessment to identify the change and error on the input to the model...between many of the independent or predictor variables, the issue of multicollinearity may arise [18]. VII. SUMMARY Accurate decisions concerning

Revisiting the Psychology of Intelligence Analysis: From Rational Actors to Adaptive Thinkers

ERIC Educational Resources Information Center

Puvathingal, Bess J.; Hantula, Donald A.

2012-01-01

Intelligence analysis is a decision-making process rife with ambiguous, conflicting, irrelevant, important, and excessive information. The U.S. Intelligence Community is primed for psychology to lend its voice to the "analytic transformation" movement aimed at improving the quality of intelligence analysis. Traditional judgment and decision making…

Causal Analysis/Diagnosis Decision Information System (CADDIS)

EPA Pesticide Factsheets

The Causal Analysis/Diagnosis Decision Information System, or CADDIS, is a website developed to help scientists and engineers in the Regions, States, and Tribes conduct causal assessments in aquatic systems to determine the cause of contamination.

The Application of Climate Risk Informed Decision Analysis to the Ioland Water Treatment Plant in Lusaka, Zambia

NASA Astrophysics Data System (ADS)

Kucharski, John; Tkach, Mark; Olszewski, Jennifer; Chaudhry, Rabia; Mendoza, Guillermo

2016-04-01

This presentation demonstrates the application of Climate Risk Informed Decision Analysis (CRIDA) at Zambia's principal water treatment facility, The Iolanda Water Treatment Plant. The water treatment plant is prone to unacceptable failures during periods of low hydropower production at the Kafue Gorge Dam Hydroelectric Power Plant. The case study explores approaches of increasing the water treatment plant's ability to deliver acceptable levels of service under the range of current and potential future climate states. The objective of the study is to investigate alternative investments to build system resilience that might have been informed by the CRIDA process, and to evaluate the extra resource requirements by a bilateral donor agency to implement the CRIDA process. The case study begins with an assessment of the water treatment plant's vulnerability to climate change. It does so by following general principals described in "Confronting Climate Uncertainty in Water Resource Planning and Project Design: the Decision Tree Framework". By utilizing relatively simple bootstrapping methods a range of possible future climate states is generated while avoiding the use of more complex and costly downscaling methodologies; that are beyond the budget and technical capacity of many teams. The resulting climate vulnerabilities and uncertainty in the climate states that produce them are analyzed as part of a "Level of Concern" analysis. CRIDA principals are then applied to this Level of Concern analysis in order to arrive at a set of actionable water management decisions. The principal goals of water resource management is to transform variable, uncertain hydrology into dependable services (e.g. water supply, flood risk reduction, ecosystem benefits, hydropower production, etc…). Traditional approaches to climate adaptation require the generation of predicted future climate states but do little guide decision makers how this information should impact decision making. In this context it is not surprising that the increased hydrologic variability and uncertainty produced by many climate risk analyses bedevil water resource decision making. The Climate Risk Informed Decision Analysis (CRIDA) approach builds on work found in "Confronting Climate Uncertainty in Water Resource Planning and Project Design: the Decision Tree Framework" which provide guidance of vulnerability assessments. It guides practitioners through a "Level of Concern" analysis where climate vulnerabilities are analyzed to produce actionable alternatives and decisions.

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

EPA Science Inventory

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

PATIENT-CENTERED DECISION MAKING: LESSONS FROM MULTI-CRITERIA DECISION ANALYSIS FOR QUANTIFYING PATIENT PREFERENCES.

PubMed

Marsh, Kevin; Caro, J Jaime; Zaiser, Erica; Heywood, James; Hamed, Alaa

2018-01-01

Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered. This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences. The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported. The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.

Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

PubMed

Dhukaram, Anandhi Vivekanandan; Baber, Chris

2015-06-01

Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Characterising bias in regulatory risk and decision analysis: An analysis of heuristics applied in health technology appraisal, chemicals regulation, and climate change governance.

PubMed

MacGillivray, Brian H

2017-08-01

In many environmental and public health domains, heuristic methods of risk and decision analysis must be relied upon, either because problem structures are ambiguous, reliable data is lacking, or decisions are urgent. This introduces an additional source of uncertainty beyond model and measurement error - uncertainty stemming from relying on inexact inference rules. Here we identify and analyse heuristics used to prioritise risk objects, to discriminate between signal and noise, to weight evidence, to construct models, to extrapolate beyond datasets, and to make policy. Some of these heuristics are based on causal generalisations, yet can misfire when these relationships are presumed rather than tested (e.g. surrogates in clinical trials). Others are conventions designed to confer stability to decision analysis, yet which may introduce serious error when applied ritualistically (e.g. significance testing). Some heuristics can be traced back to formal justifications, but only subject to strong assumptions that are often violated in practical applications. Heuristic decision rules (e.g. feasibility rules) in principle act as surrogates for utility maximisation or distributional concerns, yet in practice may neglect costs and benefits, be based on arbitrary thresholds, and be prone to gaming. We highlight the problem of rule-entrenchment, where analytical choices that are in principle contestable are arbitrarily fixed in practice, masking uncertainty and potentially introducing bias. Strategies for making risk and decision analysis more rigorous include: formalising the assumptions and scope conditions under which heuristics should be applied; testing rather than presuming their underlying empirical or theoretical justifications; using sensitivity analysis, simulations, multiple bias analysis, and deductive systems of inference (e.g. directed acyclic graphs) to characterise rule uncertainty and refine heuristics; adopting "recovery schemes" to correct for known biases; and basing decision rules on clearly articulated values and evidence, rather than convention. Copyright © 2017. Published by Elsevier Ltd.

An EGR performance evaluation and decision-making approach based on grey theory and grey entropy analysis

PubMed Central

2018-01-01

Exhaust gas recirculation (EGR) is one of the main methods of reducing NOX emissions and has been widely used in marine diesel engines. This paper proposes an optimized comprehensive assessment method based on multi-objective grey situation decision theory, grey relation theory and grey entropy analysis to evaluate the performance and optimize rate determination of EGR, which currently lack clear theoretical guidance. First, multi-objective grey situation decision theory is used to establish the initial decision-making model according to the main EGR parameters. The optimal compromise between diesel engine combustion and emission performance is transformed into a decision-making target weight problem. After establishing the initial model and considering the characteristics of EGR under different conditions, an optimized target weight algorithm based on grey relation theory and grey entropy analysis is applied to generate the comprehensive evaluation and decision-making model. Finally, the proposed method is successfully applied to a TBD234V12 turbocharged diesel engine, and the results clearly illustrate the feasibility of the proposed method for providing theoretical support and a reference for further EGR optimization. PMID:29377956

An EGR performance evaluation and decision-making approach based on grey theory and grey entropy analysis.

PubMed

Zu, Xianghuan; Yang, Chuanlei; Wang, Hechun; Wang, Yinyan

2018-01-01

Exhaust gas recirculation (EGR) is one of the main methods of reducing NOX emissions and has been widely used in marine diesel engines. This paper proposes an optimized comprehensive assessment method based on multi-objective grey situation decision theory, grey relation theory and grey entropy analysis to evaluate the performance and optimize rate determination of EGR, which currently lack clear theoretical guidance. First, multi-objective grey situation decision theory is used to establish the initial decision-making model according to the main EGR parameters. The optimal compromise between diesel engine combustion and emission performance is transformed into a decision-making target weight problem. After establishing the initial model and considering the characteristics of EGR under different conditions, an optimized target weight algorithm based on grey relation theory and grey entropy analysis is applied to generate the comprehensive evaluation and decision-making model. Finally, the proposed method is successfully applied to a TBD234V12 turbocharged diesel engine, and the results clearly illustrate the feasibility of the proposed method for providing theoretical support and a reference for further EGR optimization.

Brain network response underlying decisions about abstract reinforcers.

PubMed

Mills-Finnerty, Colleen; Hanson, Catherine; Hanson, Stephen Jose

2014-12-01

Decision making studies typically use tasks that involve concrete action-outcome contingencies, in which subjects do something and get something. No studies have addressed decision making involving abstract reinforcers, where there are no action-outcome contingencies and choices are entirely hypothetical. The present study examines these kinds of choices, as well as whether the same biases that exist for concrete reinforcer decisions, specifically framing effects, also apply during abstract reinforcer decisions. We use both General Linear Model as well as Bayes network connectivity analysis using the Independent Multi-sample Greedy Equivalence Search (IMaGES) algorithm to examine network response underlying choices for abstract reinforcers under positive and negative framing. We find for the first time that abstract reinforcer decisions activate the same network of brain regions as concrete reinforcer decisions, including the striatum, insula, anterior cingulate, and VMPFC, results that are further supported via comparison to a meta-analysis of decision making studies. Positive and negative framing activated different parts of this network, with stronger activation in VMPFC during negative framing and in DLPFC during positive, suggesting different decision making pathways depending on frame. These results were further clarified using connectivity analysis, which revealed stronger connections between anterior cingulate, insula, and accumbens during negative framing compared to positive. Taken together, these results suggest that not only do abstract reinforcer decisions rely on the same brain substrates as concrete reinforcers, but that the response underlying framing effects on abstract reinforcers also resemble those for concrete reinforcers, specifically increased limbic system connectivity during negative frames. Copyright © 2014 Elsevier Inc. All rights reserved.

Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis.

PubMed

Wyatt, Kirk D; Branda, Megan E; Inselman, Jonathan W; Ting, Henry H; Hess, Erik P; Montori, Victor M; LeBlanc, Annie

2014-09-02

Gender differences in communication styles between clinicians and patients have been postulated to impact patient care, but the extent to which the gender dyad structure impacts outcomes in shared decision making remains unclear. Participant-level meta-analysis of 775 clinical encounters within 7 randomized trials where decision aids, shared decision making tools, were used at the point of care. Outcomes analysed include decisional conflict scale scores, satisfaction with the clinical encounter, concordance between stated decision and action taken, and degree of patient engagement by the clinician using the OPTION scale. An estimated minimal important difference was used to determine if nonsignificant results could be explained by low power. We did not find a statistically significant interaction between clinician/patient gender mix and arm for decisional conflict, satisfaction with the clinical encounter or patient engagement. A borderline significant interaction (p = 0.05) was observed for one outcome: concordance between stated decision and action taken, where encounters with female clinician/male patient showed increased concordance in the decision aid arm compared to control (8% more concordant encounters). All other gender dyads showed decreased concordance with decision aid use (6% fewer concordant encounters for same-gender, 16% fewer concordant encounters for male clinician/female patient). In this participant-level meta-analysis of 7 randomized trials, decision aids used at the point of care demonstrated comparable efficacy across gender dyads. Purported barriers to shared decision making based on gender were not detected when tested for a minimum detected difference. ClinicalTrials.gov NCT00888537, NCT01077037, NCT01029288, NCT00388050, NCT00578981, NCT00949611, NCT00217061.

ELICIT: An alternative imprecise weight elicitation technique for use in multi-criteria decision analysis for healthcare.

PubMed

Diaby, Vakaramoko; Sanogo, Vassiki; Moussa, Kouame Richard

2016-01-01

In this paper, the readers are introduced to ELICIT, an imprecise weight elicitation technique for multicriteria decision analysis for healthcare. The application of ELICIT consists of two steps: the rank ordering of evaluation criteria based on decision-makers' (DMs) preferences using the principal component analysis; and the estimation of criteria weights and their descriptive statistics using the variable interdependent analysis and the Monte Carlo method. The application of ELICIT is illustrated with a hypothetical case study involving the elicitation of weights for five criteria used to select the best device for eye surgery. The criteria were ranked from 1-5, based on a strict preference relationship established by the DMs. For each criterion, the deterministic weight was estimated as well as the standard deviation and 95% credibility interval. ELICIT is appropriate in situations where only ordinal DMs' preferences are available to elicit decision criteria weights.

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

PubMed

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

2017-08-16

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

Learning from examples - Generation and evaluation of decision trees for software resource analysis

NASA Technical Reports Server (NTRS)

Selby, Richard W.; Porter, Adam A.

1988-01-01

A general solution method for the automatic generation of decision (or classification) trees is investigated. The approach is to provide insights through in-depth empirical characterization and evaluation of decision trees for software resource data analysis. The trees identify classes of objects (software modules) that had high development effort. Sixteen software systems ranging from 3,000 to 112,000 source lines were selected for analysis from a NASA production environment. The collection and analysis of 74 attributes (or metrics), for over 4,700 objects, captured information about the development effort, faults, changes, design style, and implementation style. A total of 9,600 decision trees were automatically generated and evaluated. The trees correctly identified 79.3 percent of the software modules that had high development effort or faults, and the trees generated from the best parameter combinations correctly identified 88.4 percent of the modules on the average.

The use of a cognitive task analysis-based multimedia program to teach surgical decision making in flexor tendon repair.

PubMed

Luker, Kali R; Sullivan, Maura E; Peyre, Sarah E; Sherman, Randy; Grunwald, Tiffany

2008-01-01

The aim of this study was to compare the surgical knowledge of residents before and after receiving a cognitive task analysis-based multimedia teaching module. Ten plastic surgery residents were evaluated performing flexor tendon repair on 3 occasions. Traditional learning occurred between the first and second trial and served as the control. A teaching module was introduced as an intervention between the second and third trial using cognitive task analysis to illustrate decision-making skills. All residents showed improvement in their decision-making ability when performing flexor tendon repair after each surgical procedure. The group improved through traditional methods as well as exposure to our talk-aloud protocol (P > .01). After being trained using the cognitive task analysis curriculum the group displayed a statistically significant knowledge expansion (P < .01). Residents receiving cognitive task analysis-based multimedia surgical curriculum instruction achieved greater command of problem solving and are better equipped to make correct decisions in flexor tendon repair.

Egalitarianism and Achievement in the Involvement of Others in Consumer Decisions: A Functional Analysis.

ERIC Educational Resources Information Center

Miller, Duane I.

1980-01-01

Studied how egalitaranism and success through individual achievement, were expressed in the involvement of others in consumer decisions. Results found egalitarians involved others in seeking more information. Individual achievement subjects delegated more decision responsibility for non-ego involving decisions. Suggests involvement of others could…

Logit Estimation of a Gravity Model of the College Enrollment Decision.

ERIC Educational Resources Information Center

Leppel, Karen

1993-01-01

A study investigated the factors influencing students' decisions about attending a college to which they had been admitted. Logit analysis confirmed gravity model predictions that geographic distance and student ability would most influence the enrollment decision and found other variables, although affecting earlier stages of decision making, did…

A Critical Analysis of HRD Evaluation Models from a Decision-Making Perspective

ERIC Educational Resources Information Center

Holton, Elwood F., III; Naquin, Sharon

2005-01-01

HRD evaluation models are recommended for use by organizations to improve decisions made about HRD interventions. However, the organizational decision-making literature has been virtually ignored by evaluation researchers. In this article, we review the organizational decision-making literature and critically review HRD evaluation research through…

Decision-Making Theory Applied to Architectural Programming: Some Research Implications.

ERIC Educational Resources Information Center

Green, Meg

The implications of delineating and determining the sequence of programming decisions are shown in the selection of building committee membership. The role relationships of client and architect are discussed in terms of decision-making function. Decision tables are described as aids in problem analysis. Other topics include information and…

12 CFR 313.90 - Content of decision.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Content of decision. 313.90 Section 313.90... CORPORATE DEBT COLLECTION Administrative Wage Garnishment § 313.90 Content of decision. The written decision shall include: (a) A summary of the facts presented; (b) The hearing official's findings, analysis and...

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

PubMed

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

2015-02-01

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

Web-Based Versus Usual Care and Other Formats of Decision Aids to Support Prostate Cancer Screening Decisions: Systematic Review and Meta-Analysis.

PubMed

Baptista, Sofia; Teles Sampaio, Elvira; Heleno, Bruno; Azevedo, Luís Filipe; Martins, Carlos

2018-06-26

Prostate cancer is a leading cause of cancer among men. Because screening for prostate cancer is a controversial issue, many experts in the field have defended the use of shared decision making using validated decision aids, which can be presented in different formats (eg, written, multimedia, Web). Recent studies have concluded that decision aids improve knowledge and reduce decisional conflict. This meta-analysis aimed to investigate the impact of using Web-based decision aids to support men's prostate cancer screening decisions in comparison with usual care and other formats of decision aids. We searched PubMed, CINAHL, PsycINFO, and Cochrane CENTRAL databases up to November 2016. This search identified randomized controlled trials, which assessed Web-based decision aids for men making a prostate cancer screening decision and reported quality of decision-making outcomes. Two reviewers independently screened citations for inclusion criteria, extracted data, and assessed risk of bias. Using a random-effects model, meta-analyses were conducted pooling results using mean differences (MD), standardized mean differences (SMD), and relative risks (RR). Of 2406 unique citations, 7 randomized controlled trials met the inclusion criteria. For risk of bias, selective outcome reporting and participant/personnel blinding were mostly rated as unclear due to inadequate reporting. Based on seven items, two studies had high risk of bias for one item. Compared to usual care, Web-based decision aids increased knowledge (SMD 0.46; 95% CI 0.18-0.75), reduced decisional conflict (MD -7.07%; 95% CI -9.44 to -4.71), and reduced the practitioner control role in the decision-making process (RR 0.50; 95% CI 0.31-0.81). Web-based decision aids compared to printed decision aids yielded no differences in knowledge, decisional conflict, and participation in decision or screening behaviors. Compared to video decision aids, Web-based decision aids showed lower average knowledge scores (SMD -0.50; 95% CI -0.88 to -0.12) and a slight decrease in prostate-specific antigen screening (RR 1.12; 95% CI 1.01-1.25). According to this analysis, Web-based decision aids performed similarly to alternative formats (ie, printed, video) for the assessed decision-quality outcomes. The low cost, readiness, availability, and anonymity of the Web can be an advantage for increasing access to decision aids that support prostate cancer screening decisions among men. ©Sofia Baptista, Elvira Teles Sampaio, Bruno Heleno, Luís Filipe Azevedo, Carlos Martins. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 26.06.2018.

Sensitivity Analysis in Sequential Decision Models.

PubMed

Chen, Qiushi; Ayer, Turgay; Chhatwal, Jagpreet

2017-02-01

Sequential decision problems are frequently encountered in medical decision making, which are commonly solved using Markov decision processes (MDPs). Modeling guidelines recommend conducting sensitivity analyses in decision-analytic models to assess the robustness of the model results against the uncertainty in model parameters. However, standard methods of conducting sensitivity analyses cannot be directly applied to sequential decision problems because this would require evaluating all possible decision sequences, typically in the order of trillions, which is not practically feasible. As a result, most MDP-based modeling studies do not examine confidence in their recommended policies. In this study, we provide an approach to estimate uncertainty and confidence in the results of sequential decision models. First, we provide a probabilistic univariate method to identify the most sensitive parameters in MDPs. Second, we present a probabilistic multivariate approach to estimate the overall confidence in the recommended optimal policy considering joint uncertainty in the model parameters. We provide a graphical representation, which we call a policy acceptability curve, to summarize the confidence in the optimal policy by incorporating stakeholders' willingness to accept the base case policy. For a cost-effectiveness analysis, we provide an approach to construct a cost-effectiveness acceptability frontier, which shows the most cost-effective policy as well as the confidence in that for a given willingness to pay threshold. We demonstrate our approach using a simple MDP case study. We developed a method to conduct sensitivity analysis in sequential decision models, which could increase the credibility of these models among stakeholders.

Multi-criteria decision making to support waste management: A critical review of current practices and methods.

PubMed

Goulart Coelho, Lineker M; Lange, Liséte C; Coelho, Hosmanny Mg

2017-01-01

Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.

Shared decision-making in the paediatric field: a literature review and concept analysis.

PubMed

Park, Eun Sook; Cho, In Young

2017-09-13

The concept of shared decision-making is poorly defined and often used interchangeably with related terms. The aim of this study was to delineate and clarify the concept of shared decision-making in the paediatric field. Rodgers and Knafl's evolutionary concept analysis was used to delineate and clarify the concept. Following a search of the CINAHL, PubMed and MEDLINE databases and online journals between 1995 and 2016, we included a total of 42 articles that referred to shared decision-making in the paediatric field. The attributes included active participation of the three: parents, children and health professionals; collaborative partnership; reaching a compromise; and common goal for child's health. Antecedents were existing several options with different possible outcomes; substantial decisional conflict; recognising child's health situations that decision-making is needed; and willingness to participate in decision-making. Finally, the consequences included decreased decisional conflict; mutual empowerment; improved child health status; and improved quality of paediatric health care. This study provides a theoretical understanding of the concept of shared decision-making in the paediatric field; furthermore, by integrating this concept into paediatric practice, it may help to reduce the gap between theory and practice. The analysis could also provide nursing researchers with insight into paediatric decision-making and establish a foundation to develop future interventions and situation-specific theory for promoting high-quality decision-making in the paediatric field. © 2017 Nordic College of Caring Science.

Opinion Dynamics and Decision of Vote in Bipolar Political Systems

NASA Astrophysics Data System (ADS)

Caruso, Filippo; Castorina, Paolo

A model of the opinion dynamics underlying the political decision is proposed. The analysis is restricted to a bipolar scheme with a possible third political area. The interaction among voters is local but the final decision strongly depends on global effects such as the rating of the governments. As in the realistic case, the individual decision making process is determined by the most relevant personal interests and problems. The phenomenological analysis of the national vote in Italy and Germany has been carried out and a prediction of the next Italian vote as a function of the government rating is presented.

Decision-making in rectal and colorectal cancer: systematic review and qualitative analysis of surgeons' preferences.

PubMed

Broc, Guillaume; Gana, Kamel; Denost, Quentin; Quintard, Bruno

2017-04-01

Surgeons are experiencing difficulties implementing recommendations not only owing to incomplete, confusing or conflicting information but also to the increasing involvement of patients in decisions relating to their health. This study sought to establish which common factors including heuristic factors guide surgeons' decision-making in colon and rectal cancers. We conducted a systematic literature review of surgeons' decision-making factors related to colon and rectal cancer treatment. Eleven of 349 identified publications were eligible for data analyses. Using the IRaMuTeQ (Interface of R for the Multidimensional Analyses of Texts and Questionnaire), we carried out a qualitative analysis of the significant factors collected in the studies reviewed. Several validation procedures were applied to control the robustness of the findings. Five categories of factors (i.e. patient, surgeon, treatment, tumor and organizational cues) were found to influence surgeons' decision-making. Specifically, all decision criteria including biomedical (e.g. tumor information) and heuristic (e.g. surgeons' dispositional factors) criteria converged towards the factor 'age of patient' in the similarity analysis. In the light of the results, we propose an explanatory model showing the impact of heuristic criteria on medical issues (i.e. diagnosis, prognosis, treatment features, etc.) and thus on decision-making. Finally, the psychosocial complexity involved in decision-making is discussed and a medico-psycho-social grid for use in multidisciplinary meetings is proposed.

More primary care patients regret health decisions if they experienced decisional conflict in the consultation: a secondary analysis of a multicenter descriptive study.

PubMed

Becerra-Perez, Maria-Margarita; Menear, Matthew; Turcotte, Stephane; Labrecque, Michel; Légaré, France

2016-11-10

We sought to estimate the extent of decision regret among primary care patients and identify risk factors associated with regret. Secondary analysis of an observational descriptive study conducted in two Canadian provinces. Unique patient-physician dyads were recruited from 17 primary care clinics and data on patient, physician and consultation characteristics were collected before, during and immediately after consultations, as well as two weeks post-consultation, when patients completed the Decision Regret Scale (DRS). We examined the DRS score distribution and performed ordinal logistic regression analysis to identify predictors of regret. Among 258 unique patient-physicians dyads, mean ± standard deviation of decision regret scores was 11.7 ± 15.1 out of 100. Overall, 43 % of patients reported no regret, 45 % reported mild regret and 12 % reported moderate to strong regret. In multivariate analyses, higher decision regret was strongly associated with increased decisional conflict and less significantly associated with patient age and education, as well with male (vs. female) physicians and residents (vs. teachers). After consulting family physicians, most primary care patients experience little decision regret, but some experience more regret if there is decisional conflict. Strategies for reducing decisional conflict in primary care, such as shared decision-making with decision aids, seem warranted.

A decision impact, decision conflict and economic assessment of routine Oncotype DX testing of 146 women with node-negative or pNImi, ER-positive breast cancer in the U.K.

PubMed

Holt, S; Bertelli, G; Humphreys, I; Valentine, W; Durrani, S; Pudney, D; Rolles, M; Moe, M; Khawaja, S; Sharaiha, Y; Brinkworth, E; Whelan, S; Jones, S; Bennett, H; Phillips, C J

2013-06-11

Tumour gene expression analysis is useful in predicting adjuvant chemotherapy benefit in early breast cancer patients. This study aims to examine the implications of routine Oncotype DX testing in the U.K. Women with oestrogen receptor positive (ER+), pNO or pN1mi breast cancer were assessed for adjuvant chemotherapy and subsequently offered Oncotype DX testing, with changes in chemotherapy decisions recorded. A subset of patients completed questionnaires about their uncertainties regarding chemotherapy decisions pre- and post-testing. All patients were asked to complete a diary of medical interactions over the next 6 months, from which economic data were extracted to model the cost-effectiveness of testing. Oncotype DX testing resulted in changes in chemotherapy decisions in 38 of 142 (26.8%) women, with 26 of 57 (45.6%) spared chemotherapy and 12 of 85 (14.1%) requiring chemotherapy when not initially recommended (9.9% reduction overall). Decision conflict analysis showed that Oncotype DX testing increased patients' confidence in treatment decision making. Economic analysis showed that routine Oncotype DX testing costs £6232 per quality-adjusted life year gained. Oncotype DX decreased chemotherapy use and increased confidence in treatment decision making in patients with ER+ early-stage breast cancer. Based on these findings, Oncotype DX is cost-effective in the UK setting.

Policy Analysis | Energy Analysis | NREL

Science.gov Websites

policymakers and inform decision making. Featured Analysis 2016: Measuring the Impacts of Federal Tax Credit state policy on decision makers. Learn more about clean energy policy on the NREL State and Local Portfolio Standards also shows national water withdrawals and water consumption by fossil-fuel plants were

34 CFR 602.36 - Senior Department official's decision.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the agency with an opportunity to respond to the final staff analysis. Any decision made by the senior...; and (2) The staff with an opportunity to present its analysis in writing. (g) If relevant and material... matter to Department staff for review and analysis under § 602.32 or § 602.33, as appropriate, and...

Developing a Value Framework: The Need to Reflect the Opportunity Costs of Funding Decisions.

PubMed

Sculpher, Mark; Claxton, Karl; Pearson, Steven D

2017-02-01

A growing number of health care systems internationally use formal economic evaluation methods to support health care funding decisions. Recently, a range of organizations have been advocating forms of analysis that have been termed "value frameworks." There has also been a push for analytical methods to reflect a fuller range of benefits of interventions through multicriteria decision analysis. A key principle that is invariably neglected in current and proposed frameworks is the need to reflect evidence on the opportunity costs that health systems face when making funding decisions. The mechanisms by which opportunity costs are realized vary depending on the system's financial arrangements, but they always mean that a decision to fund a specific intervention for a particular patient group has the potential to impose costs on others in terms of forgone benefits. These opportunity costs are rarely explicitly reflected in analysis to support decisions, but recent developments to quantify benefits forgone make more appropriate analyses feasible. Opportunity costs also need to be reflected in decisions if a broader range of attributes of benefit is considered, and opportunity costs are a key consideration in determining the appropriate level of total expenditure in a system. The principles by which opportunity costs can be reflected in analysis are illustrated in this article by using the example of the proposed methods for value-based pricing in the United Kingdom. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

SPATIAL ANALYSIS AND DECISION ASSISTANCE (SADA) TRAINING COURSE

EPA Science Inventory

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

Integrating Climate and Risk-Informed Science to Support Critical Decisions

ScienceCinema

None

2018-01-16

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Integrating Climate and Risk-Informed Science to Support Critical Decisions

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

None

2016-07-27

The PNNL Environmental Health and Remediation Sector stewards several decision support capabilities to integrate climate- and risk-informed science to support critical decisions. Utilizing our expertise in risk and decision analysis, integrated Earth systems modeling, and remote sensing and geoinformatics, PNNL is influencing the way science informs high level decisions at national, regional and local scales to protect and preserve our most critical assets.

Shaping the Conversation: A Secondary Analysis of Reproductive Decision-Making Among Black Mothers with HIV.

PubMed

Amutah, Ndidiamaka N; Gifuni, Jacqueline; Wesley, Yvonne

2016-01-01

The purpose of this qualitative secondary data analysis is to examine the major influencers on mothers with HIV in their childbearing decisions, as well as how those influencers shape conversations with clinicians and health-care providers regarding HIV treatment and prevention. The original study gained insight into the reproductive decision-making of mothers with HIV. By analyzing a subsample of 15 interviews from an original cohort of 25 participants in the earlier study, three major themes were identified as follows: (1) family members, not health-care providers, influence reproductive decisions; (2) negative attitudes toward subsequent pregnancies are mainly due to HIV transmission; and (3) birth control decisions were predominately supported by family members, while health-care providers were not consulted.

Risk manager formula for success: Influencing decision making.

PubMed

Midgley, Mike

2017-10-01

Providing the ultimate decision makers with a quantitative risk analysis based on thoughtful assessment by the organization's experts enables an efficient decision. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

The use of economic evaluations in NHS decision-making: a review and empirical investigation.

PubMed

Williams, I; McIver, S; Moore, D; Bryan, S

2008-04-01

To determine the extent to which health economic information is used in health policy decision-making in the UK, and to consider factors associated with the utilisation of such research findings. Major electronic databases were searched up to 2004. A systematic review of existing reviews on the use of economic evaluations in policy decision-making, of health and non-health literature on the use of economic analyses in policy making and of studies identifying actual or perceived barriers to the use of economic evaluations was undertaken. Five UK case studies of committees from four local and one national organisation [the Technology Appraisal Committee of the National Institute for Health and Clinical Excellence (NICE)] were conducted. Local case studies were augmented by documentary analysis of new technology request forms and by workshop discussions with members of local decision-making committees. The systematic review demonstrated few previous systematic reviews of evidence in the area. At the local level in the NHS, it was an exception for economic evaluation to inform technology coverage decisions. Local decision-making focused primarily on evidence of clinical benefit and cost implications. And whilst information on implementation was frequently requested, cost-effectiveness information was rarely accessed. A number of features of the decision-making environment appeared to militate against emphasis on cost-effectiveness analysis. Constraints on the capacity to generate, access and interpret information, led to a minor role for cost-effectiveness analysis in the local decision-making process. At the national policy level in the UK, economic analysis was found to be highly integrated into NICE's technology appraisal programme. Attitudes to economic evaluation varied between committee members with some significant disagreement and extraneous factors diluted the health economics analysis available to the committee. There was strong evidence of an ordinal approach to consideration of clinical effectiveness and cost-effectiveness information. Some interviewees considered the key role of a cost-effectiveness analysis to be the provision of a framework for decision-making. Interviewees indicated that NICE makes use of some form of cost-effectiveness threshold but expressed concern about its basis and its use in decision-making. Frustrations with the appraisal process were expressed in terms of the scope of the policy question being addressed. Committee members raised concerns about lack of understanding of the economic analysis but felt that a single measure of benefit, e.g. the quality-adjusted life-year, was useful in allowing comparison of disparate health interventions and in providing a benchmark for later decisions. The importance of ensuring that committee members understood the limitations of the analysis was highlighted for model-based analyses. This study suggests that research is needed into structures, processes and mechanisms by which technology coverage decisions can and should be made in healthcare. Further development of 'resource centres' may be useful to provide independent published analyses in order to support local decision-makers. Improved methods of economic analyses and of their presentation, which take account of the concerns of their users, are needed. Finally, the findings point to the need for further assessment of the feasibility and value of a formal process of clarification of the objectives that we seek from investments in healthcare.

Development of Decision Analysis Specifically for Arctic Offshore Drilling Islands.

DTIC Science & Technology

1985-12-01

the decision analysis method will - give tradeoffs between costs and design wave height, production and depth • :of water for an oil platform , etc...optimizing the type of platform that is best suited for a particular site has become an extremely difficult decision. Over fifty- one different types of...drilling and production platforms have been identified for the Arctic environment, with new concepts being developed - every year, Boslov et al (198j

Skill Transfer and Virtual Training for IND Response Decision-Making: Analysis of Decision-Making Skills for Large Scale Incidents

DTIC Science & Technology

2016-01-01

issues comes from the Fukushima Daiichi nuclear disaster (2011). The local medical health professional on staff at the U.S. embassy in Tokyo was not...distribution unlimited. This page intentionally left blank. iii EXECUTIVE SUMMARY An improvised nuclear device (IND...from the phase one analysis are as follows : • There is strong consistency in both the key decisions and underlying skills emphasized by emergency

Model of the best-of-N nest-site selection process in honeybees.

PubMed

Reina, Andreagiovanni; Marshall, James A R; Trianni, Vito; Bose, Thomas

2017-05-01

The ability of a honeybee swarm to select the best nest site plays a fundamental role in determining the future colony's fitness. To date, the nest-site selection process has mostly been modeled and theoretically analyzed for the case of binary decisions. However, when the number of alternative nests is larger than two, the decision-process dynamics qualitatively change. In this work, we extend previous analyses of a value-sensitive decision-making mechanism to a decision process among N nests. First, we present the decision-making dynamics in the symmetric case of N equal-quality nests. Then, we generalize our findings to a best-of-N decision scenario with one superior nest and N-1 inferior nests, previously studied empirically in bees and ants. Whereas previous binary models highlighted the crucial role of inhibitory stop-signaling, the key parameter in our new analysis is the relative time invested by swarm members in individual discovery and in signaling behaviors. Our new analysis reveals conflicting pressures on this ratio in symmetric and best-of-N decisions, which could be solved through a time-dependent signaling strategy. Additionally, our analysis suggests how ecological factors determining the density of suitable nest sites may have led to selective pressures for an optimal stable signaling ratio.

The neural correlates of moral decision-making: A systematic review and meta-analysis of moral evaluations and response decision judgements.

PubMed

Garrigan, Beverley; Adlam, Anna L R; Langdon, Peter E

2016-10-01

The aims of this systematic review were to determine: (a) which brain areas are consistently more active when making (i) moral response decisions, defined as choosing a response to a moral dilemma, or deciding whether to accept a proposed solution, or (ii) moral evaluations, defined as judging the appropriateness of another's actions in a moral dilemma, rating moral statements as right or wrong, or identifying important moral issues; and (b) shared and significantly different activation patterns for these two types of moral judgements. A systematic search of the literature returned 28 experiments. Activation likelihood estimate analysis identified the brain areas commonly more active for moral response decisions and for moral evaluations. Conjunction analysis revealed shared activation for both types of moral judgement in the left middle temporal gyrus, cingulate gyrus, and medial frontal gyrus. Contrast analyses found no significant clusters of increased activation for the moral evaluations-moral response decisions contrast, but found that moral response decisions additionally activated the left and right middle temporal gyrus and the right precuneus. Making one's own moral decisions involves different brain areas compared to judging the moral actions of others, implying that these judgements may involve different processes. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Model of the best-of-N nest-site selection process in honeybees

NASA Astrophysics Data System (ADS)

Reina, Andreagiovanni; Marshall, James A. R.; Trianni, Vito; Bose, Thomas

2017-05-01

The ability of a honeybee swarm to select the best nest site plays a fundamental role in determining the future colony's fitness. To date, the nest-site selection process has mostly been modeled and theoretically analyzed for the case of binary decisions. However, when the number of alternative nests is larger than two, the decision-process dynamics qualitatively change. In this work, we extend previous analyses of a value-sensitive decision-making mechanism to a decision process among N nests. First, we present the decision-making dynamics in the symmetric case of N equal-quality nests. Then, we generalize our findings to a best-of-N decision scenario with one superior nest and N -1 inferior nests, previously studied empirically in bees and ants. Whereas previous binary models highlighted the crucial role of inhibitory stop-signaling, the key parameter in our new analysis is the relative time invested by swarm members in individual discovery and in signaling behaviors. Our new analysis reveals conflicting pressures on this ratio in symmetric and best-of-N decisions, which could be solved through a time-dependent signaling strategy. Additionally, our analysis suggests how ecological factors determining the density of suitable nest sites may have led to selective pressures for an optimal stable signaling ratio.

Dying cancer patients talk about physician and patient roles in DNR decision making.

PubMed

Eliott, Jaklin A; Olver, Ian

2011-06-01

Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do-not-resuscitate or do-not-resuscitate (DNR) decision], but there is little analysis of patient perspectives. Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Discursive analysis of qualitative data gathered during semi-structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Participants' descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision-making process. Participants' endorsement of physicians as decision makers rested upon physicians' enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. When patients' and physicians' understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. © 2010 Blackwell Publishing Ltd.

Nurses' decision-making process in cases of physical restraint in acute elderly care: a qualitative study.

PubMed

Goethals, S; Dierckx de Casterlé, B; Gastmans, C

2013-05-01

The increasing vulnerability of patients in acute elderly care requires constant critical reflection in ethically charged situations such as when employing physical restraint. Qualitative evidence concerning nurses' decision making in cases of physical restraint is limited and fragmented. A thorough understanding of nurses' decision-making process could be useful to understand how nurses reason and make decisions in ethically laden situations. The aims of this study were to explore and describe nurses' decision-making process in cases of physical restraint. We used a qualitative interview design inspired by the Grounded Theory approach. Data analysis was guided by the Qualitative Analysis Guide of Leuven. Twelve hospitals geographically spread throughout the five provinces of Flanders, Belgium. Twenty-one acute geriatric nurses interviewed between October 2009 and April 2011 were purposively and theoretically selected, with the aim of including nurses having a variety of characteristics and experiences concerning decisions on using physical restraint. In cases of physical restraint in acute elderly care, nurses' decision making was never experienced as a fixed decision but rather as a series of decisions. Decision making was mostly reasoned upon and based on rational arguments; however, decisions were also made routinely and intuitively. Some nurses felt very certain about their decisions, while others experienced feelings of uncertainty regarding their decisions. Nurses' decision making is an independent process that requires nurses to obtain a good picture of the patient, to be constantly observant, and to assess and reassess the patient's situation. Coming to thoughtful and individualized decisions requires major commitment and constant critical reflection. Copyright © 2012 Elsevier Ltd. All rights reserved.

Global Design Optimization for Aerodynamics and Rocket Propulsion Components

NASA Technical Reports Server (NTRS)

Shyy, Wei; Papila, Nilay; Vaidyanathan, Rajkumar; Tucker, Kevin; Turner, James E. (Technical Monitor)

2000-01-01

Modern computational and experimental tools for aerodynamics and propulsion applications have matured to a stage where they can provide substantial insight into engineering processes involving fluid flows, and can be fruitfully utilized to help improve the design of practical devices. In particular, rapid and continuous development in aerospace engineering demands that new design concepts be regularly proposed to meet goals for increased performance, robustness and safety while concurrently decreasing cost. To date, the majority of the effort in design optimization of fluid dynamics has relied on gradient-based search algorithms. Global optimization methods can utilize the information collected from various sources and by different tools. These methods offer multi-criterion optimization, handle the existence of multiple design points and trade-offs via insight into the entire design space, can easily perform tasks in parallel, and are often effective in filtering the noise intrinsic to numerical and experimental data. However, a successful application of the global optimization method needs to address issues related to data requirements with an increase in the number of design variables, and methods for predicting the model performance. In this article, we review recent progress made in establishing suitable global optimization techniques employing neural network and polynomial-based response surface methodologies. Issues addressed include techniques for construction of the response surface, design of experiment techniques for supplying information in an economical manner, optimization procedures and multi-level techniques, and assessment of relative performance between polynomials and neural networks. Examples drawn from wing aerodynamics, turbulent diffuser flows, gas-gas injectors, and supersonic turbines are employed to help demonstrate the issues involved in an engineering design context. Both the usefulness of the existing knowledge to aid current design practices and the need for future research are identified.

Strategic Decision-Making by Deans in Academic Health Centers: A Framework Analysis

ERIC Educational Resources Information Center

Keeney, Brianne

2012-01-01

This study examines strategic decision-making at the college level in relation to seven theoretical frames. Strategic decisions are those made by top executives, have wide-ranging influence throughout the organization, affect the long-term future of the organization, and are connected to the external environment. The seven decision-making frames…

An Introduction to Solar Decision-Making Tools

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

Mow, Benjamin

2017-09-12

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

User Oriented Techniques to Support Interaction and Decision Making with Large Educational Databases

ERIC Educational Resources Information Center

Hartley, Roger; Almuhaidib, Saud M. Y.

2007-01-01

Information Technology is developing rapidly and providing policy/decision makers with large amounts of information that require processing and analysis. Decision support systems (DSS) aim to provide tools that not only help such analyses, but enable the decision maker to experiment and simulate the effects of different policies and selection…

The Wildland Fire Decision Support System: Integrating science, technology, and fire management

Treesearch

Morgan Pence; Tom Zimmerman

2011-01-01

Federal agency policy requires documentation and analysis of all wildland fire response decisions. In the past, planning and decision documentation for fires were completed using multiple unconnected processes, yielding many limitations. In response, interagency fire management executives chartered the development of the Wildland Fire Decision Support System (WFDSS)....

Path Analysis on Educational Fiscal Decision-Making Mechanism in China

ERIC Educational Resources Information Center

Zhao, Hongbin; Sun, Baicai

2007-01-01

In China's current educational fiscal decision making, problems are as follows: no law to trust or not abiding by available laws, absence of equity and efficiency, as well as the standardization of decision-making procedures. It is necessary to set up effective fiscal decision-making mechanism in education and rationally devise reliable paths.

75 FR 71729 - Notice of Availability of the Record of Decision (ROD) for the Tuskegee Airmen National Historic...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

...'s Order Number 12 (Conservation Planning, Environmental Impact Analysis, and Decision- making) the... DEPARTMENT OF THE INTERIOR National Park Service Notice of Availability of the Record of Decision... ROD for the project. The ROD includes a description of the project's background, a decision statement...

Integrated Energy Solutions Research | Integrated Energy Solutions | NREL

Science.gov Websites

that spans the height and width of the wall they are facing. Decision Science and Informatics Enabling decision makers with rigorous, technology-neutral, data-backed decision support to maximize the impact of security in energy systems through analysis, decision support, advanced energy technology development, and

Decision-Making Models in a Tunisian University: Towards a Framework for Analysis

ERIC Educational Resources Information Center

Khefacha, I.; Belkacem, L.

2014-01-01

This study investigates how decisions are made in Tunisian public higher education establishments. Some factors are identified as having a potentially significant impact on the odds that the decision-making process follows the characteristics of one of the most well known decision-making models: collegial, political, bureaucratic or anarchical…

An integrated, ethically driven environmental model of clinical decision making in emergency settings.

PubMed

Wolf, Lisa

2013-02-01

To explore the relationship between multiple variables within a model of critical thinking and moral reasoning. A quantitative descriptive correlational design using a purposive sample of 200 emergency nurses. Measured variables were accuracy in clinical decision-making, moral reasoning, perceived care environment, and demographics. Analysis was by bivariate correlation using Pearson's product-moment correlation coefficients, chi square and multiple linear regression analysis. The elements as identified in the integrated ethically-driven environmental model of clinical decision-making (IEDEM-CD) corrected depict moral reasoning and environment of care as factors significantly affecting accuracy in decision-making. The integrated, ethically driven environmental model of clinical decision making is a framework useful for predicting clinical decision making accuracy for emergency nurses in practice, with further implications in education, research and policy. A diagnostic and therapeutic framework for identifying and remediating individual and environmental challenges to accurate clinical decision making. © 2012, The Author. International Journal of Nursing Knowledge © 2012, NANDA International.

Strategic planning decision making using fuzzy SWOT-TOPSIS with reliability factor

NASA Astrophysics Data System (ADS)

Mohamad, Daud; Afandi, Nur Syamimi; Kamis, Nor Hanimah

2015-10-01

Strategic planning is a process of decision making and action for long-term activities in an organization. The Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis has been commonly used to help organizations in strategizing their future direction by analyzing internal and external environment. However, SWOT analysis has some limitations as it is unable to prioritize appropriately the multiple alternative strategic decisions. Some efforts have been made to solve this problem by incorporating Multi Criteria Decision Making (MCDM) methods. Nevertheless, another important aspect has raised concerns on obtaining the decision that is the reliability of the information. Decision makers evaluate differently depending on their level of confidence or sureness in the evaluation. This study proposes a decision making procedure for strategic planning using SWOT-TOPSIS method by incorporating the reliability factor of the evaluation based on Z-number. An example using a local authority in the east coast of Malaysia is illustrated to determine the strategic options ranking and to prioritize factors in each SWOT category.

Attitudes towards poverty, organizations, ethics and morals: Israeli social workers' shared decision making.

PubMed

Levin, Lia; Schwartz-Tayri, Talia

2017-06-01

Partnerships between service users and social workers are complex in nature and can be driven by both personal and contextual circumstances. This study sought to explore the relationship between social workers' involvement in shared decision making with service users, their attitudes towards service users in poverty, moral standards and health and social care organizations' policies towards shared decision making. Based on the responses of 225 licensed social workers from health and social care agencies in the public, private and third sectors in Israel, path analysis was used to test a hypothesized model. Structural attributions for poverty contributed to attitudes towards people who live in poverty, which led to shared decision making. Also, organizational support in shared decision making, and professional moral identity, contributed to ethical behaviour which led to shared decision making. The results of this analysis revealed that shared decision making may be a scion of branched roots planted in the relationship between ethics, organizations and Stigma. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Multi-Criteria Decision Making for a Spatial Decision Support System on the Analysis of Changing Risk

NASA Astrophysics Data System (ADS)

Olyazadeh, Roya; van Westen, Cees; Bakker, Wim H.; Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

2014-05-01

Natural hazard risk management requires decision making in several stages. Decision making on alternatives for risk reduction planning starts with an intelligence phase for recognition of the decision problems and identifying the objectives. Development of the alternatives and assigning the variable by decision makers to each alternative are employed to the design phase. Final phase evaluates the optimal choice by comparing the alternatives, defining indicators, assigning a weight to each and ranking them. This process is referred to as Multi-Criteria Decision Making analysis (MCDM), Multi-Criteria Evaluation (MCE) or Multi-Criteria Analysis (MCA). In the framework of the ongoing 7th Framework Program "CHANGES" (2011-2014, Grant Agreement No. 263953) of the European Commission, a Spatial Decision Support System is under development, that has the aim to analyse changes in hydro-meteorological risk and provide support to selecting the best risk reduction alternative. This paper describes the module for Multi-Criteria Decision Making analysis (MCDM) that incorporates monetary and non-monetary criteria in the analysis of the optimal alternative. The MCDM module consists of several components. The first step is to define criteria (or Indicators) which are subdivided into disadvantages (criteria that indicate the difficulty for implementing the risk reduction strategy, also referred to as Costs) and advantages (criteria that indicate the favorability, also referred to as benefits). In the next step the stakeholders can use the developed web-based tool for prioritizing criteria and decision matrix. Public participation plays a role in decision making and this is also planned through the use of a mobile web-version where the general local public can indicate their agreement on the proposed alternatives. The application is being tested through a case study related to risk reduction of a mountainous valley in the Alps affected by flooding. Four alternatives are evaluated in this case study namely: construction of defense structures, relocation, implementation of an early warning system and spatial planning regulations. Some of the criteria are determined partly in other modules of the CHANGES SDSS, such as the costs for implementation, the risk reduction in monetary values, and societal risk. Other criteria, which could be environmental, economic, cultural, perception in nature, are defined by different stakeholders such as local authorities, expert organizations, private sector, and local public. In the next step, the stakeholders weight the importance of the criteria by pairwise comparison and visualize the decision matrix, which is a matrix based on criteria versus alternatives values. Finally alternatives are ranked by Analytic Hierarchy Process (AHP) method. We expect that this approach will help the decision makers to ease their works and reduce their costs, because the process is more transparent, more accurate and involves a group decision. In that way there will be more confidence in the overall decision making process. Keywords: MCDM, Analytic Hierarchy Process (AHP), SDSS, Natural Hazard Risk Management

Integrative evaluation for sustainable decisions of urban wastewater system management under uncertainty

NASA Astrophysics Data System (ADS)

Hadjimichael, A.; Corominas, L.; Comas, J.

2017-12-01

With sustainable development as their overarching goal, urban wastewater system (UWS) managers need to take into account multiple social, economic, technical and environmental facets related to their decisions. In this complex decision-making environment, uncertainty can be formidable. It is present both in the ways the system is interpreted stochastically, but also in its natural ever-shifting behavior. This inherent uncertainty suggests that wiser decisions would be made under an adaptive and iterative decision-making regime. No decision-support framework has been presented in the literature to effectively addresses all these needs. The objective of this work is to describe such a conceptual framework to evaluate and compare alternative solutions for various UWS challenges within an adaptive management structure. Socio-economic aspects such as externalities are taken into account, along with other traditional criteria as necessary. Robustness, reliability and resilience analyses test the performance of the system against present and future variability. A valuation uncertainty analysis incorporates uncertain valuation assumptions in the decision-making process. The framework is demonstrated with an application to a case study presenting a typical problem often faced by managers: poor river water quality, increasing population, and more stringent water quality legislation. The application of the framework made use of: i) a cost-benefit analysis including monetized environmental benefits and damages; ii) a robustness analysis of system performance against future conditions; iii) reliability and resilience analyses of the system given contextual variability; and iv) a valuation uncertainty analysis of model parameters. The results suggest that the installation of bigger volumes would give rise to increased benefits despite larger capital costs, as well as increased robustness and resilience. Population numbers appear to affect the estimated benefits most, followed by electricity prices and climate change projections. The presented framework is expected to be a valuable tool for the next generation of UWS decision-making and the application demonstrates a novel and valuable integration of metrics and methods for UWS analysis.

Cost-effectiveness analysis and formulary decision making in England: findings from research.

PubMed

Williams, Iestyn P; Bryan, Stirling

2007-11-01

In a context of rapid technological advances in health care and increasing demand for expensive treatments, local formulary committees are key players in the management of scarce resources. However, little is known about the information and processes used when making decisions on the inclusion of new treatments. This paper reports research on the use of economic evaluations in technology coverage decisions in England, although the findings have a relevance to other health care systems with devolved responsibility for resource allocation. It reports a study of four local formulary committees in which both qualitative and quantitative data were collected. Our main research finding is that it is an exception for cost-effectiveness analysis to inform technology coverage decisions. Barriers to use include access and expertise levels, concerns relating to the independence of analyses and problems with implementation of study recommendations. Further barriers derive from the constraints on decision makers, a lack of clarity over functions and aims of local committees, and the challenge of disinvestment in medical technologies. The relative weakness of the research-practice dynamics in this context suggests the need for a rethinking of the role of both analysts and decision makers. Our research supports the view that in order to be useful, analysis needs to better reflect the constraints of the local decision-making environment. We also recommend that local decision-making committees and bodies in the National Health Service more clearly identify the 'problems' which they are charged with solving and how their outputs contribute to broader finance and commissioning functions. This would help to establish the ways in which the routine use of cost-effectiveness analysis might become a reality.

Two decision aids for mode of delivery among women with previous caesarean section: randomised controlled trial.

PubMed

Montgomery, Alan A; Emmett, Clare L; Fahey, Tom; Jones, Claire; Ricketts, Ian; Patel, Roshni R; Peters, Tim J; Murphy, Deirdre J

2007-06-23

To determine the effects of two computer based decision aids on decisional conflict and mode of delivery among pregnant women with a previous caesarean section. Randomised trial, conducted from May 2004 to August 2006. Four maternity units in south west England, and Scotland. 742 pregnant women with one previous lower segment caesarean section and delivery expected at >or=37 weeks. Non-English speakers were excluded. Usual care: standard care given by obstetric and midwifery staff. Information programme: women navigated through descriptions and probabilities of clinical outcomes for mother and baby associated with planned vaginal birth, elective caesarean section, and emergency caesarean section. Decision analysis: mode of delivery was recommended based on utility assessments performed by the woman combined with probabilities of clinical outcomes within a concealed decision tree. Both interventions were delivered via a laptop computer after brief instructions from a researcher. Total score on decisional conflict scale, and mode of delivery. Women in the information programme (adjusted difference -6.2, 95% confidence interval -8.7 to -3.7) and the decision analysis (-4.0, -6.5 to -1.5) groups had reduced decisional conflict compared with women in the usual care group. The rate of vaginal birth was higher for women in the decision analysis group compared with the usual care group (37% v 30%, adjusted odds ratio 1.42, 0.94 to 2.14), but the rates were similar in the information programme and usual care groups. Decision aids can help women who have had a previous caesarean section to decide on mode of delivery in a subsequent pregnancy. The decision analysis approach might substantially affect national rates of caesarean section. Trial Registration Current Controlled Trials ISRCTN84367722.

A Multi-Objective Decision-Making Model for Resources Allocation in Humanitarian Relief

DTIC Science & Technology

2007-03-01

Applied Mathematics and Computation 163, 2005, pp756 19. Malczewski, J., GIS and Multicriteria Decision Analysis , John Wiley and Sons, New York... used when interpreting the results of the analysis . (Raimo et al. 2002) (7) Sensitivity analysis Sensitivity analysis in a DA process answers...Budget Scenario Analysis The MILP is solved ( using LINDO 6.1) for high, medium and low budget scenarios in both damage degree levels. Tables 17 and

The effect of uncertainties in distance-based ranking methods for multi-criteria decision making

NASA Astrophysics Data System (ADS)

Jaini, Nor I.; Utyuzhnikov, Sergei V.

2017-08-01

Data in the multi-criteria decision making are often imprecise and changeable. Therefore, it is important to carry out sensitivity analysis test for the multi-criteria decision making problem. The paper aims to present a sensitivity analysis for some ranking techniques based on the distance measures in multi-criteria decision making. Two types of uncertainties are considered for the sensitivity analysis test. The first uncertainty is related to the input data, while the second uncertainty is towards the Decision Maker preferences (weights). The ranking techniques considered in this study are TOPSIS, the relative distance and trade-off ranking methods. TOPSIS and the relative distance method measure a distance from an alternative to the ideal and antiideal solutions. In turn, the trade-off ranking calculates a distance of an alternative to the extreme solutions and other alternatives. Several test cases are considered to study the performance of each ranking technique in both types of uncertainties.

Nicotine replacement therapy decision based on fuzzy multi-criteria analysis

NASA Astrophysics Data System (ADS)

Tarmudi, Zamali; Matmali, Norfazillah; Abdullah, Mohd Lazim

2017-08-01

It has been observed that Nicotine Replacement Therapy (NRT) is one of the alternatives to control and reduce smoking addiction among smokers. Since the decision to choose the best NRT alternative involves uncertainty, ambiguity factors and diverse input datasets, thus, this paper proposes a fuzzy multi-criteria analysis (FMA) to overcome these issues. It focuses on how the fuzzy approach can unify the diversity of datasets based on NRT's decision-making problem. The analysis done employed the advantage of the cost-benefit criterion to unify the mixture of dataset input. The performance matrix was utilised to derive the performance scores. An empirical example regarding the NRT's decision-making problem was employed to illustrate the proposed approach. Based on the calculations, this analytical approach was found to be highly beneficial in terms of usability. It was also very applicable and efficient in dealing with the mixture of input datasets. Hence, the decision-making process can easily be used by experts and patients who are interested to join the therapy/cessation program.

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

PubMed

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

2015-03-01

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

Philosophical Foundations for Curriculum Decision: A Reflective Analysis

ERIC Educational Resources Information Center

Belbase, Shashidhar

2011-01-01

This paper discusses the author's curriculum experiences under different philosophical, epistemological and theoretical backdrops. The analysis of different perspectives bridges epistemological and philosophical/theoretical lenses to my understanding of curriculum and different curricular decisions. This praxeological experience as a student and…

A Decision Making Analysis of Persuasive Argumentation and the Choice Shift Effect

ERIC Educational Resources Information Center

Vinokur, Amiram; And Others

1975-01-01

A subjective expected utility (SEU) decision-making analysis was performed on the content of arguments generated by subjects privately or during group discussion in response to choice-dilemmas shown to shift toward risk and caution. (Editor)

Seeing the NICE side of cost-effectiveness analysis: a qualitative investigation of the use of CEA in NICE technology appraisals.

PubMed

Bryan, Stirling; Williams, Iestyn; McIver, Shirley

2007-02-01

Resource scarcity is the raison d'être for the discipline of economics. Thus, the primary purpose of economic analysis is to help decision-makers when addressing problems arising due to the scarcity problem. The research reported here was concerned with how cost-effectiveness information is used by the National Institute for Health & Clinical Excellence (NICE) in national technology coverage decisions in the UK, and how its impact might be increased. The research followed a qualitative case study methodology with semi-structured interviews, supported by observation and analysis of secondary sources. Our research highlights that the technology appraisal function of NICE represents an important progression for the UK health economics community: new cost-effectiveness work is commissioned for each technology and that work directly informs national health policy. However, accountability in policy decisions necessitates that the information upon which decisions are based (including cost-effectiveness analysis, CEA) is accessible. This was found to be a serious problem and represents one of the main ongoing challenges. Other issues highlighted include perceived weaknesses in analysis methods and the poor alignment between the health maximisation objectives assumed in economic analyses and the range of other objectives facing decision-makers in reality. Copyright (c) 2006 John Wiley & Sons, Ltd.

Dynamic decision making for dam-break emergency management - Part 1: Theoretical framework

NASA Astrophysics Data System (ADS)

Peng, M.; Zhang, L. M.

2013-02-01

An evacuation decision for dam breaks is a very serious issue. A late decision may lead to loss of lives and properties, but a very early evacuation will incur unnecessary expenses. This paper presents a risk-based framework of dynamic decision making for dam-break emergency management (DYDEM). The dam-break emergency management in both time scale and space scale is introduced first to define the dynamic decision problem. The probability of dam failure is taken as a stochastic process and estimated using a time-series analysis method. The flood consequences are taken as functions of warning time and evaluated with a human risk analysis model (HURAM) based on Bayesian networks. A decision criterion is suggested to decide whether to evacuate the population at risk (PAR) or to delay the decision. The optimum time for evacuating the PAR is obtained by minimizing the expected total loss, which integrates the time-related probabilities and flood consequences. When a delayed decision is chosen, the decision making can be updated with available new information. A specific dam-break case study is presented in a companion paper to illustrate the application of this framework to complex dam-breaching problems.

Theory of the decision/problem state

NASA Technical Reports Server (NTRS)

Dieterly, D. L.

1980-01-01

A theory of the decision-problem state was introduced and elaborated. Starting with the basic model of a decision-problem condition, an attempt was made to explain how a major decision-problem may consist of subsets of decision-problem conditions composing different condition sequences. In addition, the basic classical decision-tree model was modified to allow for the introduction of a series of characteristics that may be encountered in an analysis of a decision-problem state. The resulting hierarchical model reflects the unique attributes of the decision-problem state. The basic model of a decision-problem condition was used as a base to evolve a more complex model that is more representative of the decision-problem state and may be used to initiate research on decision-problem states.

Development of an intervention to support patients and clinicians with advanced lung cancer when considering systematic anticancer therapy: protocol for the PACT study.

PubMed

Anagnostou, Despina; Sivell, Stephanie; Noble, Simon; Lester, Jason; Byrne, Anthony; Sampson, Catherine; Longo, Mirella; Nelson, Annmarie

2017-07-12

Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options. PACT is a five-stage, multimethod and multicentre study. Participants : Patients and health professionals will be recruited from three health boards. Methods : Non-participant observation of multidisciplinary team meetings (n=12) will be used to determine patients' allocation to treatment pathways (stage I). Non-participant observation of patient-clinician consultations (n=20-30) will be used to explore communication of treatment options and decision-making. Extent of participation in decision-making will be assessed using the Observing Patient Involvement in Shared Decision-Making tool. Interviews with patients (stage III) and their clinicians (stage IV) will explore the perception of treatment options and involvement in decision-making. Based on stages I-IV, an expert consensus meeting will finalise the content and format of the intervention. Cognitive interviews with patients will then determine the face validity of the intervention (stage V). Analysis : analysis will be according to data type and research question and will include mediated discourse analysis, thematic analysis, framework analysis and interpretative phenomenological analysis. Ethical approval has been granted. The study findings will contribute to and promote shared and informed decision-making in the best interest of patients and prudent healthcare. We therefore aim to disseminate results via relevant respiratory, oncology and palliative care journals and conferences. © 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.

Assessing Corporate Culture and Infrastructure before Undertaking Cost-Benefit Analysis.

ERIC Educational Resources Information Center

Driscoll, Margaret

1993-01-01

One of the simplest definitions of cost-benefit analysis states "ultimately, it is nothing more than a logical attempt to weigh the pros and cons of a decision" (Gramlich 1981). This definition highlights two issues: practitioners should be clear about what decisions will be made as a result of this analysis, and they need to decide how…

Decision Making Methods in Space Economics and Systems Engineering

NASA Technical Reports Server (NTRS)

Shishko, Robert

2006-01-01

This viewgraph presentation reviews various methods of decision making and the impact that they have on space economics and systems engineering. Some of the methods discussed are: Present Value and Internal Rate of Return (IRR); Cost-Benefit Analysis; Real Options; Cost-Effectiveness Analysis; Cost-Utility Analysis; Multi-Attribute Utility Theory (MAUT); and Analytic Hierarchy Process (AHP).

Impaired decision-making and brain shrinkage in alcoholism.

PubMed

Le Berre, A-P; Rauchs, G; La Joie, R; Mézenge, F; Boudehent, C; Vabret, F; Segobin, S; Viader, F; Allain, P; Eustache, F; Pitel, A-L; Beaunieux, H

2014-03-01

Alcohol-dependent individuals usually favor instant gratification of alcohol use and ignore its long-term negative consequences, reflecting impaired decision-making. According to the somatic marker hypothesis, decision-making abilities are subtended by an extended brain network. As chronic alcohol consumption is known to be associated with brain shrinkage in this network, the present study investigated relationships between brain shrinkage and decision-making impairments in alcohol-dependent individuals early in abstinence using voxel-based morphometry. Thirty patients performed the Iowa Gambling Task and underwent a magnetic resonance imaging investigation (1.5T). Decision-making performances and brain data were compared with those of age-matched healthy controls. In the alcoholic group, a multiple regression analysis was conducted with two predictors (gray matter [GM] volume and decision-making measure) and two covariates (number of withdrawals and duration of alcoholism). Compared with controls, alcoholics had impaired decision-making and widespread reduced gray matter volume, especially in regions involved in decision-making. The regression analysis revealed links between high GM volume in the ventromedial prefrontal cortex, dorsal anterior cingulate cortex and right hippocampal formation, and high decision-making scores (P<0.001, uncorrected). Decision-making deficits in alcoholism may result from impairment of both emotional and cognitive networks. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Criteria for assessing problem solving and decision making in complex environments

NASA Technical Reports Server (NTRS)

Orasanu, Judith

1993-01-01

Training crews to cope with unanticipated problems in high-risk, high-stress environments requires models of effective problem solving and decision making. Existing decision theories use the criteria of logical consistency and mathematical optimality to evaluate decision quality. While these approaches are useful under some circumstances, the assumptions underlying these models frequently are not met in dynamic time-pressured operational environments. Also, applying formal decision models is both labor and time intensive, a luxury often lacking in operational environments. Alternate approaches and criteria are needed. Given that operational problem solving and decision making are embedded in ongoing tasks, evaluation criteria must address the relation between those activities and satisfaction of broader task goals. Effectiveness and efficiency become relevant for judging reasoning performance in operational environments. New questions must be addressed: What is the relation between the quality of decisions and overall performance by crews engaged in critical high risk tasks? Are different strategies most effective for different types of decisions? How can various decision types be characterized? A preliminary model of decision types found in air transport environments will be described along with a preliminary performance model based on an analysis of 30 flight crews. The performance analysis examined behaviors that distinguish more and less effective crews (based on performance errors). Implications for training and system design will be discussed.

Reimbursement decisions in health policy--extending our understanding of the elements of decision-making.

PubMed

Wirtz, Veronika; Cribb, Alan; Barber, Nick

2005-09-08

Previous theoretical and empirical work on health policy decisions about reimbursement focuses on specific rationales such as effectiveness, economic considerations and equal access for equal needs. As reimbursement decisions take place in a social and political context we propose that the analysis of decision-making should incorporate factors, which go beyond those commonly discussed. As an example we chose three health technologies (sildenafil, rivastigmine and statins) to investigate how decisions about reimbursement of medicines are made in the United Kingdom National Health Service and what factors influence these decisions. From face-to-face, in-depth interviews with a purposive sample of 20 regional and national policy makers and stakeholders we identified two dimensions of decision-making, which extend beyond the rationales conventionally cited. The first dimension relates to the role of 'subjectivity' or 'the personal' in the decisions, including personal experiences of the condition and excitement about the novelty or potential benefit of the technology-these factors affect what counts as evidence, or how evidence is interpreted, in practice. The second dimension relates to the social and political function of decision-making and broadens what counts as the relevant ends of decision-making to include such things as maintaining relationships, avoiding organisational burden, generating politically and legally defensible decisions and demonstrating the willingness to care. More importantly, we will argue that these factors should not be treated as contaminants of an otherwise rational decision-making. On the contrary we suggest that they seem relevant, reasonable and also of substantial importance in considering in decision-making. Complementing the analysis of decision-making about reimbursement by incorporating these factors could increase our understanding and potentially improve decision-making.

Initiating decision-making conversations in palliative care: an ethnographic discourse analysis.

PubMed

Bélanger, Emmanuelle; Rodríguez, Charo; Groleau, Danielle; Légaré, France; Macdonald, Mary Ellen; Marchand, Robert

2014-01-01

Conversations about end-of-life care remain challenging for health care providers. The tendency to delay conversations about care options represents a barrier that impedes the ability of terminally-ill patients to participate in decision-making. Family physicians with a palliative care practice are often responsible for discussing end-of-life care preferences with patients, yet there is a paucity of research directly observing these interactions. In this study, we sought to explore how patients and family physicians initiated decision-making conversations in the context of a community hospital-based palliative care service. This qualitative study combined discourse analysis with ethnographic methods. The field research lasted one year, and data were generated through participant observation and audio-recordings of consultations. A total of 101 consultations were observed longitudinally between 18 patients, 6 family physicians and 2 pivot nurses. Data analysis consisted in exploring the different types of discourses initiating decision-making conversations and how these discourses were affected by the organizational context in which they took place. The organization of care had an impact on decision-making conversations. The timing and origin of referrals to palliative care shaped whether patients were still able to participate in decision-making, and the decisions that remained to be made. The type of decisions to be made also shaped how conversations were initiated. Family physicians introduced decision-making conversations about issues needing immediate attention, such as symptom management, by directly addressing or eliciting patients' complaints. When decisions involved discussing impending death, decision-making conversations were initiated either indirectly, by prompting the patients to express their understanding of the disease and its progression, or directly, by providing a justification for broaching a difficult topic. Decision-making conversations and the initiation thereof were framed by the organization of care and the referral process prior to initial encounters. While symptom management was taken for granted as part of health care professionals' expected role, engaging in decisions regarding preparation for death implicitly remained under patients' control. This work makes important clinical contributions by exposing the rhetorical function of family physicians' discourse when introducing palliative care decisions.

A Multimethod Analysis of Shared Decision-Making in Hospice Interdisciplinary Team Meetings Including Family Caregivers

PubMed Central

Washington, Karla T.; Oliver, Debra Parker; Gage, L. Ashley; Albright, David L.; Demiris, George

2015-01-01

Background Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. Aim We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. Design We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Setting/participants Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Results Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in health care delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. Conclusions The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. PMID:26281854

A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers.

PubMed

Washington, Karla T; Oliver, Debra Parker; Gage, L Ashley; Albright, David L; Demiris, George

2016-03-01

Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. © The Author(s) 2015.

Politics and Educational Reform

ERIC Educational Resources Information Center

Merritt, Richard L.; Coombs, Fred S.

1977-01-01

Provides a brief analysis of educational policymaking processes in terms of how they underscore the political basis of educational decisions. Examines four approaches to explaining collective decisions--rational decisionmaking theory, pluralist theory, systems analysis, and cybernetic theory--to explore how each might relate in quite different…

Integrated corridor management initiative : demonstration phase evaluation - Dallas decision support system analysis test plan.

DOT National Transportation Integrated Search

2012-08-01

This report presents the test plan for conducting the Decision Support System (DSS) Analysis for the United States Department of Transportation (U.S. DOT) evaluation of the Dallas U.S. 75 Integrated Corridor Management (ICM) Initiative Demonstration....

Dying cancer patients talk about physician and patient roles in DNR decision making

PubMed Central

Eliott, Jaklin A.; Olver, Ian

2011-01-01

Abstract Background  Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do‐not‐resuscitate or do‐not‐resuscitate (DNR) decision], but there is little analysis of patient perspectives. Objective  Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Design and participants  Discursive analysis of qualitative data gathered during semi‐structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Results  Participants’ descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision‐making process. Participants’ endorsement of physicians as decision makers rested upon physicians’ enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. Conclusion  When patients’ and physicians’ understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. PMID:20860782

Role of scientific data in health decisions.

PubMed Central

Samuels, S W

1979-01-01

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

Validation of the Tactical Air Force’s Decision Making Process to Prioritize Modifications Using the Analytic Hierarchy Process.

DTIC Science & Technology

1987-12-01

were presented. The second part of the thesis proposed the alternative methods of decision analysis and PROMETHEE to solve TAF’s . prioritization...of decision analysis (DA) and Preference Ranking Orqanization Method for Enrichment Evaluations ( PROMETHEE ) will be explained. First, the...dollars. However, once this task is successfully accomplished, TAF would be able to use DA to prioritize their mods. The PROMETHEE is a "new class of

Decision curve analysis: a novel method for evaluating prediction models.

PubMed

Vickers, Andrew J; Elkin, Elena B

2006-01-01

Diagnostic and prognostic models are typically evaluated with measures of accuracy that do not address clinical consequences. Decision-analytic techniques allow assessment of clinical outcomes but often require collection of additional information and may be cumbersome to apply to models that yield a continuous result. The authors sought a method for evaluating and comparing prediction models that incorporates clinical consequences,requires only the data set on which the models are tested,and can be applied to models that have either continuous or dichotomous results. The authors describe decision curve analysis, a simple, novel method of evaluating predictive models. They start by assuming that the threshold probability of a disease or event at which a patient would opt for treatment is informative of how the patient weighs the relative harms of a false-positive and a false-negative prediction. This theoretical relationship is then used to derive the net benefit of the model across different threshold probabilities. Plotting net benefit against threshold probability yields the "decision curve." The authors apply the method to models for the prediction of seminal vesicle invasion in prostate cancer patients. Decision curve analysis identified the range of threshold probabilities in which a model was of value, the magnitude of benefit, and which of several models was optimal. Decision curve analysis is a suitable method for evaluating alternative diagnostic and prognostic strategies that has advantages over other commonly used measures and techniques.

Evaluating Utility in Diagnostic Decision Making.

ERIC Educational Resources Information Center

Harber, Jean R.

1981-01-01

The utility of the procedures special educators apply in making decisions about the identification of handicapped individuals has not been thoroughly studied. The paper examines the utility of diagnostic decision making from the perspective of receiver operating curve analysis. (Author)

Decision making in high-velocity environments: implications for healthcare.

PubMed

Stepanovich, P L; Uhrig, J D

1999-01-01

Healthcare can be considered a high-velocity environment and, as such, can benefit from research conducted in other industries regarding strategic decision making. Strategic planning is not only relevant to firms in high-velocity environments, but is also important for high performance and survival. Specifically, decision-making speed seems to be instrumental in differentiating between high and low performers; fast decision makers outperform slow decision makers. This article outlines the differences between fast and slow decision makers, identifies five paralyses that can slow decision making in healthcare, and outlines the role of a planning department in circumventing these paralyses. Executives can use the proposed planning structure to improve both the speed and quality of strategic decisions. The structure uses planning facilitators to avoid the following five paralyses: 1. Analysis. Decision makers can no longer afford the luxury of lengthy, detailed analysis but must develop real-time systems that provide appropriate, timely information. 2. Alternatives. Many alternatives (beyond the traditional two or three) need to be considered and the alternatives must be evaluated simultaneously. 3. Group Think. Decision makers must avoid limited mind-sets and autocratic leadership styles by seeking out independent, knowledgeable counselors. 4. Process. Decision makers need to resolve conflicts through "consensus with qualification," as opposed to waiting for everyone to come on board. 5. Separation. Successful implementation requires a structured process that cuts across disciplines and levels.

Group decision-making techniques for natural resource management applications

USGS Publications Warehouse

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

1992-01-01

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

Contrasting models of driver behaviour in emergencies using retrospective verbalisations and network analysis.

PubMed

Banks, Victoria A; Stanton, Neville A

2015-01-01

Automated assistance in driving emergencies aims to improve the safety of our roads by avoiding or mitigating the effects of accidents. However, the behavioural implications of such systems remain unknown. This paper introduces the driver decision-making in emergencies (DDMiEs) framework to investigate how the level and type of automation may affect driver decision-making and subsequent responses to critical braking events using network analysis to interrogate retrospective verbalisations. Four DDMiE models were constructed to represent different levels of automation within the driving task and its effects on driver decision-making. Findings suggest that whilst automation does not alter the decision-making pathway (e.g. the processes between hazard detection and response remain similar), it does appear to significantly weaken the links between information-processing nodes. This reflects an unintended yet emergent property within the task network that could mean that we may not be improving safety in the way we expect. This paper contrasts models of driver decision-making in emergencies at varying levels of automation using the Southampton University Driving Simulator. Network analysis of retrospective verbalisations indicates that increasing the level of automation in driving emergencies weakens the link between information-processing nodes essential for effective decision-making.

End of life decisions: nurses perceptions, feelings and experiences.

PubMed

McMillen, Rachel E

2008-08-01

Decisions to withdraw treatment are made on a regular basis in intensive care units. While nurses play a central role in patient care, previous studies have found that they are not always involved in withdrawal decisions. To explore the experiences of ICU nurses caring for patients who have had their treatment withdrawn and to answer two research questions: what role do nurses play and how does this affect them? Constructivist grounded theory was used to explore the experiences and feelings of ICU nurses. A purposive sample of eight ICU nurses participated and semi-structured interviews were used to collect data. Framework analysis was used to facilitate systematic analysis. The analysis revealed two major themes (1) the nurse's role: experience counts, not really a nurse's decision, planting the seed, supporting the family and being a patient advocate and (2) perceptions of the withdrawal of treatment: getting the timing right and emotional labour. Nurses make an important contribution to end of life decisions and care. Guidelines recommend they have input into withdrawal decisions, therefore it is imperative that nurses are supported in this role and their responsibilities to continue to provide care during withdrawal.

Human/Automation Trade Methodology for the Moon, Mars and Beyond

NASA Technical Reports Server (NTRS)

Korsmeyer, David J.

2009-01-01

It is possible to create a consistent trade methodology that can characterize operations model alternatives for crewed exploration missions. For example, a trade-space that is organized around the objective of maximizing Crew Exploration Vehicle (CEV) independence would have the input as a classification of the category of analysis to be conducted or decision to be made, and a commitment to a detailed point in a mission profile during which the analysis or decision is to be made. For example, does the decision have to do with crew activity planning, or life support? Is the mission phase trans-Earth injection, cruise, or lunar descent? Different kinds of decision analysis of the trade-space between human and automated decisions will occurs at different points in a mission's profile. The necessary objectives at a given point in time during a mission will call for different kinds of response with respect to where and how computers and automation are expected to help provide an accurate, safe, and timely response. In this paper, a consistent methodology for assessing the trades between human and automated decisions on-board will be presented and various examples discussed.

[Decisions in case of "problematic" cost-effectiveness ratios based on the example of a clinical trial in rehabilitation care].

PubMed

Leidl, R; Jacobi, E; Knab, J; Schweikert, B

2006-04-01

Economic assessment of an additional psychological intervention in the rehabilitation of patients with chronic low-back pain and evaluation of results by decision makers. Piggy-back cost-utility analysis of a randomised clinical trial, including a bootstrap analysis. Costs were measured by using the cost accounting systems of the rehabilitation clinics and by surveying patients. Health-related quality of life was measured using the EQ-5D. Implications of different representations of the decision problem and corresponding decision rules concerning the cost-effectiveness plane are discussed. As compared with the 126 patients of the control arm, the 98 patients in the intervention arm gained 3.5 days in perfect health on average as well as 1219 euro cost saving. However, because of the uncertainty involved, the results of a bootstrap analysis cover all quadrants of the cost-effectiveness plane. Using maximum willingness-to-pay per effect unit gained, decision rules can be defined for parts of the cost-effectiveness plane. These have to be aggregated in a further valuation step. Study results show that decisions on stochastic economic evaluation results may require an additional valuation step aggregating the various parts of the cost-effectiveness plane.

Shaping the Conversation: A Secondary Analysis of Reproductive Decision-Making Among Black Mothers with HIV

PubMed Central

Amutah, Ndidiamaka N.; Gifuni, Jacqueline; Wesley, Yvonne

2016-01-01

The purpose of this qualitative secondary data analysis is to examine the major influencers on mothers with HIV in their childbearing decisions, as well as how those influencers shape conversations with clinicians and health-care providers regarding HIV treatment and prevention. The original study gained insight into the reproductive decision-making of mothers with HIV. By analyzing a subsample of 15 interviews from an original cohort of 25 participants in the earlier study, three major themes were identified as follows: (1) family members, not health-care providers, influence reproductive decisions; (2) negative attitudes toward subsequent pregnancies are mainly due to HIV transmission; and (3) birth control decisions were predominately supported by family members, while health-care providers were not consulted. PMID:27158227

A retrospective analysis to identify the factors affecting infection in patients undergoing chemotherapy.

PubMed

Park, Ji Hyun; Kim, Hyeon-Young; Lee, Hanna; Yun, Eun Kyoung

2015-12-01

This study compares the performance of the logistic regression and decision tree analysis methods for assessing the risk factors for infection in cancer patients undergoing chemotherapy. The subjects were 732 cancer patients who were receiving chemotherapy at K university hospital in Seoul, Korea. The data were collected between March 2011 and February 2013 and were processed for descriptive analysis, logistic regression and decision tree analysis using the IBM SPSS Statistics 19 and Modeler 15.1 programs. The most common risk factors for infection in cancer patients receiving chemotherapy were identified as alkylating agents, vinca alkaloid and underlying diabetes mellitus. The logistic regression explained 66.7% of the variation in the data in terms of sensitivity and 88.9% in terms of specificity. The decision tree analysis accounted for 55.0% of the variation in the data in terms of sensitivity and 89.0% in terms of specificity. As for the overall classification accuracy, the logistic regression explained 88.0% and the decision tree analysis explained 87.2%. The logistic regression analysis showed a higher degree of sensitivity and classification accuracy. Therefore, logistic regression analysis is concluded to be the more effective and useful method for establishing an infection prediction model for patients undergoing chemotherapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Swift and Smart Decision Making: Heuristics that Work

ERIC Educational Resources Information Center

Hoy, Wayne K.; Tarter, C. J.

2010-01-01

Purpose: The aim of this paper is to examine the research literature on decision making and identify and develop a set of heuristics that work for school decision makers. Design/methodology/approach: This analysis is a synthesis of the research on decision-making heuristics that work. Findings: A set of nine rules for swift and smart decision…

Ignorance- versus Evidence-Based Decision Making: A Decision Time Analysis of the Recognition Heuristic

ERIC Educational Resources Information Center

Hilbig, Benjamin E.; Pohl, Rudiger F.

2009-01-01

According to part of the adaptive toolbox notion of decision making known as the recognition heuristic (RH), the decision process in comparative judgments--and its duration--is determined by whether recognition discriminates between objects. By contrast, some recently proposed alternative models predict that choices largely depend on the amount of…

Effects of Practice on Task Architecture: Combined Evidence from Interference Experiments and Random-Walk Models of Decision Making

ERIC Educational Resources Information Center

Kamienkowski, Juan E.; Pashler, Harold; Dehaene, Stanislas; Sigman, Mariano

2011-01-01

Does extensive practice reduce or eliminate central interference in dual-task processing? We explored the reorganization of task architecture with practice by combining interference analysis (delays in dual-task experiment) and random-walk models of decision making (measuring the decision and non-decision contributions to RT). The main delay…

Risk assessment and decision making about in-labour transfer from rural maternity care: a social judgment and signal detection analysis

PubMed Central

2012-01-01

Background The importance of respecting women’s wishes to give birth close to their local community is supported by policy in many developed countries. However, persistent concerns about the quality and safety of maternity care in rural communities have been expressed. Safe childbirth in rural communities depends on good risk assessment and decision making as to whether and when the transfer of a woman in labour to an obstetric led unit is required. This is a difficult decision. Wide variation in transfer rates between rural maternity units have been reported suggesting different decision making criteria may be involved; furthermore, rural midwives and family doctors report feeling isolated in making these decisions and that staff in urban centres do not understand the difficulties they face. In order to develop more evidence based decision making strategies greater understanding of the way in which maternity care providers currently make decisions is required. This study aimed to examine how midwives working in urban and rural settings and obstetricians make intrapartum transfer decisions, and describe sources of variation in decision making. Methods The study was conducted in three stages. 1. 20 midwives and four obstetricians described factors influencing transfer decisions. 2. Vignettes depicting an intrapartum scenario were developed based on stage one data. 3. Vignettes were presented to 122 midwives and 12 obstetricians who were asked to assess the level of risk in each case and decide whether to transfer or not. Social judgment analysis was used to identify the factors and factor weights used in assessment. Signal detection analysis was used to identify participants’ ability to distinguish high and low risk cases and personal decision thresholds. Results When reviewing the same case information in vignettes midwives in different settings and obstetricians made very similar risk assessments. Despite this, a wide range of transfer decisions were still made, suggesting that the main source of variation in decision making and transfer rates is not in the assessment but the personal decision thresholds of clinicians. Conclusions Currently health care practice focuses on supporting or improving decision making through skills training and clinical guidelines. However, these methods alone are unlikely to be effective in improving consistency of decision making. PMID:23114289

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

PubMed

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

2015-01-01

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

DECISION-COMPONENTS OF NICE'S TECHNOLOGY APPRAISALS ASSESSMENT FRAMEWORK.

PubMed

de Folter, Joost; Trusheim, Mark; Jonsson, Pall; Garner, Sarah

2018-01-01

Value assessment frameworks have gained prominence recently in the context of U.S. healthcare. Such frameworks set out a series of factors that are considered in funding decisions. The UK's National Institute of Health and Care Excellence (NICE) is an established health technology assessment (HTA) agency. We present a novel application of text analysis that characterizes NICE's Technology Appraisals in the context of the newer assessment frameworks and present the results in a visual way. A total of 243 documents of NICE's medicines guidance from 2007 to 2016 were analyzed. Text analysis was used to identify a hierarchical set of decision factors considered in the assessments. The frequency of decision factors stated in the documents was determined and their association with terms related to uncertainty. The results were incorporated into visual representations of hierarchical factors. We identified 125 decision factors, and hierarchically grouped these into eight domains: Clinical Effectiveness, Cost Effectiveness, Condition, Current Practice, Clinical Need, New Treatment, Studies, and Other Factors. Textual analysis showed all domains appeared consistently in the guidance documents. Many factors were commonly associated with terms relating to uncertainty. A series of visual representations was created. This study reveals the complexity and consistency of NICE's decision-making processes and demonstrates that cost effectiveness is not the only decision-criteria. The study highlights the importance of processes and methodology that can take both quantitative and qualitative information into account. Visualizations can help effectively communicate this complex information during the decision-making process and subsequently to stakeholders.

A decision-analytic approach to predict state regulation of hydraulic fracturing.

PubMed

Linkov, Igor; Trump, Benjamin; Jin, David; Mazurczak, Marcin; Schreurs, Miranda

2014-01-01

The development of horizontal drilling and hydraulic fracturing methods has dramatically increased the potential for the extraction of previously unrecoverable natural gas. Nonetheless, the potential risks and hazards associated with such technologies are not without controversy and are compounded by frequently changing information and an uncertain landscape of international politics and laws. Where each nation has its own energy policies and laws, predicting how a state with natural gas reserves that require hydraulic fracturing will regulate the industry is of paramount importance for potential developers and extractors. We present a method for predicting hydraulic fracturing decisions using multiple-criteria decision analysis. The case study evaluates the decisions of five hypothetical countries with differing political, social, environmental, and economic priorities, choosing among four policy alternatives: open hydraulic fracturing, limited hydraulic fracturing, completely banned hydraulic fracturing, and a cap and trade program. The result is a model that identifies the preferred policy alternative for each archetypal country and demonstrates the sensitivity the decision to particular metrics. Armed with such information, observers can predict each country's likely decisions related to natural gas exploration as more data become available or political situations change. Decision analysis provides a method to manage uncertainty and address forecasting concerns where rich and objective data may be lacking. For the case of hydraulic fracturing, the various political pressures and extreme uncertainty regarding the technology's risks and benefits serve as a prime platform to demonstrate how decision analysis can be used to predict future behaviors.

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

PubMed Central

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

2016-01-01

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

Decision science and cervical cancer.

PubMed

Cantor, Scott B; Fahs, Marianne C; Mandelblatt, Jeanne S; Myers, Evan R; Sanders, Gillian D

2003-11-01

Mathematical modeling is an effective tool for guiding cervical cancer screening, diagnosis, and treatment decisions for patients and policymakers. This article describes the use of mathematical modeling as outlined in five presentations from the Decision Science and Cervical Cancer session of the Second International Conference on Cervical Cancer held at The University of Texas M. D. Anderson Cancer Center, April 11-14, 2002. The authors provide an overview of mathematical modeling, especially decision analysis and cost-effectiveness analysis, and examples of how it can be used for clinical decision making regarding the prevention, diagnosis, and treatment of cervical cancer. Included are applications as well as theory regarding decision science and cervical cancer. Mathematical modeling can answer such questions as the optimal frequency for screening, the optimal age to stop screening, and the optimal way to diagnose cervical cancer. Results from one mathematical model demonstrated that a vaccine against high-risk strains of human papillomavirus was a cost-effective use of resources, and discussion of another model demonstrated the importance of collecting direct non-health care costs and time costs for cost-effectiveness analysis. Research presented indicated that care must be taken when applying the results of population-wide, cost-effectiveness analyses to reduce health disparities. Mathematical modeling can encompass a variety of theoretical and applied issues regarding decision science and cervical cancer. The ultimate objective of using decision-analytic and cost-effectiveness models is to identify ways to improve women's health at an economically reasonable cost. Copyright 2003 American Cancer Society.

A decision impact, decision conflict and economic assessment of routine Oncotype DX testing of 146 women with node-negative or pNImi, ER-positive breast cancer in the UK

PubMed Central

Holt, S; Bertelli, G; Humphreys, I; Valentine, W; Durrani, S; Pudney, D; Rolles, M; Moe, M; Khawaja, S; Sharaiha, Y; Brinkworth, E; Whelan, S; Jones, S; Bennett, H; Phillips, C J

2013-01-01

Background: Tumour gene expression analysis is useful in predicting adjuvant chemotherapy benefit in early breast cancer patients. This study aims to examine the implications of routine Oncotype DX testing in the UK. Methods: Women with oestrogen receptor positive (ER+), pNO or pN1mi breast cancer were assessed for adjuvant chemotherapy and subsequently offered Oncotype DX testing, with changes in chemotherapy decisions recorded. A subset of patients completed questionnaires about their uncertainties regarding chemotherapy decisions pre- and post-testing. All patients were asked to complete a diary of medical interactions over the next 6 months, from which economic data were extracted to model the cost-effectiveness of testing. Results: Oncotype DX testing resulted in changes in chemotherapy decisions in 38 of 142 (26.8%) women, with 26 of 57 (45.6%) spared chemotherapy and 12 of 85 (14.1%) requiring chemotherapy when not initially recommended (9.9% reduction overall). Decision conflict analysis showed that Oncotype DX testing increased patients' confidence in treatment decision making. Economic analysis showed that routine Oncotype DX testing costs £6232 per quality-adjusted life year gained. Conclusion: Oncotype DX decreased chemotherapy use and increased confidence in treatment decision making in patients with ER+ early-stage breast cancer. Based on these findings, Oncotype DX is cost-effective in the UK setting. PMID:23695023

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

PubMed

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

2014-04-01

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

How accurate are interpretations of curriculum-based measurement progress monitoring data? Visual analysis versus decision rules.

PubMed

Van Norman, Ethan R; Christ, Theodore J

2016-10-01

Curriculum based measurement of oral reading (CBM-R) is used to monitor the effects of academic interventions for individual students. Decisions to continue, modify, or terminate these interventions are made by interpreting time series CBM-R data. Such interpretation is founded upon visual analysis or the application of decision rules. The purpose of this study was to compare the accuracy of visual analysis and decision rules. Visual analysts interpreted 108 CBM-R progress monitoring graphs one of three ways: (a) without graphic aids, (b) with a goal line, or (c) with a goal line and a trend line. Graphs differed along three dimensions, including trend magnitude, variability of observations, and duration of data collection. Automated trend line and data point decision rules were also applied to each graph. Inferential analyses permitted the estimation of the probability of a correct decision (i.e., the student is improving - continue the intervention, or the student is not improving - discontinue the intervention) for each evaluation method as a function of trend magnitude, variability of observations, and duration of data collection. All evaluation methods performed better when students made adequate progress. Visual analysis and decision rules performed similarly when observations were less variable. Results suggest that educators should collect data for more than six weeks, take steps to control measurement error, and visually analyze graphs when data are variable. Implications for practice and research are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Decision Support System Requirements Definition for Human Extravehicular Activity Based on Cognitive Work Analysis

PubMed Central

Miller, Matthew James; McGuire, Kerry M.; Feigh, Karen M.

2016-01-01

The design and adoption of decision support systems within complex work domains is a challenge for cognitive systems engineering (CSE) practitioners, particularly at the onset of project development. This article presents an example of applying CSE techniques to derive design requirements compatible with traditional systems engineering to guide decision support system development. Specifically, it demonstrates the requirements derivation process based on cognitive work analysis for a subset of human spaceflight operations known as extravehicular activity. The results are presented in two phases. First, a work domain analysis revealed a comprehensive set of work functions and constraints that exist in the extravehicular activity work domain. Second, a control task analysis was performed on a subset of the work functions identified by the work domain analysis to articulate the translation of subject matter states of knowledge to high-level decision support system requirements. This work emphasizes an incremental requirements specification process as a critical component of CSE analyses to better situate CSE perspectives within the early phases of traditional systems engineering design. PMID:28491008

Decision Support System Requirements Definition for Human Extravehicular Activity Based on Cognitive Work Analysis.

PubMed

Miller, Matthew James; McGuire, Kerry M; Feigh, Karen M

2017-06-01

The design and adoption of decision support systems within complex work domains is a challenge for cognitive systems engineering (CSE) practitioners, particularly at the onset of project development. This article presents an example of applying CSE techniques to derive design requirements compatible with traditional systems engineering to guide decision support system development. Specifically, it demonstrates the requirements derivation process based on cognitive work analysis for a subset of human spaceflight operations known as extravehicular activity . The results are presented in two phases. First, a work domain analysis revealed a comprehensive set of work functions and constraints that exist in the extravehicular activity work domain. Second, a control task analysis was performed on a subset of the work functions identified by the work domain analysis to articulate the translation of subject matter states of knowledge to high-level decision support system requirements. This work emphasizes an incremental requirements specification process as a critical component of CSE analyses to better situate CSE perspectives within the early phases of traditional systems engineering design.

Advanced Economic Analysis

NASA Technical Reports Server (NTRS)

Greenberg, Marc W.; Laing, William

2013-01-01

An Economic Analysis (EA) is a systematic approach to the problem of choosing the best method of allocating scarce resources to achieve a given objective. An EA helps guide decisions on the "worth" of pursuing an action that departs from status quo ... an EA is the crux of decision-support.

Decision Analysis Using Spreadsheets.

ERIC Educational Resources Information Center

Sounderpandian, Jayavel

1989-01-01

Discussion of decision analysis and its importance in a business curriculum focuses on the use of spreadsheets instead of commercial software packages for computer assisted instruction. A hypothetical example is given of a company drilling for oil, and suggestions are provided for classroom exercises using spreadsheets. (seven references) (LRW)

ELICIT: An alternative imprecise weight elicitation technique for use in multi-criteria decision analysis for healthcare

PubMed Central

Diaby, Vakaramoko; Sanogo, Vassiki; Moussa, Kouame Richard

2015-01-01

Objective In this paper, the readers are introduced to ELICIT, an imprecise weight elicitation technique for multicriteria decision analysis for healthcare. Methods The application of ELICIT consists of two steps: the rank ordering of evaluation criteria based on decision-makers’ (DMs) preferences using the principal component analysis; and the estimation of criteria weights and their descriptive statistics using the variable interdependent analysis and the Monte Carlo method. The application of ELICIT is illustrated with a hypothetical case study involving the elicitation of weights for five criteria used to select the best device for eye surgery. Results The criteria were ranked from 1–5, based on a strict preference relationship established by the DMs. For each criterion, the deterministic weight was estimated as well as the standard deviation and 95% credibility interval. Conclusions ELICIT is appropriate in situations where only ordinal DMs’ preferences are available to elicit decision criteria weights. PMID:26361235

Formulary evaluation of third-generation cephalosporins using decision analysis.

PubMed

Cano, S B; Fujita, N K

1988-03-01

A structured, objective approach to formulary review of third-generation cephalosporins using the decision-analysis model is described. The pharmacy and therapeutics (P&T) committee approved the evaluation criteria for this drug class and assigned priority weights (as percentages of 100) to those drug characteristics deemed most important. Clinical data (spectrum of activity, pharmacokinetics, adverse effects, and stability) and financial data (cost of acquisition and cost of therapy per day) were used to determine ranking scores for each drug. Total scores were determined by multiplying ranking scores by the assigned priority weights for the criteria. The two highest-scoring drugs were selected for inclusion in the formulary. By this decision-analysis process, the P&T committee recommended that all current third-generation cephalosporins (cefotaxime, cefoperazone, and moxalactam) be removed from the institutions's formulary and be replaced with ceftazidime and ceftriaxone. P&T committees at other institutions may structure their criteria differently, and different recommendations may result. Using decision analysis for formulary review may promote rational drug therapy and achieve cost savings.

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

EPA Science Inventory

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

Decision Analysis for a Sustainable Environment, Economy & Society

EPA Science Inventory

Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts. ...

Decision Analysis For A Sustainable Environment, Economy, & Society

EPA Science Inventory

Environmental decisions are often made without consideration of the roles that ecosystem services play. Most decision-makers do not currently have access to useful or usable methods and approaches when they are presented with choices that will have significant ecosystem impacts....

Teachers as Decision-Makers.

ERIC Educational Resources Information Center

Shedd, Joseph B.; And Others

Scholars working from various perspectives are beginning to define teaching as a decision-making process. Research shows that teachers are reflective and connect knowledge to situations through observation, understanding, analysis, interpretation, and decision-making. This paper provides empirical evidence to show the relationship of…

Agent-based Decision Support System for the Third Generation Distributed Dynamic Decision-making (DDD-III) Simulator

DTIC Science & Technology

2004-06-01

suitable form of organizational adaptation is effective organizational diagnosis and analysis. The organizational diagnosis and analysis involve...related to the mission environment, organizational structure, and strategy is imperative for an effective and efficient organizational diagnosis . The...not easily articulated nor expressed otherwise. These displays are crucial to facilitate effective organizational diagnosis and analysis, and

Value focused rationality in AIDS policy.

PubMed

Wenstøp, F; Magnus, P

2001-07-01

A health policy analysis to contain the effects of the HIV epidemic in Norway has been carried out. It was performed as a Multi Criteria Decision Analysis where participants in a decision panel used personal values to weight benefits and costs of alternative policies. The analysis is of particular interest since Norway afterwards adopted a controversial HIV policy: the authorities warned the general population against sexual relations with immigrants from countries south of Sahara. The policy might reap benefits, but a certain cost was to stigmatise that group. This paper describes the analysis and defends the underlying consequentialistic ethics against other approaches involving rule-based ethics and benefit-cost analysis. The main argument is based on Hume's insight that reason alone does not prompt action; values will always be involved and should therefore be more explicitly focused on. The paper concludes that we need an extended notion of rationality that includes well-foundedness of values. Decision-makers should try to reach an emotional equilibrium where their values concerning the issue at hand become stable. The paradigm of decision analysis provides useful methods to approach this situation, although it must be considered only an input to policy rather than something producing a final answer.

"Effects of Stress on Decisions Under Uncertainty: A Meta-Analysis": Correction to Starcke and Brand (2016).

PubMed

2016-09-01

Reports an error in "Effects of Stress on Decisions Under Uncertainty: A Meta-Analysis" by Katrin Starcke and Matthias Brand ( Psychological Bulletin , Advanced Online Publication, May 23, 2016, np). It should have been reported that the inverted u-shaped relationship between cortisol stress responses and decision-making performance was only observed in female, but not in male participants as suggested by the study by van den Bos, Harteveld, and Stoop (2009). Corrected versions of the affected sentences are provided. (The following abstract of the original article appeared in record 2016-25465-001.) The purpose of the present meta-analysis was to quantify the effects that stress has on decisions made under uncertainty. We hypothesized that stress increases reward seeking and risk taking through alterations of dopamine firing rates and reduces executive control by hindering optimal prefrontal cortex functioning. In certain decision situations, increased reward seeking and risk taking is dysfunctional, whereas in others, this is not the case. We also assumed that the type of stressor plays a role. In addition, moderating variables are analyzed, such as the hormonal stress response, the time between stress onset and decisions, and the participants' age and gender. We included studies in the meta-analysis that investigated decision making after a laboratory stress-induction versus a control condition (k = 32 datasets, N = 1829 participants). A random-effects model revealed that overall, stress conditions lead to decisions that can be described as more disadvantageous, more reward seeking, and more risk taking than nonstress conditions (d = .17). In those situations in which increased reward seeking and risk taking is disadvantageous, stress had significant effects (d = .26), whereas in other situations, no effects were observed (d = .01). Effects were observed under processive stressors (d = .19), but not under systemic ones (d = .09). Moderation analyses did not reveal any significant results. We concluded that stress deteriorates overall decision-making performance through the mechanisms proposed. The effects differ, depending on the decision situation and the type of stressor, but not on the characteristics of the individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Decision Support Methods and Tools

NASA Technical Reports Server (NTRS)

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

2006-01-01

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

Postoptimality Analysis in the Selection of Technology Portfolios

NASA Technical Reports Server (NTRS)

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

2006-01-01

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

On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

PubMed

Pieterse, Arwen H; de Vries, Marieke

2013-09-01

Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis

PubMed Central

Pieterse, Arwen H.; de Vries, Marieke

2011-01-01

Abstract Background  Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference‐sensitive health‐care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic‐based VCMs. Objective  To critically analyse the suitability of the ‘take the best’ (TTB) and ‘tallying’ fast and frugal heuristics in the context of patient decision making. Strategy  Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. Conclusion  The specific nature of patient preference‐sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. PMID:21902770

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

PubMed

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

2013-04-01

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

Decision or no decision: how do patient-physician interactions end and what matters?

PubMed

Tai-Seale, Ming; Bramson, Rachel; Bao, Xiaoming

2007-03-01

A clearly stated clinical decision can induce a cognitive closure in patients and is an important investment in the end of patient-physician communications. Little is known about how often explicit decisions are made in primary care visits. To use an innovative videotape analysis approach to assess physicians' propensity to state decisions explicitly, and to examine the factors influencing decision patterns. We coded topics discussed in 395 videotapes of primary care visits, noting the number of instances and the length of discussions on each topic, and how discussions ended. A regression analysis tested the relationship between explicit decisions and visit factors such as the nature of topics under discussion, instances of discussion, the amount of time the patient spoke, and competing demands from other topics. About 77% of topics ended with explicit decisions. Patients spoke for an average of 58 seconds total per topic. Patients spoke more during topics that ended with an explicit decision, (67 seconds), compared with 36 seconds otherwise. The number of instances of a topic was associated with higher odds of having an explicit decision (OR = 1.73, p < 0.01). Increases in the number of topics discussed in visits (OR = 0.95, p < .05), and topics on lifestyle and habits (OR = 0.60, p < .01) were associated with lower odds of explicit decisions. Although discussions often ended with explicit decisions, there were variations related to the content and dynamics of interactions. We recommend strengthening patients' voice and developing clinical tools, e.g., an "exit prescription," to improving decision making.

The Effect of Naval Academy Training on the Decision Styles of Individuals

DTIC Science & Technology

1975-05-22

researcher’s knowledge in the areas of decision styles, psychological theory, and brain wave analysis. Talks with Dr. Michael Driver of the - 5 University of...personality/motivational factors. 4. Analysis of Naval Academy training to determine what factors in it might cause a change in decision style. 5 ...sophomore year. The test was given to the First Regiment on 5 September 1974 and to the Second Regiment on 6 September 1974. The test was given in Room

Development of the Expert System Domain Advisor and Analysis Tool

DTIC Science & Technology

1991-09-01

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

Accommodating complexity and human behaviors in decision analysis.

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

Backus, George A.; Siirola, John Daniel; Schoenwald, David Alan

2007-11-01

This is the final report for a LDRD effort to address human behavior in decision support systems. One sister LDRD effort reports the extension of this work to include actual human choices and additional simulation analyses. Another provides the background for this effort and the programmatic directions for future work. This specific effort considered the feasibility of five aspects of model development required for analysis viability. To avoid the use of classified information, healthcare decisions and the system embedding them became the illustrative example for assessment.

What To Do, What To Do? Determining a Course of Action at the Operational Level of War

DTIC Science & Technology

1992-05-18

and making choices can expand the limits of human rationality . 5 Where decisions involve the lives of soldiers and the future of nations, any edge or...ANALYSIS 15. N5Iu,,3E•a -r PAGES115 OPERATIONAL DECISION - MAKING MISSION ANALYSIS 115 COURSE OF ACTION SELECTION STAFF ESTIMATES I1. SECUlPIT... decision - making procedures for the operational level of war. These doctrinal procedures are found in emerging joint doctrine. For these procedures to be

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

PubMed Central

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

2016-01-01

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

Decision analysis to support development of the Glen Canyon Dam long-term experimental and management plan

USGS Publications Warehouse

Runge, Michael C.; LaGory, Kirk E.; Russell, Kendra; Balsom, Janet R.; Butler, R. Alan; Coggins,, Lewis G.; Grantz, Katrina A.; Hayse, John; Hlohowskyj, Ihor; Korman, Josh; May, James E.; O'Rourke, Daniel J.; Poch, Leslie A.; Prairie, James R.; VanKuiken, Jack C.; Van Lonkhuyzen, Robert A.; Varyu, David R.; Verhaaren, Bruce T.; Veselka, Thomas D.; Williams, Nicholas T.; Wuthrich, Kelsey K.; Yackulic, Charles B.; Billerbeck, Robert P.; Knowles, Glen W.

2016-01-07

The results of the decision analysis are meant to serve as only one of many sources of information that can be used to evaluate the alternatives proposed in the Environmental Impact Statement. These results only focus on those resource goals for which quantitative performance metrics could be formulated and evaluated; there are other important aspects of the resource goals that also need to be considered. Not all the stakeholders who were invited to participate in the decision analysis chose to do so; thus, the Bureau of Reclamation, National Park Service, and U.S. Department of Interior may want to consider other input.

Interpreting indirect treatment comparisons and network meta-analysis for health-care decision making: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 1.

PubMed

Jansen, Jeroen P; Fleurence, Rachael; Devine, Beth; Itzler, Robbin; Barrett, Annabel; Hawkins, Neil; Lee, Karen; Boersma, Cornelis; Annemans, Lieven; Cappelleri, Joseph C

2011-06-01

Evidence-based health-care decision making requires comparisons of all relevant competing interventions. In the absence of randomized, controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for judiciously selecting the best choice(s) of treatment. Mixed treatment comparisons, a special case of network meta-analysis, combine direct and indirect evidence for particular pairwise comparisons, thereby synthesizing a greater share of the available evidence than a traditional meta-analysis. This report from the ISPOR Indirect Treatment Comparisons Good Research Practices Task Force provides guidance on the interpretation of indirect treatment comparisons and network meta-analysis to assist policymakers and health-care professionals in using its findings for decision making. We start with an overview of how networks of randomized, controlled trials allow multiple treatment comparisons of competing interventions. Next, an introduction to the synthesis of the available evidence with a focus on terminology, assumptions, validity, and statistical methods is provided, followed by advice on critically reviewing and interpreting an indirect treatment comparison or network meta-analysis to inform decision making. We finish with a discussion of what to do if there are no direct or indirect treatment comparisons of randomized, controlled trials possible and a health-care decision still needs to be made. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Behavioral and Organizational Considerations in the Design of Information Systems and Processes for Planning and Decision Support,

DTIC Science & Technology

1981-06-01

analysis and display capability provided by management information systems to include interpretation and aggregation of information and values such as...accomplishment of these) 2. analysis of the issue d) systems analysis and modeling (determination of the structure of the decision situation, the...existingltrtie2) Surveying lsata i situation’ alternatives I altraivDsad Is this alternative -" altrnav acceptable? ANALYSIS o NOYES SHave a sufficient

Probabilistic sensitivity analysis incorporating the bootstrap: an example comparing treatments for the eradication of Helicobacter pylori.

PubMed

Pasta, D J; Taylor, J L; Henning, J M

1999-01-01

Decision-analytic models are frequently used to evaluate the relative costs and benefits of alternative therapeutic strategies for health care. Various types of sensitivity analysis are used to evaluate the uncertainty inherent in the models. Although probabilistic sensitivity analysis is more difficult theoretically and computationally, the results can be much more powerful and useful than deterministic sensitivity analysis. The authors show how a Monte Carlo simulation can be implemented using standard software to perform a probabilistic sensitivity analysis incorporating the bootstrap. The method is applied to a decision-analytic model evaluating the cost-effectiveness of Helicobacter pylori eradication. The necessary steps are straightforward and are described in detail. The use of the bootstrap avoids certain difficulties encountered with theoretical distributions. The probabilistic sensitivity analysis provided insights into the decision-analytic model beyond the traditional base-case and deterministic sensitivity analyses and should become the standard method for assessing sensitivity.

The use of decision analysis to examine ethical decision making by critical care nurses.

PubMed

Hughes, K K; Dvorak, E M

1997-01-01

To examine the extent to which critical care staff nurses make ethical decisions that coincide with those recommended by a decision analytic model. Nonexperimental, ex post facto. Midwestern university-affiliated 500 bed tertiary care medical center. One hundred critical care staff nurses randomly selected from seven critical care units. Complete responses were obtained from 82 nurses (for a final response rate of 82%). The dependent variable--consistent decision making--was measured as staff nurses' abilities to make ethical decisions that coincided with those prescribed by the decision model. Subjects completed two instruments, the Ethical Decision Analytic Model, a computer-administered instrument designed to measure staff nurses' abilities to make consistent decisions about a chemically-impaired colleague; and a Background Inventory. The results indicate marked consensus among nurses when informal methods were used. However, there was little consistency between the nurses' informal decisions and those recommended by the decision analytic model. Although 50% (n = 41) of all nurses chose a course of action that coincided with the model's least optimal alternative, few nurses agreed with the model as to the most optimal course of action. The findings also suggest that consistency was unrelated (p > 0.05) to the nurses' educational background or years of clinical experience; that most subjects reported receiving little or no education in decision making during their basic nursing education programs; but that exposure to decision-making strategies was related to years of nursing experience (p < 0.05). The findings differ from related studies that have found a moderate degree of consistency between nurses and decision analytic models for strictly clinical decision tasks, especially when those tasks were less complex. However, the findings partially coincide with other findings that decision analysis may not be particularly well-suited to the critical care environment. Additional research is needed to determine whether critical care nurses use the same decision-making methods as do other nurses; and to clarify the effects of decision task (clinical versus ethical) on nurses' decision making. It should not be assumed that methods used to study nurses' clinical decision making are applicable for all nurses or all types of decisions, including ethical decisions.

DEVELOPMENT PLAN FOR THE CAUSAL ANALYSIS / DIAGNOSIS DECISION INFORMATION SYSTEM (CADDIS) 2001-2004

EPA Science Inventory

The Causal Analysis/Diagnosis Decision Information System (CADDIS) is a web-based system that provides technical support for states, tribes and other users of the Office of Water's Stressor Identification Guidance. The Stressor Identific...

Managing Uncertainty: Environmental Analysis/Forecasting in Academic Planning.

ERIC Educational Resources Information Center

Morrison, James L.; Mecca, Thomas V.

An approach to environmental analysis and forecasting that educational policymakers can employ in dealing with the level of uncertainty in strategic decision making is presented. Traditional planning models are weak in identifying environmental changes and assessing their organizational impact. The proposed approach does not lead decision makers…

Amy Rose | NREL

Science.gov Websites

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

FUZZY DECISION ANALYSIS FOR INTEGRATED ENVIRONMENTAL VULNERABILITY ASSESSMENT OF THE MID-ATLANTIC REGION

EPA Science Inventory

A fuzzy decision analysis method for integrating ecological indicators is developed. This is a combination of a fuzzy ranking method and the Analytic Hierarchy Process (AHP). The method is capable ranking ecosystems in terms of environmental conditions and suggesting cumula...

General Methodology Combining Engineering Optimization of Primary HVAC and R Plants with Decision Analysis Methods--Part II: Uncertainty and Decision Analysis

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

Jiang, Wei; Reddy, T. A.; Gurian, Patrick

2007-01-31

A companion paper to Jiang and Reddy that presents a general and computationally efficient methodology for dyanmic scheduling and optimal control of complex primary HVAC&R plants using a deterministic engineering optimization approach.

Averse to Initiative: Risk Management’s Effect on Mission Command

DTIC Science & Technology

2017-05-25

military decision making process (MDMP). Other changes to structure reveal administrative and safety risk information (i.e. personal operated vehicle... decision making , it requires commanders to have the capacity to make an informed , intuitive decision . Uncertainty...analysis. His situation required him to embrace uncertainty, and exercise an informed intuition to make a risk decision to create opportunity

Placement Decisions and Disparities among Aboriginal Groups: An Application of the Decision Making Ecology through Multi-Level Analysis

ERIC Educational Resources Information Center

Fluke, John D.; Chabot, Martin; Fallon, Barbara; MacLaurin, Bruce; Blackstock, Cindy

2010-01-01

Objective: This paper examined the relative influence of clinical and organizational characteristics on the decision to place a child in out-of-home care at the conclusion of a child maltreatment investigation. It tested the hypothesis that extraneous factors, specifically, organizational characteristics, impact the decision to place a child in…

School-Leaving Decisions in Australia: A Cohort Analysis

ERIC Educational Resources Information Center

Le, Anh T.; Miller, Paul W.

2004-01-01

The decision to invest in education is influenced by a large number of economic, social, family, personal and institutional factors. Many of these changed in Australia during the 1970s and 1980s. Several of the more important of these changes, such as the Equal Pay for Equal Work decision of 1969, the Equal Pay for Work of Equal Value decision of…

Eliciting societal preferences of reimbursement decision criteria for anti cancer drugs in South Korea.

PubMed

Kwon, Sun-Hong; Park, Sun-Kyeong; Byun, Ji-Hye; Lee, Eui-Kyung

2017-08-01

In order to look beyond the cost-effectiveness analysis, this study used a multi-criteria decision analysis (MCDA), which reflects societal values with regard to reimbursement decisions. This study aims to elicit societal preferences of the reimbursement decision criteria for anti cancer drugs from public and healthcare professionals. Eight criteria were defined based on a literature review and focus group sessions: disease severity, disease population size, pediatrics targets, unmet needs, innovation, clinical benefits, cost-effectiveness, and budget impacts. Using quota sampling and purposive sampling, 300 participants from the Korean public and 30 healthcare professionals were selected for the survey. Preferences were elicited using an analytic hierarchy process. Both groups rated clinical benefits the highest, followed by cost-effectiveness and disease severity, but differed with regard to disease population size and unmet needs. Innovation was the least preferred criteria. Clinical benefits and other social values should be reflected appropriately with cost-effectiveness in healthcare coverage. MCDA can be used to assess decision priorities for complicated health policy decisions, including reimbursement decisions. It is a promising method for making logical and transparent drug reimbursement decisions that consider a broad range of factors, which are perceived as important by relevant stakeholders.

A critical narrative analysis of shared decision-making in acute inpatient mental health care.

PubMed

Stacey, Gemma; Felton, Anne; Morgan, Alastair; Stickley, Theo; Willis, Martin; Diamond, Bob; Houghton, Philip; Johnson, Beverley; Dumenya, John

2016-01-01

Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients' care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place.

Hospice decision making: diagnosis makes a difference.

PubMed

Waldrop, Deborah P; Meeker, Mary Ann

2012-10-01

This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36 hospice patients and 55 caregivers after 2 weeks of hospice care. The study was guided by Janis and Mann's conflict theory model (CTM) of decision making. Qualitative data analysis involved a directed content analysis using concepts from the CTM. A model of hospice enrollment decision making is presented. Concepts from the CTM (appraisal, surveying and weighing the alternatives, deliberations, adherence) were used as an organizing framework to illustrate the dynamics. Distinct differences were found by diagnosis (cancer vs. other chronic illness, e.g., heart and lung diseases) during the pre-encounter phase or before the hospice referral but no differences emerged during the post-encounter phase. Differences in decision making by diagnosis suggest the need for research about effective means for tailored communication in end-of-life decision making by type of illness. Recognition that decision making about hospice admission varies is important for clinicians who aim to provide person-centered and family-focused care.

32 CFR 651.4 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operational testers, producers, users, and disposers) into the decision-making process. (v) Initiate the... environmental perspective, and to ensure that these determinations are part of the Army decision process. (p... agency input into the decision-making process. (5) Ensure that NEPA analysis is prepared and staffed...

78 FR 77101 - Certain New Pneumatic Off-the-Road Tires From the People's Republic of China: Final Results of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... Decision Memorandum and electronic versions of the Issues and Decision Memorandum are identical in content. Analysis of Comments Received All issues raised in this review are addressed in the Issues and Decision...

Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications.

PubMed

Kerns, Jennifer L; Mengesha, Biftu; McNamara, Blair C; Cassidy, Arianna; Pearlson, Geffan; Kuppermann, Miriam

2018-06-01

We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, p<.0001), as were posttraumatic stress and grief scores (r=0.7, p<.0001). In the adjusted analysis, higher decision satisfaction was associated with lower grief and posttraumatic stress scores (p=.02 and p=.01, respectively) and higher shared decision making was associated with lower posttraumatic stress scores (p=.01). Decision satisfaction and shared decision making have a positive effect on psychological outcomes after second-trimester abortion for pregnancy complications. Counseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. These results highlight the importance of patient-centered counseling for women seeking pregnancy termination. Copyright © 2018. Published by Elsevier Inc.

Combining conversation analysis and event sequencing to study health communication.

PubMed

Pecanac, Kristen E

2018-06-01

Good communication is essential in patient-centered care. The purpose of this paper is to describe conversation analysis and event sequencing and explain how integrating these methods strengthened the analysis in a study of communication between clinicians and surrogate decision makers in an intensive care unit. Conversation analysis was first used to determine how clinicians introduced the need for decision-making regarding life-sustaining treatment and how surrogate decision makers responded. Event sequence analysis then was used to determine the transitional probability (probability of one event leading to another in the interaction) that a given type of clinician introduction would lead to surrogate resistance or alignment. Conversation analysis provides a detailed analysis of the interaction between participants in a conversation. When combined with a quantitative analysis of the patterns of communication in an interaction, these data add information on the communication strategies that produce positive outcomes. Researchers can apply this mixed-methods approach to identify beneficial conversational practices and design interventions to improve health communication. © 2018 Wiley Periodicals, Inc.

An improved hybrid multi-criteria/multidimensional model for strategic industrial location selection: Casablanca industrial zones as a case study.

PubMed

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

2015-01-01

In this paper, we examine the issue of strategic industrial location selection in uncertain decision making environments for implanting new industrial corporation. In fact, the industrial location issue is typically considered as a crucial factor in business research field which is related to many calculations about natural resources, distributors, suppliers, customers, and most other things. Based on the integration of environmental, economic and social decisive elements of sustainable development, this paper presents a hybrid decision making model combining fuzzy multi-criteria analysis with analytical capabilities that OLAP systems can provide for successful and optimal industrial location selection. The proposed model mainly consists in three stages. In the first stage, a decision-making committee has been established to identify the evaluation criteria impacting the location selection process. In the second stage, we develop fuzzy AHP software based on the extent analysis method to assign the importance weights to the selected criteria, which allows us to model the linguistic vagueness, ambiguity, and incomplete knowledge. In the last stage, OLAP analysis integrated with multi-criteria analysis employs these weighted criteria as inputs to evaluate, rank and select the strategic industrial location for implanting new business corporation in the region of Casablanca, Morocco. Finally, a sensitivity analysis is performed to evaluate the impact of criteria weights and the preferences given by decision makers on the final rankings of strategic industrial locations.

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

NASA Astrophysics Data System (ADS)

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

2014-09-01

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

Decision-making when data and inferences are not conclusive: risk-benefit and acceptable regret approach.

PubMed

Hozo, Iztok; Schell, Michael J; Djulbegovic, Benjamin

2008-07-01

The absolute truth in research is unobtainable, as no evidence or research hypothesis is ever 100% conclusive. Therefore, all data and inferences can in principle be considered as "inconclusive." Scientific inference and decision-making need to take into account errors, which are unavoidable in the research enterprise. The errors can occur at the level of conclusions that aim to discern the truthfulness of research hypothesis based on the accuracy of research evidence and hypothesis, and decisions, the goal of which is to enable optimal decision-making under present and specific circumstances. To optimize the chance of both correct conclusions and correct decisions, the synthesis of all major statistical approaches to clinical research is needed. The integration of these approaches (frequentist, Bayesian, and decision-analytic) can be accomplished through formal risk:benefit (R:B) analysis. This chapter illustrates the rational choice of a research hypothesis using R:B analysis based on decision-theoretic expected utility theory framework and the concept of "acceptable regret" to calculate the threshold probability of the "truth" above which the benefit of accepting a research hypothesis outweighs its risks.

Decision technologies and the independent professional: the future's challenge to learning and leadership

PubMed Central

Dowie, J.

2001-01-01

Most references to "leadership" and "learning" as sources of quality improvement in medical care reflect an implicit commitment to the decision technology of "clinical judgement". All attempts to sustain this waning decision technology by clinical guidelines, care pathways, "evidence based practice", problem based curricula, and other stratagems only increase the gap between what is expected of doctors in today's clinical situation and what is humanly possible, hence the morale, stress, and health problems they are increasingly experiencing. Clinical guidance programmes based on decision analysis represent the coming decision technology, and proactive adaptation will produce independent doctors who can deliver excellent evidence based and preference driven care while concentrating on the human aspects of the therapeutic relation, having been relieved of the unbearable burdens of knowledge and information processing currently laid on them. History is full of examples of the incumbents of dominant technologies preferring to die than to adapt, and medicine needs both learning and leadership if it is to avoid repeating this mistake. Key Words: decision technology; clinical guidance programmes; decision analysis PMID:11700381

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

USGS Publications Warehouse

Caughlan, L.

2002-01-01

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

Can streamlined multi-criteria decision analysis be used to implement shared decision making for colorectal cancer screening?

PubMed Central

Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas F.

2013-01-01

Background Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multi-criteria decision analysis (MCDA) is an established methodology well suited for supporting shared decision making. Our study goal was to determine if a streamlined form of MCDA using rank order based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods We converted priorities for four decision criteria and three sub-criteria regarding colorectal cancer screening obtained from 484 average risk patients using the Analytic Hierarchy Process (AHP) in a prior study into rank order-based priorities using rank order centroids. We compared the two sets of priorities using Spearman rank correlation and non-parametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank order-based versus the AHP-based priorities on the results of a full MCDA comparing three currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Results Correlations between the two sets of priorities for the seven criteria ranged from 0.55 to 0.92. The proportions of absolute differences between rank order-based and AHP-based priorities that were more than ± 0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal and the relative rankings of the three screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Conclusion Rank order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making. PMID:24300851

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

NASA Technical Reports Server (NTRS)

Herbert, T. T.

1971-01-01

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

Closed-Loop Analysis of Soft Decisions for Serial Links

NASA Technical Reports Server (NTRS)

Lansdowne, Chatwin A.; Steele, Glen F.; Zucha, Joan P.; Schlesinger, Adam M.

2013-01-01

We describe the benefit of using closed-loop measurements for a radio receiver paired with a counterpart transmitter. We show that real-time analysis of the soft decision output of a receiver can provide rich and relevant insight far beyond the traditional hard-decision bit error rate (BER) test statistic. We describe a Soft Decision Analyzer (SDA) implementation for closed-loop measurements on single- or dual- (orthogonal) channel serial data communication links. The analyzer has been used to identify, quantify, and prioritize contributors to implementation loss in live-time during the development of software defined radios. This test technique gains importance as modern receivers are providing soft decision symbol synchronization as radio links are challenged to push more data and more protocol overhead through noisier channels, and software-defined radios (SDRs) use error-correction codes that approach Shannon's theoretical limit of performance.

Using decision analysis to assess comparative clinical efficacy of surgical treatment of unstable ankle fractures.

PubMed

Michelson, James D

2013-11-01

The development of a robust treatment algorithm for ankle fractures based on well-established stability criteria has been shown to be prognostic with respect to treatment and outcomes. In parallel with the development of improved understanding of the biomechanical rationale of ankle fracture treatment has been an increased emphasis on assessing the effectiveness of medical and surgical interventions. The purpose of this study was to investigate the use of using decision analysis in the assessment of the cost effectiveness of operative treatment of ankle fractures based on the existing clinical data in the literature. Using the data obtained from a previous structured review of the ankle fracture literature, decision analysis trees were constructed using standard software. The decision nodes for the trees were based on ankle fracture stability criteria previously published. The outcomes were assessed by calculated Quality-Adjusted Life Years (QALYs) assigned to achieving normal ankle function, developing posttraumatic arthritis, or sustaining a postoperative infection. Sensitivity analysis was undertaken by varying the patient's age, incidence of arthritis, and incidence or infection. Decision analysis trees captured the essential aspects of clinical decision making in ankle fracture treatment in a clinically useful manner. In general, stable fractures yielded better outcomes with nonoperative treatment, whereas unstable fractures had better outcomes with surgery. These were consistent results over a wide range of postoperative infection rates. Varying the age of the patient did not qualitatively change the results. Between the ages of 30 and 80 years, surgery yielded higher expected QALYs than nonoperative care for unstable fractures, and generated lower QALYs than nonoperative care for stable fractures. Using local cost estimates for operative and nonoperative treatment, the incremental cost of surgery for unstable fractures was less than $40,000 per QALY (the usual cutoff for the determination of cost effectiveness) for patients aged up to 90 years. Decision analysis is a useful methodology in developing treatment guidelines. Numerous previous studies have indicated superior clinical outcomes when unstable ankle fractures underwent operative reduction and stabilization. What has been lacking was an examination of the cost effectiveness of such an approach, particularly in older patients who have fewer expected years of life. In light of the evidence for satisfactory outcomes for surgery of severe ankle fractures in older people, the justification for operative intervention is an obvious question that can be asked in the current increasingly cost-conscious environment. Using a decision-tree decision analysis structured around the stability-based ankle fracture classification system, in conjunction with a relatively simple cost effectiveness analysis, this study was able to demonstrate that surgical treatment of unstable ankle fractures in elderly patients is in fact cost effective. The clinical implication of the present analysis is that these existing treatment protocols for ankle fracture treatment are also cost effective when quality of life outcome measures are taken into account. Economic Level II. See Instructions for Authors for a complete description of levels of evidence.

Selective exposure to information: how different modes of decision making affect subsequent confirmatory information processing.

PubMed

Fischer, Peter; Fischer, Julia; Weisweiler, Silke; Frey, Dieter

2010-12-01

We investigated whether different modes of decision making (deliberate, intuitive, distracted) affect subsequent confirmatory processing of decision-consistent and inconsistent information. Participants showed higher levels of confirmatory information processing when they made a deliberate or an intuitive decision versus a decision under distraction (Studies 1 and 2). As soon as participants have a cognitive (i.e., deliberate cognitive analysis) or affective (i.e., intuitive and gut feeling) reason for their decision, the subjective confidence in the validity of their decision increases, which results in increased levels of confirmatory information processing (Study 2). In contrast, when participants are distracted during decision making, they are less certain about the validity of their decision and thus are subsequently more balanced in the processing of decision-relevant information.

Shared decision-making - Rhetoric and reality: Women's experiences and perceptions of adjuvant treatment decision-making for breast cancer.

PubMed

Mahmoodi, Neda; Sargeant, Sally

2017-01-01

This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients' subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor-patient power dynamics within shared decision-making for breast cancer.

The Development and Validation of a Generic Instrument, QoDoS, for Assessing the Quality of Decision Making.

PubMed

Donelan, Ronan; Walker, Stuart; Salek, Sam

2016-01-01

The impact of decision-making during the development and the regulatory review of medicines greatly influences the delivery of new medicinal products. Currently, there is no generic instrument that can be used to assess the quality of decision-making. This study describes the development of the Quality of Decision-Making Orientation Scheme QoDoS(©) instrument for appraising the quality of decision-making. Semi-structured interviews about decision-making were carried out with 29 senior decision makers from the pharmaceutical industry (10), regulatory authorities (9) and contract research organizations (10). The interviews offered a qualified understanding of the subjective decision-making approach, influences, behaviors and other factors that impact such processes for individuals and organizations involved in the delivery of new medicines. Thematic analysis of the transcribed interviews was carried out using NVivo8® software. Content validity was carried out using qualitative and quantitative data by an expert panel, which led to the developmental version of the QoDoS. Further psychometric evaluations were performed, including factor analysis, item reduction, reliability testing and construct validation. The thematic analysis of the interviews yielded a 94-item initial version of the QoDoS(©) with a 5-point Likert scale. The instrument was tested for content validity using a panel of experts for language clarity, completeness, relevance and scaling, resulting in a favorable agreement by panel members with an intra-class correlation coefficient value of 0.89 (95% confidence interval = 0.56, 0.99). A 76-item QoDoS(©) (version 2) emerged from content validation. Factor analysis produced a 47-item measure with four domains. The 47-item QoDoS(©) (version 3) showed high internal consistency (n = 120, Cronbach's alpha = 0.89), high reproducibility (n = 20, intra-class correlation = 0.77) and a mean completion time of 10 min. Reliability testing and construct validation was successfully performed. The QoDoS(©) is both reliable and valid for use. It has the potential for extensive use in medicines development by both the pharmaceutical industry and regulatory authorities. The QoDoS(©) can be used to assess the quality of decision-making and to inform decision makers of the factors that influence decision-making.

Psychophysical Models for Signal Detection with Time Varying Uncertainty. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Gai, E.

1975-01-01

Psychophysical models for the behavior of the human operator in detection tasks which include change in detectability, correlation between observations and deferred decisions are developed. Classical Signal Detection Theory (SDT) is discussed and its emphasis on the sensory processes is contrasted to decision strategies. The analysis of decision strategies utilizes detection tasks with time varying signal strength. The classical theory is modified to include such tasks and several optimal decision strategies are explored. Two methods of classifying strategies are suggested. The first method is similar to the analysis of ROC curves, while the second is based on the relation between the criterion level (CL) and the detectability. Experiments to verify the analysis of tasks with changes of signal strength are designed. The results show that subjects are aware of changes in detectability and tend to use strategies that involve changes in the CL's.

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

NASA Technical Reports Server (NTRS)

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

1978-01-01

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

QTest: Quantitative Testing of Theories of Binary Choice.

PubMed

Regenwetter, Michel; Davis-Stober, Clintin P; Lim, Shiau Hong; Guo, Ying; Popova, Anna; Zwilling, Chris; Cha, Yun-Shil; Messner, William

2014-01-01

The goal of this paper is to make modeling and quantitative testing accessible to behavioral decision researchers interested in substantive questions. We provide a novel, rigorous, yet very general, quantitative diagnostic framework for testing theories of binary choice. This permits the nontechnical scholar to proceed far beyond traditionally rather superficial methods of analysis, and it permits the quantitatively savvy scholar to triage theoretical proposals before investing effort into complex and specialized quantitative analyses. Our theoretical framework links static algebraic decision theory with observed variability in behavioral binary choice data. The paper is supplemented with a custom-designed public-domain statistical analysis package, the QTest software. We illustrate our approach with a quantitative analysis using published laboratory data, including tests of novel versions of "Random Cumulative Prospect Theory." A major asset of the approach is the potential to distinguish decision makers who have a fixed preference and commit errors in observed choices from decision makers who waver in their preferences.

Using decision analysis to support proactive management of emerging infectious wildlife diseases

USGS Publications Warehouse

Grant, Evan H. Campbell; Muths, Erin L.; Katz, Rachel A.; Canessa, Stefano; Adams, Michael J.; Ballard, Jennifer R.; Berger, Lee; Briggs, Cheryl J.; Coleman, Jeremy; Gray, Matthew J.; Harris, M. Camille; Harris, Reid N.; Hossack, Blake R.; Huyvaert, Kathryn P.; Kolby, Jonathan E.; Lips, Karen R.; Lovich, Robert E.; McCallum, Hamish I.; Mendelson, Joseph R.; Nanjappa, Priya; Olson, Deanna H.; Powers, Jenny G.; Richgels, Katherine L. D.; Russell, Robin E.; Schmidt, Benedikt R.; Spitzen-van der Sluijs, Annemarieke; Watry, Mary Kay; Woodhams, Douglas C.; White, C. LeAnn

2017-01-01

Despite calls for improved responses to emerging infectious diseases in wildlife, management is seldom considered until a disease has been detected in affected populations. Reactive approaches may limit the potential for control and increase total response costs. An alternative, proactive management framework can identify immediate actions that reduce future impacts even before a disease is detected, and plan subsequent actions that are conditional on disease emergence. We identify four main obstacles to developing proactive management strategies for the newly discovered salamander pathogen Batrachochytrium salamandrivorans (Bsal). Given that uncertainty is a hallmark of wildlife disease management and that associated decisions are often complicated by multiple competing objectives, we advocate using decision analysis to create and evaluate trade-offs between proactive (pre-emergence) and reactive (post-emergence) management options. Policy makers and natural resource agency personnel can apply principles from decision analysis to improve strategies for countering emerging infectious diseases.

The financial crisis and the European Parliament: An analysis of the Two-Pack legislation

PubMed Central

Roger, Léa; Otjes, Simon

2017-01-01

The left–right line of conflict has been the dominant dimension of decision-making in the European Parliament since 1979. A pro-/anti-European Union integration dimension is of secondary importance. Limited evidence exists on the conditions under which these different dimensions matter. This study examines parliamentary decision-making about the so-called Two-Pack, which moved responsibilities about budgetary decision-making to the European Commission. The article uses in-depth interviews, textual analysis of committee debates and roll call voting analysis in order to determine which lines of conflict matter at which stage of decision-making. The evidence indicates that left–right division is dominant in the informal stage preceding committee debates, while both the pro-/anti-European Union and the left/right dimensions matter during the committee stage, whereas for plenary votes, the pro-/anti-European Union dimension is crucial. PMID:29187803

The financial crisis and the European Parliament: An analysis of the Two-Pack legislation.

PubMed

Roger, Léa; Otjes, Simon; van der Veer, Harmen

2017-12-01

The left-right line of conflict has been the dominant dimension of decision-making in the European Parliament since 1979. A pro-/anti-European Union integration dimension is of secondary importance. Limited evidence exists on the conditions under which these different dimensions matter. This study examines parliamentary decision-making about the so-called Two-Pack, which moved responsibilities about budgetary decision-making to the European Commission. The article uses in-depth interviews, textual analysis of committee debates and roll call voting analysis in order to determine which lines of conflict matter at which stage of decision-making. The evidence indicates that left-right division is dominant in the informal stage preceding committee debates, while both the pro-/anti-European Union and the left/right dimensions matter during the committee stage, whereas for plenary votes, the pro-/anti-European Union dimension is crucial.

The use of multi-criteria decision analysis to tackle waste management problems: a literature review.

PubMed

Achillas, Charisios; Moussiopoulos, Nicolas; Karagiannidis, Avraam; Banias, Georgias; Perkoulidis, George

2013-02-01

Problems in waste management have become more and more complex during recent decades. The increasing volumes of waste produced and social environmental consciousness present prominent drivers for environmental managers towards the achievement of a sustainable waste management scheme. However, in practice, there are many factors and influences - often mutually conflicting - criteria for finding solutions in real-life applications. This paper presents a review of the literature on multi-criteria decision aiding in waste management problems for all reported waste streams. Despite limitations, which are clearly stated, most of the work published in this field is reviewed. The present review aims to provide environmental managers and decision-makers with a thorough list of practical applications of the multi-criteria decision analysis techniques that are used to solve real-life waste management problems, as well as the criteria that are mostly employed in such applications according to the nature of the problem under study. Moreover, the paper explores the advantages and disadvantages of using multi-criteria decision analysis techniques in waste management problems in comparison to other available alternatives.

Decision analysis of emergency ventilation and evacuation strategies against suddenly released contaminant indoors by considering the uncertainty of source locations.

PubMed

Cai, Hao; Long, Weiding; Li, Xianting; Kong, Lingjuan; Xiong, Shuang

2010-06-15

In case hazardous contaminants are suddenly released indoors, the prompt and proper emergency responses are critical to protect occupants. This paper aims to provide a framework for determining the optimal combination of ventilation and evacuation strategies by considering the uncertainty of source locations. The certainty of source locations is classified as complete certainty, incomplete certainty, and complete uncertainty to cover all the possible situations. According to this classification, three types of decision analysis models are presented. A new concept, efficiency factor of contaminant source (EFCS), is incorporated in these models to evaluate the payoffs of the ventilation and evacuation strategies. A procedure of decision-making based on these models is proposed and demonstrated by numerical studies of one hundred scenarios with ten ventilation modes, two evacuation modes, and five source locations. The results show that the models can be useful to direct the decision analysis of both the ventilation and evacuation strategies. In addition, the certainty of the source locations has an important effect on the outcomes of the decision-making. Copyright 2010 Elsevier B.V. All rights reserved.

Couple decision making and use of cultural scripts in Malawi.

PubMed

Mbweza, Ellen; Norr, Kathleen F; McElmurry, Beverly

2008-01-01

To examine the decision-making processes of husband and wife dyads in matrilineal and patrilineal marriage traditions of Malawi in the areas of money, food, pregnancy, contraception, and sexual relations. Qualitative grounded theory using simultaneous interviews of 60 husbands and wives (30 couples). Data were analyzed according to the guidelines of simultaneous data collection and analysis. The analysis resulted in development of core categories and categories of decision-making process. Data matrixes were used to identify similarities and differences within couples and across cases. Most couples reported using a mix of final decision-making approaches: husband-dominated, wife-dominated, and shared. Gender based and nongender based cultural scripts provided rationales for their approaches to decision making. Gender based cultural scripts (husband-dominant and wife-dominant) were used to justify decision-making approaches. Non-gender based cultural scripts (communicating openly, maintaining harmony, and children's welfare) supported shared decision making. Gender based cultural scripts were used in decision making more often among couples from the district with a patrilineal marriage tradition and where the husband had less than secondary school education and was not formally employed. Nongender based cultural scripts to encourage shared decision making can be used in designing culturally tailored reproductive health interventions for couples. Nurses who work with women and families should be aware of the variations that occur in actual couple decision-making approaches. Shared decision making can be used to encourage the involvement of men in reproductive health programs.

The Context of Medical Decision-Making: An Analysis of Practitioner/Patient Communication.

ERIC Educational Resources Information Center

Fisher, Sue

This paper examines how the exchange of information in medical interviews is organized, and how that organization produces and constrains the negotiation of treatment decisions. The analysis is drawn from the verbatim transcripts of audio-taped practitioner/patient communications, information gathered from medical files, and other ethnographic…

Child Custody Decisions: Content Analysis of a Judicial Survey.

ERIC Educational Resources Information Center

Settle, Shirley A; Lowery, Carol R.

1982-01-01

Surveyed judges and trial commissioners (N=80) regarding child custody decisions in divorce. The content analysis described the responents' comments which clarified their reasons for attaching greater or lesser importance to a particular consideration or the method using in assessing a particular consideration during a court proceeding. (JAC)

INTEGRATING SOCIAL, ECONOMIC AND ECOLOGICAL ANALYSIS TO IMPROVE WILDFIRE MANAGEMENT IN THE U.S.: TESTING A NEW ORGANIZING APPROACH FOR ENVIRONMENTAL ASSESSMENT

EPA Science Inventory

Conducting an integrated analysis to evaluate the societal and ecological consequences of environmental management actions requires decisions about data collection, theory development, modeling and valuation. Approaching these decisions in coordinated fashion necessitates a syste...

Demonstrating Empathy: A Phenomenological Study of Instructional Designers Making Instructional Strategy Decisions for Adult Learners

ERIC Educational Resources Information Center

Vann, Linda S.

2017-01-01

Instructional designers are tasked with making instructional strategy decisions to facilitate achievement of learning outcomes as part of their professional responsibilities. While the instructional design process includes learner analysis, that analysis alone does not embody opportunities to assist instructional designers with demonstrations of…

Using System Dynamics Analysis for Evaluating Neighborhood Economic Outcomes from Transportation and Land Use Decisions

EPA Science Inventory

Proposed Title: Using System Dynamics Analysis for Evaluating Neighborhood Economic Outcomes from Transportation and Land Use Decisions Topic (must choose one item from a drop-down list): Community Indicators Learning Objectives (must list 2): • What are the benefits and l...

Multi Objective Decision Analysis for Assignment Problems

DTIC Science & Technology

2011-03-01

needed data or try to get data from related databases. 2.3.8 Deterministic Analysis In order to determine an overall score for each...The views expressed in this thesis are those of the author and do not reflect the official policy or position of the Turkish Air...DECISION ANALYSIS FOR ASSIGNMENT PROBLEMS THESIS Presented to the Faculty Department of Operational Sciences Graduate School of

Natural Resource Information System, design analysis

NASA Technical Reports Server (NTRS)

1972-01-01

The computer-based system stores, processes, and displays map data relating to natural resources. The system was designed on the basis of requirements established in a user survey and an analysis of decision flow. The design analysis effort is described, and the rationale behind major design decisions, including map processing, cell vs. polygon, choice of classification systems, mapping accuracy, system hardware, and software language is summarized.

Lending Officers' Decisions to Recommend Innovative Agricultural Technology.

ERIC Educational Resources Information Center

McIntosh, Wm. Alex; Zey-Ferrell, Mary

1986-01-01

Path analysis examines an analytical model of decision making by lending officers of 211 Texas banks when recommending agricultural technology to farmer-clients. Model analyzes effects of loan officers' ascribed/achieved personal characteristics and perceptions of organizational constraints during three stages of decision process: using…

A Comparison of Coverage of Speech and Press Verdicts of Supreme Court.

ERIC Educational Resources Information Center

Hale, F. Dennis

1979-01-01

An analysis of the coverage by ten newspapers of 20 United States Supreme Court decisions concerning freedom of the press and 20 decisions concerning freedom of speech revealed that the newspapers gave significantly greater coverage to the press decisions. (GT)

Medical Problem-Solving: A Critique of the Literature.

ERIC Educational Resources Information Center

McGuire, Christine H.

1985-01-01

Prescriptive, decision-analysis of medical problem-solving has been based on decision theory that involves calculation and manipulation of complex probability and utility values to arrive at optimal decisions that will maximize patient benefits. The studies offer a methodology for improving clinical judgment. (Author/MLW)

Evaluation and Institutional Research: Aids to Decision-Making and Innovation

ERIC Educational Resources Information Center

McIntosh, Naomi E.

1977-01-01

The traditional "test and measurement" approach to educational evaluation is contrasted with the "use of information for decision-making" developed in the industrial sector. Evaluation strategy should be determined by an analysis of the problem and the decisions to be made. (Author/LBH)

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

EPA Science Inventory

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

14 CFR § 1216.302 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... responsible for overseeing and guiding NASA's integration of NEPA into the Agency's planning and decision... NEPA analysis into Agency planning and decision-making processes. The SEO shall monitor this process to... Agency's planning and decision making for all NASA activities. The HQ/EMD provides advice and...

32 CFR 651.9 - Introduction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... decision-making reflect Army environmental values, such as compliance with environmental policy, laws, and... early as possible to avoid potential delays. (b) All Army decision-making that may impact the human... ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) National Environmental Policy Act and the Decision Process...

Assessing the teaching of procedural skills: can cognitive task analysis add to our traditional teaching methods?

PubMed

Sullivan, Maura E; Ortega, Adrian; Wasserberg, Nir; Kaufman, Howard; Nyquist, Julie; Clark, Richard

2008-01-01

The purpose of this study was to determine if a cognitive task analysis (CTA) could capture steps and decision points that were not articulated during traditional teaching of a colonoscopy. Three expert colorectal surgeons were videotaped performing a colonoscopy. After the videotapes were transcribed, the experts participated in a CTA. A 26-step procedural checklist and a 16-step cognitive demands table was created by using information obtained in the CTA. The videotape transcriptions were transposed onto the procedural checklist and cognitive demands table to identify steps and decision points that were omitted during traditional teaching. Surgeon A described 50% of "how-to" steps and 43% of decision points. Surgeon B described 30% of steps and 25% of decisions. Surgeon C described 26% of steps and 38% of cognitive decisions. By using CTA, we were able to identify relevant steps and decision points that were omitted during traditional teaching by all 3 experts.

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

PubMed

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

2009-01-01

The continuously changing drivers of the water treatment industry, embodied by rigorous environmental and health regulations and the challenge of emerging contaminants, necessitates the development of decision support systems for the selection of appropriate treatment trains. This paper explores a systematic approach to developing decision support systems, which includes the analysis of the treatment problem(s), knowledge acquisition and representation, and the identification and evaluation of criteria controlling the selection of optimal treatment systems. The objective of this article is to review approaches and methods used in decision support systems developed to aid in the selection, sequencing of unit processes and design of drinking water, domestic wastewater, and industrial wastewater treatment systems. Not surprisingly, technical considerations were found to dominate the logic of the developed systems. Most of the existing decision-support tools employ heuristic knowledge. It has been determined that there is a need to develop integrated decision support systems that are generic, usable and consider a system analysis approach.

Decision Making in Nursing Practice: A Concept Analysis.

PubMed

Johansen, Mary L; O'Brien, Janice L

2016-01-01

The study aims to gain an understanding of the concept of decision making as it relates to the nurse practice environment. Rodgers' evolutionary method on concept analysis was used as a framework for the study of the concept. Articles from 1952 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JSTOR, PubMed, and Science Direct. Findings suggest that decision making in the nurse practice environment is a complex process, integral to the nursing profession. The definition of decision making, and the attributes, antecedents, and consequences, are discussed. Contextual factors that influence the process are also discussed. An exemplar is presented to illustrate the concept. Decision making in the nurse practice environment is a dynamic conceptual process that may affect patient outcomes. Nurses need to call upon ways of knowing to make sound decisions and should be self-reflective in order to develop the process further in the professional arena. The need for further research is discussed. © 2015 Wiley Periodicals, Inc.

HPV vaccine introduction at the local level in a developing country: attitudes and criteria among key actors.

PubMed

Piñeros, Marion; Wiesner, Carolina; Cortés, Claudia; Trujillo, Lina María

2010-05-01

In most developing countries, HPV vaccines have been licensed but there are no national policy recommendations, nor is it clear how decisions on the introduction of this new vaccine are made. Decentralization processes in many Latin American countries favor decision-making at the local level. Through a qualitative study we explored knowledge regarding the HPV vaccine and the criteria that influence decision-making among local health actors in four regions of Colombia. We conducted a total of 14 in-depths interviews with different actors; for the analysis we performed content analysis. Results indicate that decision-making on the HPV vaccine at the local level has mainly been driven by pressure from local political actors, in a setting where there is low technical knowledge of the vaccine. This increases the risk of initiatives that may foster inequity. Local decisions and initiatives need to be strengthened technically and supported by national-level decisions, guidelines and follow-up.

A decision science approach for integrating social science in climate and energy solutions

NASA Astrophysics Data System (ADS)

Wong-Parodi, Gabrielle; Krishnamurti, Tamar; Davis, Alex; Schwartz, Daniel; Fischhoff, Baruch

2016-06-01

The social and behavioural sciences are critical for informing climate- and energy-related policies. We describe a decision science approach to applying those sciences. It has three stages: formal analysis of decisions, characterizing how well-informed actors should view them; descriptive research, examining how people actually behave in such circumstances; and interventions, informed by formal analysis and descriptive research, designed to create attractive options and help decision-makers choose among them. Each stage requires collaboration with technical experts (for example, climate scientists, geologists, power systems engineers and regulatory analysts), as well as continuing engagement with decision-makers. We illustrate the approach with examples from our own research in three domains related to mitigating climate change or adapting to its effects: preparing for sea-level rise, adopting smart grid technologies in homes, and investing in energy efficiency for office buildings. The decision science approach can facilitate creating climate- and energy-related policies that are behaviourally informed, realistic and respectful of the people whom they seek to aid.

A qualitative analysis of parental decision making for childhood immunisation.

PubMed

Marshall, S; Swerissen, H

1999-10-01

Achieving high rates of childhood immunisation is an important public health aim. Currently, however, immunisation uptake in Australia is disappointing. This qualitative study investigated the factors that influence parental decision making for childhood immunisation, and whether parents' experiences were better conceptualised in terms of static subjective expected utility models or in terms of a more dynamic process. Semi-structured in-depth interviews were conducted with 20 predominantly middle-class mothers--17 immunizers and three non-immunizers, in Melbourne, Victoria, in 1997. The data were then examined using thematic analysis. The results suggested that for these participants the decision regarding childhood immunization was better conceptualized as a dynamic process. The decision required initial consideration, implementation then maintenance. If a better understanding of immunization decision making is to be achieved, future studies must look beyond static frameworks. Clearer insight into the dynamic nature of immunization decision making should assist in the identification of more effective methods of promoting childhood immunization to groups at risk of non-compliance.

A simple way to unify multicriteria decision analysis (MCDA) and stochastic multicriteria acceptability analysis (SMAA) using a Dirichlet distribution in benefit-risk assessment.

PubMed

Saint-Hilary, Gaelle; Cadour, Stephanie; Robert, Veronique; Gasparini, Mauro

2017-05-01

Quantitative methodologies have been proposed to support decision making in drug development and monitoring. In particular, multicriteria decision analysis (MCDA) and stochastic multicriteria acceptability analysis (SMAA) are useful tools to assess the benefit-risk ratio of medicines according to the performances of the treatments on several criteria, accounting for the preferences of the decision makers regarding the relative importance of these criteria. However, even in its probabilistic form, MCDA requires the exact elicitations of the weights of the criteria by the decision makers, which may be difficult to achieve in practice. SMAA allows for more flexibility and can be used with unknown or partially known preferences, but it is less popular due to its increased complexity and the high degree of uncertainty in its results. In this paper, we propose a simple model as a generalization of MCDA and SMAA, by applying a Dirichlet distribution to the weights of the criteria and by making its parameters vary. This unique model permits to fit both MCDA and SMAA, and allows for a more extended exploration of the benefit-risk assessment of treatments. The precision of its results depends on the precision parameter of the Dirichlet distribution, which could be naturally interpreted as the strength of confidence of the decision makers in their elicitation of preferences. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The role of economic evaluation in the decision-making process of family physicians: design and methods of a qualitative embedded multiple-case study

PubMed Central

Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

2009-01-01

Background A considerable amount of resource allocation decisions take place daily at the point of the clinical encounter; especially in primary care, where 80 percent of health problems are managed. Ignoring economic evaluation evidence in individual clinical decision-making may have a broad impact on the efficiency of health services. To date, almost all studies on the use of economic evaluation in decision-making used a quantitative approach, and few investigated decision-making at the clinical level. An important question is whether economic evaluations affect clinical practice. The project is an intervention research study designed to understand the role of economic evaluation in the decision-making process of family physicians (FPs). The contributions of the project will be from the perspective of Pierre Bourdieu's sociological theory. Methods/design A qualitative research strategy is proposed. We will conduct an embedded multiple-case study design. Ten case studies will be performed. The FPs will be the unit of analysis. The sampling strategies will be directed towards theoretical generalization. The 10 selected cases will be intended to reflect a diversity of FPs. There will be two embedded units of analysis: FPs (micro-level of analysis) and field of family medicine (macro-level of analysis). The division of the determinants of practice/behaviour into two groups, corresponding to the macro-structural level and the micro-individual level, is the basis for Bourdieu's mode of analysis. The sources of data collection for the micro-level analysis will be 10 life history interviews with FPs, documents and observational evidence. The sources of data collection for the macro-level analysis will be documents and 9 open-ended, focused interviews with key informants from medical associations and academic institutions. The analytic induction approach to data analysis will be used. A list of codes will be generated based on both the original framework and new themes introduced by the participants. We will conduct within-case and cross-case analyses of the data. Discussion The question of the role of economic evaluation in FPs' decision-making is of great interest to scientists, health care practitioners, managers and policy-makers, as well as to consultants, industry, and society. It is believed that the proposed research approach will make an original contribution to the development of knowledge, both empirical and theoretical. PMID:19210787

Perceived risks around choice and decision making at end-of-life: a literature review.

PubMed

Wilson, F; Gott, M; Ingleton, C

2013-01-01

the World Health Organization identifies meeting patient choice for care as central to effective palliative care delivery. Little is known about how choice, which implies an objective balancing of options and risks, is understood and enacted through decision making at end-of-life. to explore how perceptions of 'risk' may inform decision-making processes at end-of-life. an integrative literature review was conducted between January and February 2010. Papers were reviewed using Hawker et al.'s criteria and evaluated according to clarity of methods, analysis and evidence of ethical consideration. All literature was retained as background data, but given the significant international heterogeneity the final analysis specifically focused on the UK context. the databases Medline, PsycINFO, Assia, British Nursing Index, High Wire Press and CINAHL were explored using the search terms decision*, risk, anxiety, hospice and palliative care, end-of-life care and publication date of 1998-2010. thematic analysis of 25 papers suggests that decision making at end-of-life is multifactorial, involving a balancing of risks related to caregiver support; service provider resources; health inequalities and access; challenges to information giving; and perceptions of self-identity. Overall there is a dissonance in understandings of choice and decision making between service providers and service users. the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families.

The illusion of handy wins: Problem gambling, chasing, and affective decision-making.

PubMed

Nigro, Giovanna; Ciccarelli, Maria; Cosenza, Marina

2018-01-01

Chasing losses is a behavioral marker and a diagnostic criterion for gambling disorder. It consists in continuing gambling to recoup previous losses. Although chasing has been recognized playing a central role in gambling disorder, research on this topic is relatively scarce, and it remains unclear whether chasing affects decision-making in behavioral tasks in which participants gain or loss some money. Even if several studies found that the more the gambling involvement, the poorer the decision-making, to date no research investigated the role of chasing in decision-making. The study aimed to first investigate the relation between chasing and decision-making in adult gamblers. One hundred and four VLT players were administered the South Oaks Gambling Screen (SOGS), a computerized task measuring chasing, and the Iowa Gambling Task (IGT). Correlation analysis showed that the higher the SOGS scores, the higher the propensity to chase, and the poorer the decision-making performance. Regression analysis revealed that chasing propensity and gambling severity predicted IGT performance. Mediation analysis indicated that the association between gambling severity and poor decision-making is mediated by chasing. Gambling severity was assessed by means of a self-report measure. The generalizability of findings is limited, since the study focused only on VLT players. This study provides the first evidence that chasing, along with gambling severity, affects decision-making, at least in behavioral tasks involving money. Since chasers and non-chasers could be two different sub-types of gamblers, treatment protocols should take into account the additive role of chasing in gambling disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

Framing of Uncertainty in Scientific Publications: Towards Recommendations for Decision Support

NASA Astrophysics Data System (ADS)

Guillaume, J. H. A.; Helgeson, C.; Elsawah, S.; Jakeman, A. J.; Kummu, M.

2016-12-01

Uncertainty is recognised as an essential issue in environmental decision making and decision support. As modellers, we notably use a variety of tools and techniques within an analysis, for example related to uncertainty quantification and model validation. We also address uncertainty by how we present results. For example, experienced modellers are careful to distinguish robust conclusions from those that need further work, and the precision of quantitative results is tailored to their accuracy. In doing so, the modeller frames how uncertainty should be interpreted by their audience. This is an area which extends beyond modelling to fields such as philosophy of science, semantics, discourse analysis, intercultural communication and rhetoric. We propose that framing of uncertainty deserves greater attention in the context of decision support, and that there are opportunities in this area for fundamental research, synthesis and knowledge transfer, development of teaching curricula, and significant advances in managing uncertainty in decision making. This presentation reports preliminary results of a study of framing practices. Specifically, we analyse the framing of uncertainty that is visible in the abstracts from a corpus of scientific articles. We do this through textual analysis of the content and structure of those abstracts. Each finding that appears in an abstract is classified according to the uncertainty framing approach used, using a classification scheme that was iteratively revised based on reflection and comparison amongst three coders. This analysis indicates how frequently the different framing approaches are used, and provides initial insights into relationships between frames, how the frames relate to interpretation of uncertainty, and how rhetorical devices are used by modellers to communicate uncertainty in their work. We propose initial hypotheses for how the resulting insights might influence decision support, and help advance decision making to better address uncertainty.

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

PubMed

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

2011-06-01

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

Lifecycle analysis for automobiles: Uses and limitations

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

Gaines, L.; Stodolsky, F.

There has been a recent trend toward the use of lifecycle analysis (LCA) as a decision-making tool for the automotive industry. However, the different practitioners` methods and assumptions vary widely, as do the interpretations put on the results. The lack of uniformity has been addressed by such groups as the Society of Environmental Toxicology and Chemistry (SETAC) and the International Organization for Standardization (ISO), but standardization of methodology assures neither meaningful results nor appropriate use of the results. This paper examines the types of analysis that are possible for automobiles, explains possible pitfalls to be avoided, and suggests ways thatmore » LCA can be used as part of a rational decision-making procedure. The key to performing a useful analysis is identification of the factors that will actually be used in making the decision. It makes no sense to analyze system energy use in detail if direct financial cost is to be the decision criterion. Criteria may depend on who is making the decision (consumer, producer, regulator). LCA can be used to track system performance for a variety of criteria, including emissions, energy use, and monetary costs, and these can have spatial and temporal distributions. Because optimization of one parameter is likely to worsen another, identification of trade-offs is an important function of LCA.« less

Using the weighted area under the net benefit curve for decision curve analysis.

PubMed

Talluri, Rajesh; Shete, Sanjay

2016-07-18

Risk prediction models have been proposed for various diseases and are being improved as new predictors are identified. A major challenge is to determine whether the newly discovered predictors improve risk prediction. Decision curve analysis has been proposed as an alternative to the area under the curve and net reclassification index to evaluate the performance of prediction models in clinical scenarios. The decision curve computed using the net benefit can evaluate the predictive performance of risk models at a given or range of threshold probabilities. However, when the decision curves for 2 competing models cross in the range of interest, it is difficult to identify the best model as there is no readily available summary measure for evaluating the predictive performance. The key deterrent for using simple measures such as the area under the net benefit curve is the assumption that the threshold probabilities are uniformly distributed among patients. We propose a novel measure for performing decision curve analysis. The approach estimates the distribution of threshold probabilities without the need of additional data. Using the estimated distribution of threshold probabilities, the weighted area under the net benefit curve serves as the summary measure to compare risk prediction models in a range of interest. We compared 3 different approaches, the standard method, the area under the net benefit curve, and the weighted area under the net benefit curve. Type 1 error and power comparisons demonstrate that the weighted area under the net benefit curve has higher power compared to the other methods. Several simulation studies are presented to demonstrate the improvement in model comparison using the weighted area under the net benefit curve compared to the standard method. The proposed measure improves decision curve analysis by using the weighted area under the curve and thereby improves the power of the decision curve analysis to compare risk prediction models in a clinical scenario.

Surgical decision making in a teaching hospital: a linguistic analysis.

PubMed

Bezemer, Jeff; Murtagh, Ged; Cope, Alexandra; Kneebone, Roger

2016-10-01

The aim of the study was to gain insight in the involvement of non-operating surgeons in intraoperative surgical decision making at a teaching hospital. The decision to proceed to clip and cut the cystic duct during laparoscopic cholecystectomy was investigated through direct observation of team work. Eleven laparoscopic cholecystectomies performed by consultant surgeons and specialty trainees at a London teaching hospital were audio and video recorded. Talk among the surgical team was transcribed and subjected to linguistic analysis, in conjunction with observational analysis of the video material, sequentially marking the unfolding operation. Two components of decision making were identified, participation and rationalization. Participation refers to the degree to which agreement was sought within the surgical team prior to clipping the cystic duct. Rationalization refers to the degree to which the evidential grounds for clipping and cutting were verbalized. The decision to clip and cut the cystic duct was jointly made by members of the surgical team, rather than a solitary surgeon in the majority of cases, involving verbal explication of clinical reasoning and verbal agreement. The extent of joint decision making appears to have been mitigated by two factors: trainee's level of training and duration of the case. © 2014 Royal Australasian College of Surgeons.

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

PubMed

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

2011-09-01

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

Risky decision making in Attention-Deficit/Hyperactivity Disorder: A meta-regression analysis.

PubMed

Dekkers, Tycho J; Popma, Arne; Agelink van Rentergem, Joost A; Bexkens, Anika; Huizenga, Hilde M

2016-04-01

ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore performed a meta-regression analysis in which 37 studies (n ADHD=1175; n Control=1222) were included, containing 52 effect sizes. The overall analysis yielded a small to medium effect size (standardized mean difference=.36, p<.001, 95% CI [.22, .51]), indicating that groups with ADHD showed more risky decision making than control groups. There was a trend for a moderating influence of co-morbid Disruptive Behavior Disorders (DBD): studies including more participants with co-morbid DBD had larger effect sizes. No moderating influence of co-morbid internalizing disorders, age or task explicitness was found. These results indicate that ADHD is related to increased risky decision making in laboratory settings, which tended to be more pronounced if ADHD is accompanied by DBD. We therefore argue that risky decision making should have a more prominent role in research on the neuropsychological and -biological mechanisms of ADHD, which can be useful in ADHD assessment and intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Decision Making Analysis: Critical Factors-Based Methodology

DTIC Science & Technology

2010-04-01

the pitfalls associated with current wargaming methods such as assuming a western view of rational values in decision - making regardless of the cultures...Utilization theory slightly expands the rational decision making model as it states that “actors try to maximize their expected utility by weighing the...items to categorize the decision - making behavior of political leaders which tend to demonstrate either a rational or cognitive leaning. Leaders

Marine Steam Condenser Design Optimization.

DTIC Science & Technology

1983-12-01

to make design decisions to obtain a feasible design. CONNIN, as do most optimizers, requires complete control in determining all iterative design...neutralize all the places where such design decisions are made. By removing the ability for CONDIP to make any design decisions it became totally passive...dependent on CONNIN for design decisions , does not have that capability. Pemeabering that CONHIN requires a complete once-through analysis in order to

Bridging the gap between science and decision making.

PubMed

von Winterfeldt, Detlof

2013-08-20

All decisions, whether they are personal, public, or business-related, are based on the decision maker's beliefs and values. Science can and should help decision makers by shaping their beliefs. Unfortunately, science is not easily accessible to decision makers, and scientists often do not understand decision makers' information needs. This article presents a framework for bridging the gap between science and decision making and illustrates it with two examples. The first example is a personal health decision. It shows how a formal representation of the beliefs and values can reflect scientific inputs by a physician to combine with the values held by the decision maker to inform a medical choice. The second example is a public policy decision about managing a potential environmental hazard. It illustrates how controversial beliefs can be reflected as uncertainties and informed by science to make better decisions. Both examples use decision analysis to bridge science and decisions. The conclusions suggest that this can be a helpful process that requires skills in both science and decision making.

Bridging the gap between science and decision making

PubMed Central

von Winterfeldt, Detlof

2013-01-01

All decisions, whether they are personal, public, or business-related, are based on the decision maker’s beliefs and values. Science can and should help decision makers by shaping their beliefs. Unfortunately, science is not easily accessible to decision makers, and scientists often do not understand decision makers’ information needs. This article presents a framework for bridging the gap between science and decision making and illustrates it with two examples. The first example is a personal health decision. It shows how a formal representation of the beliefs and values can reflect scientific inputs by a physician to combine with the values held by the decision maker to inform a medical choice. The second example is a public policy decision about managing a potential environmental hazard. It illustrates how controversial beliefs can be reflected as uncertainties and informed by science to make better decisions. Both examples use decision analysis to bridge science and decisions. The conclusions suggest that this can be a helpful process that requires skills in both science and decision making. PMID:23940310

Pattern Analysis and Decision Support for Cancer through Clinico-Genomic Profiles

NASA Astrophysics Data System (ADS)

Exarchos, Themis P.; Giannakeas, Nikolaos; Goletsis, Yorgos; Papaloukas, Costas; Fotiadis, Dimitrios I.

Advances in genome technology are playing a growing role in medicine and healthcare. With the development of new technologies and opportunities for large-scale analysis of the genome, genomic data have a clear impact on medicine. Cancer prognostics and therapeutics are among the first major test cases for genomic medicine, given that all types of cancer are related with genomic instability. In this paper we present a novel system for pattern analysis and decision support in cancer. The system integrates clinical data from electronic health records and genomic data. Pattern analysis and data mining methods are applied to these integrated data and the discovered knowledge is used for cancer decision support. Through this integration, conclusions can be drawn for early diagnosis, staging and cancer treatment.

Structured decision making for managing pneumonia epizootics in bighorn sheep

USGS Publications Warehouse

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

2016-01-01

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

Defining optimum treatment of patients with pancreatic adenocarcinoma using regret-based decision curve analysis.

PubMed

Hernandez, Jonathan M; Tsalatsanis, Athanasios; Humphries, Leigh Ann; Miladinovic, Branko; Djulbegovic, Benjamin; Velanovich, Vic

2014-06-01

To use regret decision theory methodology to assess three treatment strategies in pancreatic adenocarcinoma. Pancreatic adenocarcinoma is uniformly fatal without operative intervention. Resection can prolong survival in some patients; however, it is associated with significant morbidity and mortality. Regret theory serves as a novel framework linking both rationality and intuition to determine the optimal course for physicians facing difficult decisions related to treatment. We used the Cox proportional hazards model to predict survival of patients with pancreatic adenocarcinoma and generated a decision model using regret-based decision curve analysis, which integrates both the patient's prognosis and the physician's preferences expressed in terms of regret associated with a certain action. A physician's treatment preferences are indicated by a threshold probability, which is the probability of death/survival at which the physician is uncertain whether or not to perform surgery. The analysis modeled 3 possible choices: perform surgery on all patients; never perform surgery; and act according to the prediction model. The records of 156 consecutive patients with pancreatic adenocarcinoma were retrospectively evaluated by a single surgeon at a tertiary referral center. Significant independent predictors of overall survival included preoperative stage [P = 0.005; 95% confidence interval (CI), 1.19-2.27], vitality (P < 0.001; 95% CI, 0.96-0.98), daily physical function (P < 0.001; 95% CI, 0.97-0.99), and pathological stage (P < 0.001; 95% CI, 3.06-16.05). Compared with the "always aggressive" or "always passive" surgical treatment strategies, the survival model was associated with the least amount of regret for a wide range of threshold probabilities. Regret-based decision curve analysis provides a novel perspective for making treatment-related decisions by incorporating the decision maker's preferences expressed as his or her estimates of benefits and harms associated with the treatment considered.

The anatomy of clinical decision-making in multidisciplinary cancer meetings

PubMed Central

Soukup, Tayana; Petrides, Konstantinos V.; Lamb, Benjamin W.; Sarkar, Somita; Arora, Sonal; Shah, Sujay; Darzi, Ara; Green, James S. A.; Sevdalis, Nick

2016-01-01

Abstract In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable. The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision. This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons. We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis. The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = −0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001). Hawthorne effect is the main limitation of the study. The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient profile and contributions to case review by all core disciplines. Evidence of dual-task interference was observed in relation to the meeting chairs’ input and their corresponding surgical input into case reviews. PMID:27310981

A novel computer based expert decision making model for prostate cancer disease management.

PubMed

Richman, Martin B; Forman, Ernest H; Bayazit, Yildirim; Einstein, Douglas B; Resnick, Martin I; Stovsky, Mark D

2005-12-01

We propose a strategic, computer based, prostate cancer decision making model based on the analytic hierarchy process. We developed a model that improves physician-patient joint decision making and enhances the treatment selection process by making this critical decision rational and evidence based. Two groups (patient and physician-expert) completed a clinical study comparing an initial disease management choice with the highest ranked option generated by the computer model. Participants made pairwise comparisons to derive priorities for the objectives and subobjectives related to the disease management decision. The weighted comparisons were then applied to treatment options to yield prioritized rank lists that reflect the likelihood that a given alternative will achieve the participant treatment goal. Aggregate data were evaluated by inconsistency ratio analysis and sensitivity analysis, which assessed the influence of individual objectives and subobjectives on the final rank list of treatment options. Inconsistency ratios less than 0.05 were reliably generated, indicating that judgments made within the model were mathematically rational. The aggregate prioritized list of treatment options was tabulated for the patient and physician groups with similar outcomes for the 2 groups. Analysis of the major defining objectives in the treatment selection decision demonstrated the same rank order for the patient and physician groups with cure, survival and quality of life being more important than controlling cancer, preventing major complications of treatment, preventing blood transfusion complications and limiting treatment cost. Analysis of subobjectives, including quality of life and sexual dysfunction, produced similar priority rankings for the patient and physician groups. Concordance between initial treatment choice and the highest weighted model option differed between the groups with the patient group having 59% concordance and the physician group having only 42% concordance. This study successfully validated the usefulness of a computer based prostate cancer management decision making model to produce individualized, rational, clinically appropriate disease management decisions without physician bias.

Factors influencing the surgical decision for the treatment of degenerative lumbar stenosis in a preference-based shared decision-making process.

PubMed

Kim, Ho-Joong; Park, Jae-Young; Kang, Kyoung-Tak; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

2015-02-01

In a preference-based shared decision-making system, several subjective and/or objective factors such as pain severity, degree of disability, and the radiological severity of canal stenosis may influence the final surgical decision for the treatment of lumbar spinal stenosis (LSS). However, our understanding of the shared decision-making process and the significance of each factor remain primitive. In the present study, we aimed to investigate which factors influence the surgical decision for the treatment of LSS when using a preference-based, shared decision-making process. We included 555 patients, aged 45-80 years, who used a preference-based shared decision-making process and were treated conservatively or surgically for chronic leg and/or back pain caused by LSS from April 2012 to December 2012. Univariate and multivariable-adjusted logistic regression analyses were used to assess the association of surgical decision making with age, sex, body mass index, symptom duration, radiologic stenotic grade, Oswestry Disability Index (ODI), visual analog scale (VAS) scores for back and leg pain, Short Form-36 (SF-36) subscales, and motor weakness. In univariate analysis, the following variables were associated with a higher odds of a surgical decision for LSS: male sex; the VAS score for leg pain; ODI; morphological stenotic grades B, C, and D; motor weakness; and the physical function, physical role, bodily pain, social function, and emotional role of the SF-36 subscales. Multivariate analysis revealed that male sex, ODI, morphological stenotic grades C and D, and motor weakness were significantly associated with a higher possibility of a surgical decision. Motor weakness, male sex, morphological stenotic grade, and the amount of disability are critical factors leading to a surgical decision for LSS when using a preference-based shared decision-making process.

75 FR 59206 - Ketchikan-Misty Fiords Ranger District; Tongass National Forest; Alaska; Ketchikan-Misty Fiords...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... full environmental analysis and decision-making process so interested and affected people may...;and investigations, committee meetings, agency decisions and rulings, #0;delegations of authority... Ketchikan- Misty Fiords Ranger District. The decision on the EIS will allocate recreation carrying capacity...

Hierarchical analysis of bridge decision makers : the role of new technology adoption in the timber bridge market : special project fiscal year 1992

DOT National Transportation Integrated Search

1995-08-01

Bridge design engineers and local highway officials make bridge replacement decisions across the : United States. The Analytical Hierarchy Process was used to characterize the bridge material selection : decision of these individuals. State Departmen...

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

EPA Science Inventory

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

77 FR 6092 - Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-07

... systems which provide a way to compare surveillance and detection equipment and make informed purchasing decisions. Due to rapid changes and inventions in technology, the market survey must be updated to ensure... will be analyzed by a team of subject matter experts in detection and decision analysis. Decision...

Managing risk and expected financial return from selective expansion of operating room capacity: mean-variance analysis of a hospital's portfolio of surgeons.

PubMed

Dexter, Franklin; Ledolter, Johannes

2003-07-01

Surgeons using the same amount of operating room (OR) time differ in their achieved hospital contribution margins (revenue minus variable costs) by >1000%. Thus, to improve the financial return from perioperative facilities, OR strategic decisions should selectively focus additional OR capacity and capital purchasing on a few surgeons or subspecialties. These decisions use estimates of each surgeon's and/or subspecialty's contribution margin per OR hour. The estimates are subject to uncertainty (e.g., from outliers). We account for the uncertainties by using mean-variance portfolio analysis (i.e., quadratic programming). This method characterizes the problem of selectively expanding OR capacity based on the expected financial return and risk of different portfolios of surgeons. The assessment reveals whether the choices, of which surgeons have their OR capacity expanded, are sensitive to the uncertainties in the surgeons' contribution margins per OR hour. Thus, mean-variance analysis reduces the chance of making strategic decisions based on spurious information. We also assess the financial benefit of using mean-variance portfolio analysis when the planned expansion of OR capacity is well diversified over at least several surgeons or subspecialties. Our results show that, in such circumstances, there may be little benefit from further changing the portfolio to reduce its financial risk. Surgeon and subspecialty specific hospital financial data are uncertain, a fact that should be taken into account when making decisions about expanding operating room capacity. We show that mean-variance portfolio analysis can incorporate this uncertainty, thereby guiding operating room management decision-making and reducing the chance of a strategic decision being made based on spurious information.

Sbexpert users guide (version 1.0): A knowledge-based decision-support system for spruce beetle management. Forest Service general technical report

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

Reynolds, K.M.; Holsten, E.H.; Werner, R.A.

1995-03-01

SBexpert version 1.0 is a knowledge-based decision-support system for management of spruce beetle developed for use in Microsoft Windows. The users guide provides detailed instructions on the use of all SBexpert features. SBexpert has four main subprograms; introduction, analysis, textbook, and literature. The introduction is the first of the five subtopics in the SBexpert help system. The analysis topic is an advisory system for spruce beetle management that provides recommendation for reducing spruce beetle hazard and risk to spruce stands and is the main analytical topic in SBexpert. The textbook and literature topics provide complementary decision support for analysis.

Modeling Opponents in Adversarial Risk Analysis.

PubMed

Rios Insua, David; Banks, David; Rios, Jesus

2016-04-01

Adversarial risk analysis has been introduced as a framework to deal with risks derived from intentional actions of adversaries. The analysis supports one of the decisionmakers, who must forecast the actions of the other agents. Typically, this forecast must take account of random consequences resulting from the set of selected actions. The solution requires one to model the behavior of the opponents, which entails strategic thinking. The supported agent may face different kinds of opponents, who may use different rationality paradigms, for example, the opponent may behave randomly, or seek a Nash equilibrium, or perform level-k thinking, or use mirroring, or employ prospect theory, among many other possibilities. We describe the appropriate analysis for these situations, and also show how to model the uncertainty about the rationality paradigm used by the opponent through a Bayesian model averaging approach, enabling a fully decision-theoretic solution. We also show how as we observe an opponent's decision behavior, this approach allows learning about the validity of each of the rationality models used to predict his decision by computing the models' (posterior) probabilities, which can be understood as a measure of their validity. We focus on simultaneous decision making by two agents. © 2015 Society for Risk Analysis.

Development and initial evaluation of a treatment decision dashboard.

PubMed

Dolan, James G; Veazie, Peter J; Russ, Ann J

2013-04-21

For many healthcare decisions, multiple alternatives are available with different combinations of advantages and disadvantages across several important dimensions. The complexity of current healthcare decisions thus presents a significant barrier to informed decision making, a key element of patient-centered care.Interactive decision dashboards were developed to facilitate decision making in Management, a field marked by similarly complicated choices. These dashboards utilize data visualization techniques to reduce the cognitive effort needed to evaluate decision alternatives and a non-linear flow of information that enables users to review information in a self-directed fashion. Theoretically, both of these features should facilitate informed decision making by increasing user engagement with and understanding of the decision at hand. We sought to determine if the interactive decision dashboard format can be successfully adapted to create a clinically realistic prototype patient decision aid suitable for further evaluation and refinement. We created a computerized, interactive clinical decision dashboard and performed a pilot test of its clinical feasibility and acceptability using a multi-method analysis. The dashboard summarized information about the effectiveness, risks of side effects and drug-drug interactions, out-of-pocket costs, and ease of use of nine analgesic treatment options for knee osteoarthritis. Outcome evaluations included observations of how study participants utilized the dashboard, questionnaires to assess usability, acceptability, and decisional conflict, and an open-ended qualitative analysis. The study sample consisted of 25 volunteers - 7 men and 18 women - with an average age of 51 years. The mean time spent interacting with the dashboard was 4.6 minutes. Mean evaluation scores on scales ranging from 1 (low) to 7 (high) were: mechanical ease of use 6.1, cognitive ease of use 6.2, emotional difficulty 2.7, decision-aiding effectiveness 5.9, clarification of values 6.5, reduction in decisional uncertainty 6.1, and provision of decision-related information 6.0. Qualitative findings were similarly positive. Interactive decision dashboards can be adapted for clinical use and have the potential to foster informed decision making. Additional research is warranted to more rigorously test the effectiveness and efficiency of patient decision dashboards for supporting informed decision making and other aspects of patient-centered care, including shared decision making.

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

NASA Technical Reports Server (NTRS)

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

2004-01-01

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

New technology implementation: Technical, economic and political factors

NASA Technical Reports Server (NTRS)

Dean, J. W., Jr.; Susman, G. I.; Porter, P. S.

1985-01-01

An analysis is presented of the process of implementing advanced manufacturing technology, based on studies of numerous organizations. This process is seen as consisting of a series of decisions with technical, economic, and political objectives. Frequency decisions involve specifications, equipment, resources/organization, and location. Problems in implementation are viewed as resulting from tradeoffs among the objectives, the tendency of decision makers to emphasize some objectives at the expense of others, and the propensity of problems to spread from one area to another. Three sets of recommendations, based on this analysis, are presented.

What Goes Into a Decision? How Nursing Faculty Decide Which Best Practices to Use for Classroom Testing.

PubMed

Killingsworth, Erin; Kimble, Laura P; Sudia, Tanya

2015-01-01

To explore the decision-making process of BSN faculty when determining which best practices to use for classroom testing. A descriptive, correlational study was conducted with a national sample (N = 127) of full-time BSN faculty. Participants completed a web-based survey incorporating instruments that measured beliefs about evaluation, decision-making, and best practices for item analysis and constructing and revising classroom tests. Study participants represented 31 states and were primarily middle-aged white women. In multiple linear regression analyses, faculty beliefs, contextual factors for decision-making, and decision-making processes accounted for statistically significant amounts of the variance in item analysis and test construction and revision. Strong faculty beliefs that rules were important when evaluating students was a significant predictor of increased use of best practices. Results support that understanding faculty beliefs around classroom testing is important in promoting the use of best practices.

Fuzzy decision-making framework for treatment selection based on the combined QUALIFLEX-TODIM method

NASA Astrophysics Data System (ADS)

Ji, Pu; Zhang, Hong-yu; Wang, Jian-qiang

2017-10-01

Treatment selection is a multi-criteria decision-making problem of significant concern in the medical field. In this study, a fuzzy decision-making framework is established for treatment selection. The framework mitigates information loss by introducing single-valued trapezoidal neutrosophic numbers to denote evaluation information. Treatment selection has multiple criteria that remarkably exceed the alternatives. In consideration of this characteristic, the framework utilises the idea of the qualitative flexible multiple criteria method. Furthermore, it considers the risk-averse behaviour of a decision maker by employing a concordance index based on TODIM (an acronym in Portuguese of interactive and multi-criteria decision-making) method. A sensitivity analysis is performed to illustrate the robustness of the framework. Finally, a comparative analysis is conducted to compare the framework with several extant methods. Results indicate the advantages of the framework and its better performance compared with the extant methods.

Allocating health care: cost-utility analysis, informed democratic decision making, or the veil of ignorance?

PubMed

Goold, S D

1996-01-01

Assuming that rationing health care is unavoidable, and that it requires moral reasoning, how should we allocate limited health care resources? This question is difficult because our pluralistic, liberal society has no consensus on a conception of distributive justice. In this article I focus on an alternative: Who shall decide how to ration health care, and how shall this be done to respect autonomy, pluralism, liberalism, and fairness? I explore three processes for making rationing decisions: cost-utility analysis, informed democratic decision making, and applications of the veil of ignorance. I evaluate these processes as examples of procedural justice, assuming that there is no outcome considered the most just. I use consent as a criterion to judge competing processes so that rationing decisions are, to some extent, self-imposed. I also examine the processes' feasibility in our current health care system. Cost-utility analysis does not meet criteria for actual or presumed consent, even if costs and health-related utility could be measured perfectly. Existing structures of government cannot creditably assimilate the information required for sound rationing decisions, and grassroots efforts are not representative. Applications of the veil of ignorance are more useful for identifying principles relevant to health care rationing than for making concrete rationing decisions. I outline a process of decision making, specifically for health care, that relies on substantive, selected representation, respects pluralism, liberalism, and deliberative democracy, and could be implemented at the community or organizational level.

Qualitatively understanding patients' and health professionals' experiences of the BRECONDA breast reconstruction decision aid.

PubMed

Sherman, Kerry A; Shaw, Laura-Kate; Jørgensen, Lone; Harcourt, Diana; Cameron, Linda; Boyages, John; Elder, Elisabeth; Kirk, Judy; Tucker, Katherine

2017-10-01

Women diagnosed with breast cancer or ductal carcinoma in situ and those with a genetic susceptibility to developing this disease face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA) and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision making about breast reconstruction. Semistructured interviews were conducted with women who accessed the BRECONDA intervention (N = 36) and with their healthcare providers (N = 6). All interviews were transcribed verbatim and subjected to thematic analysis by 3 independent coders. Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed 4 themes: overall impressions and aesthetics; personal relevance and utility; introducing BRECONDA; and advantages and suggested improvements. Analysis of health professionals' interviews also revealed 4 themes: need for BRECONDA, impact of BRECONDA, potential difficulties that may arise in using the decision aid, and recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey. These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources. Copyright © 2016 John Wiley & Sons, Ltd.

Atlas-guided volumetric diffuse optical tomography enhanced by generalized linear model analysis to image risk decision-making responses in young adults.

PubMed

Lin, Zi-Jing; Li, Lin; Cazzell, Mary; Liu, Hanli

2014-08-01

Diffuse optical tomography (DOT) is a variant of functional near infrared spectroscopy and has the capability of mapping or reconstructing three dimensional (3D) hemodynamic changes due to brain activity. Common methods used in DOT image analysis to define brain activation have limitations because the selection of activation period is relatively subjective. General linear model (GLM)-based analysis can overcome this limitation. In this study, we combine the atlas-guided 3D DOT image reconstruction with GLM-based analysis (i.e., voxel-wise GLM analysis) to investigate the brain activity that is associated with risk decision-making processes. Risk decision-making is an important cognitive process and thus is an essential topic in the field of neuroscience. The Balloon Analog Risk Task (BART) is a valid experimental model and has been commonly used to assess human risk-taking actions and tendencies while facing risks. We have used the BART paradigm with a blocked design to investigate brain activations in the prefrontal and frontal cortical areas during decision-making from 37 human participants (22 males and 15 females). Voxel-wise GLM analysis was performed after a human brain atlas template and a depth compensation algorithm were combined to form atlas-guided DOT images. In this work, we wish to demonstrate the excellence of using voxel-wise GLM analysis with DOT to image and study cognitive functions in response to risk decision-making. Results have shown significant hemodynamic changes in the dorsal lateral prefrontal cortex (DLPFC) during the active-choice mode and a different activation pattern between genders; these findings correlate well with published literature in functional magnetic resonance imaging (fMRI) and fNIRS studies. Copyright © 2014 The Authors. Human Brain Mapping Published by Wiley Periodicals, Inc.

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

PubMed

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

2009-08-05

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

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

ERIC Educational Resources Information Center

Rich, Peter J.; Hannafin, Michael J.

2008-01-01

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

Identification Disputes for Students with Attention Deficit Hyperactivity Disorder: An Analysis of the Case Law

ERIC Educational Resources Information Center

Martin, Stacy D.; Zirkel, Perry A.

2011-01-01

This study provides a systematic analysis of published court decisions concerning identification of students with attention deficit hyperactivity disorder under the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act. The 41 pertinent child find and eligibility court decisions yielded 51 relevant rulings,…

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

ERIC Educational Resources Information Center

Sagiv, Lilach

1999-01-01

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

What Satisfies Students?: Mining Student-Opinion Data with Regression and Decision Tree Analysis

ERIC Educational Resources Information Center

Thomas, Emily H.; Galambos, Nora

2004-01-01

To investigate how students' characteristics and experiences affect satisfaction, this study uses regression and decision tree analysis with the CHAID algorithm to analyze student-opinion data. A data mining approach identifies the specific aspects of students' university experience that most influence three measures of general satisfaction. The…

Legal Considerations in Clinical Decision Making.

ERIC Educational Resources Information Center

Ursu, Samuel C.

1992-01-01

Discussion of legal issues in dental clinical decision making looks at the nature and elements of applicable law, especially malpractice, locus of responsibility, and standards of care. Greater use of formal decision analysis in clinical dentistry and better research on diagnosis and treatment are recommended, particularly in light of increasing…

20 CFR 361.7 - Written decision following a hearing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... RECOVERY OF DEBTS OWED TO THE UNITED STATES GOVERNMENT BY GOVERNMENT EMPLOYEES § 361.7 Written decision... shall issue a written decision stating the facts evidencing the nature and origin of the alleged debt; the amount and validity of the alleged debt; and the judge or hearing official's analysis, findings...

32 CFR 989.21 - Record of decision (ROD).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Record of decision (ROD). 989.21 Section 989.21 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ENVIRONMENTAL PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.21 Record of decision (ROD). (a) The proponent and the EPF...

DASEES: A Tripartite Decision Analysis Framework to Achieve Sustainable Environment, Economy & Society Growth and Management Goals

EPA Science Inventory

Many of Societies management and growth decisions are often made without a balanced consideration of pertinent factors from environmental, economic and societal perspectives. All three of these areas are key players in many of the decisions facing societies as they strive to ope...

Decision analysis to address extreme weather : extreme weather effects on ridership and modeling the decision to invest in canopy coverage.

DOT National Transportation Integrated Search

2016-09-01

This project applies a decision analytic methodology that takes considerations of extreme weather events to quantify and assess canopy investment options. The project collected data for two cases studies in two different transit agencies: Chicago Tra...

Household Schooling Decisions in Rural Pakistan. Working Paper.

ERIC Educational Resources Information Center

Sawada, Yasuyuki; Lokshin, Michael

A study of household schooling decisions in rural Pakistan found serious supply-side constraints on female primary education in the villages studied. Field surveys of 25 Pakistani villages were integrated with economic theory and econometric analysis to investigate the sequential nature of educational decisions. The full-information maximum…

32 CFR 989.21 - Record of decision (ROD).

Code of Federal Regulations, 2014 CFR

2014-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.21 Record of decision (ROD). (a) The proponent and the EPF... all the major factors the agency weighed in making its decision, including essential considerations of... avoid, minimize, or mitigate environmental impacts and, if not, explain why not. [64 FR 38129, July 15...

32 CFR 989.21 - Record of decision (ROD).

Code of Federal Regulations, 2012 CFR

2012-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.21 Record of decision (ROD). (a) The proponent and the EPF... all the major factors the agency weighed in making its decision, including essential considerations of... avoid, minimize, or mitigate environmental impacts and, if not, explain why not. [64 FR 38129, July 15...

32 CFR 989.21 - Record of decision (ROD).

Code of Federal Regulations, 2013 CFR

2013-07-01

... ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.21 Record of decision (ROD). (a) The proponent and the EPF... all the major factors the agency weighed in making its decision, including essential considerations of... avoid, minimize, or mitigate environmental impacts and, if not, explain why not. [64 FR 38129, July 15...

32 CFR 651.26 - Record of decision.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Record of decision. 651.26 Section 651.26 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Records and Documents § 651.26 Record of decision. The Record...

Cross-Lingual Neighborhood Effects in Generalized Lexical Decision and Natural Reading

ERIC Educational Resources Information Center

Dirix, Nicolas; Cop, Uschi; Drieghe, Denis; Duyck, Wouter

2017-01-01

The present study assessed intra- and cross-lingual neighborhood effects, using both a generalized lexical decision task and an analysis of a large-scale bilingual eye-tracking corpus (Cop, Dirix, Drieghe, & Duyck, 2016). Using new neighborhood density and frequency measures, the general lexical decision task yielded an inhibitory…

School-Based Decision Making: A Principal-Agent Perspective.

ERIC Educational Resources Information Center

Ferris, James M.

1992-01-01

A principal-agent framework is used to examine potential gains in educational performance and potential threats to public accountability that school-based decision-making proposals pose. Analysis underscores the need to tailor the design of decentralized decision making to the sources of poor educational performance and threats to school…

Decerns: A framework for multi-criteria decision analysis

DOE PAGES

Yatsalo, Boris; Didenko, Vladimir; Gritsyuk, Sergey; ...

2015-02-27

A new framework, Decerns, for multicriteria decision analysis (MCDA) of a wide range of practical problems on risk management is introduced. Decerns framework contains a library of modules that are the basis for two scalable systems: DecernsMCDA for analysis of multicriteria problems, and DecernsSDSS for multicriteria analysis of spatial options. DecernsMCDA includes well known MCDA methods and original methods for uncertainty treatment based on probabilistic approaches and fuzzy numbers. As a result, these MCDA methods are described along with a case study on analysis of multicriteria location problem.

Choosing treatment and screening options congruent with values: Do decision aids help? Sub-analysis of a systematic review.

PubMed

Munro, Sarah; Stacey, Dawn; Lewis, Krystina B; Bansback, Nick

2016-04-01

To understand how well patients make value congruent decisions with and without patient decision aids (PtDAs) for screening and treatment options, and identify issues with its measurement and evaluation. A sub-analysis of trials included in the 2014 Cochrane Review of Decision Aids. Eligible trials measured value congruence with chosen option. Two reviewers independently screened 115 trials. Among 18 included trials, 8 (44%) measured value congruence using the Multidimensional Measure of Informed Choice (MMIC), 7 (39%) used heterogeneous methods, and 3 (17%) used unclear methods. Pooled results of trials that used heterogeneous measures were statistically non-significant (n=3). Results from trials that used the MMIC suggest patients are 48% more likely to make value congruent decisions when exposed to a PtDA for a screening decision (RR 1.48, 95% CI 1.01 to 2.16, n=8). Patients struggle to make value congruent decisions, but PtDAs may help. While the absolute improvement is relatively small it may be underestimated due to sample size issues, definitions, and heterogeneity of measures. Current approaches are inadequate to support patients making decisions that are consistent with their values. There is some evidence that PtDAs support patients with achieving values congruent decisions for screening choices. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A new decision sciences for complex systems.

PubMed

Lempert, Robert J

2002-05-14

Models of complex systems can capture much useful information but can be difficult to apply to real-world decision-making because the type of information they contain is often inconsistent with that required for traditional decision analysis. New approaches, which use inductive reasoning over large ensembles of computational experiments, now make possible systematic comparison of alternative policy options using models of complex systems. This article describes Computer-Assisted Reasoning, an approach to decision-making under conditions of deep uncertainty that is ideally suited to applying complex systems to policy analysis. The article demonstrates the approach on the policy problem of global climate change, with a particular focus on the role of technology policies in a robust, adaptive strategy for greenhouse gas abatement.

Value of information analysis for interventional and counterfactual Bayesian networks in forensic medical sciences.

PubMed

Constantinou, Anthony Costa; Yet, Barbaros; Fenton, Norman; Neil, Martin; Marsh, William

2016-01-01

Inspired by real-world examples from the forensic medical sciences domain, we seek to determine whether a decision about an interventional action could be subject to amendments on the basis of some incomplete information within the model, and whether it would be worthwhile for the decision maker to seek further information prior to suggesting a decision. The method is based on the underlying principle of Value of Information to enhance decision analysis in interventional and counterfactual Bayesian networks. The method is applied to two real-world Bayesian network models (previously developed for decision support in forensic medical sciences) to examine the average gain in terms of both Value of Information (average relative gain ranging from 11.45% and 59.91%) and decision making (potential amendments in decision making ranging from 0% to 86.8%). We have shown how the method becomes useful for decision makers, not only when decision making is subject to amendments on the basis of some unknown risk factors, but also when it is not. Knowing that a decision outcome is independent of one or more unknown risk factors saves us from the trouble of seeking information about the particular set of risk factors. Further, we have also extended the assessment of this implication to the counterfactual case and demonstrated how answers about interventional actions are expected to change when some unknown factors become known, and how useful this becomes in forensic medical science. Copyright © 2015 Elsevier B.V. All rights reserved.

Decision Space and Capacities in the Decentralization of Health Services in FijiComment on "Decentralisation of Health Services in Fiji: A Decision Space Analysis".

PubMed

Bossert, Thomas J

2016-05-08

The study of decentralization in Fiji shows that increasing capacities is not necessarily related to increasing decision space of local officials, which is in contrast with earlier studies in Pakistan. Future studies should address the relationship among decision space, capacities, and health system performance. © 2016 by Kerman University of Medical Sciences.

The Role of Health Care Provider and Partner Decisional Support in Patients' Cancer Treatment Decision-Making Satisfaction.

PubMed

Palmer-Wackerly, Angela L; Krieger, Janice L; Rhodes, Nancy D

2017-01-01

Cancer patients rely on multiple sources of support when making treatment decisions; however, most research studies examine the influence of health care provider support while the influence of family member support is understudied. The current study fills this gap by examining the influence of health care providers and partners on decision-making satisfaction. In a cross-sectional study via an online Qualtrics panel, we surveyed cancer patients who reported that they had a spouse or romantic partner when making cancer treatment decisions (n = 479). Decisional support was measured using 5-point, single-item scales for emotional support, informational support, informational-advice support, and appraisal support. Decision-making satisfaction was measured using Holmes-Rovner and colleagues' (1996) Satisfaction With Decision Scale. We conducted a mediated regression analysis to examine treatment decision-making satisfaction for all participants and a moderated mediation analysis to examine treatment satisfaction among those patients offered a clinical trial. Results indicated that partner support significantly and partially mediated the relationship between health care provider support and patients' decision-making satisfaction but that results did not vary by enrollment in a clinical trial. This study shows how and why decisional support from partners affects communication between health care providers and cancer patients.

Decision making in asthma exacerbation: a clinical judgement analysis

PubMed Central

Jenkins, John; Shields, Mike; Patterson, Chris; Kee, Frank

2007-01-01

Background Clinical decisions which impact directly on patient safety and quality of care are made during acute asthma attacks by individual doctors based on their knowledge and experience. Decisions include administration of systemic corticosteroids (CS) and oral antibiotics, and admission to hospital. Clinical judgement analysis provides a methodology for comparing decisions between practitioners with different training and experience, and improving decision making. Methods Stepwise linear regression was used to select clinical cues based on visual analogue scale assessments of the propensity of 62 clinicians to prescribe a short course of oral CS (decision 1), a course of antibiotics (decision 2), and/or admit to hospital (decision 3) for 60 “paper” patients. Results When compared by specialty, paediatricians' models for decision 1 were more likely to include level of alertness as a cue (54% vs 16%); for decision 2 they were more likely to include presence of crepitations (49% vs 16%) and less likely to include inhaled CS (8% vs 40%), respiratory rate (0% vs 24%) and air entry (70% vs 100%). When compared to other grades, the models derived for decision 3 by consultants/general practitioners were more likely to include wheeze severity as a cue (39% vs 6%). Conclusions Clinicians differed in their use of individual cues and the number included in their models. Patient safety and quality of care will benefit from clarification of decision‐making strategies as general learning points during medical training, in the development of guidelines and care pathways, and by clinicians developing self‐awareness of their own preferences. PMID:17428817

Watchful waiting or induction of labour--a matter of informed choice: identification, analysis and critical appraisal of decision aids and patient information regarding care options for women with uncomplicated singleton late and post term pregnancies: a review.

PubMed

Berger, Bettina; Schwarz, Christiane; Heusser, Peter

2015-05-07

Decision-making during pregnancy regarding different options of care can be difficult, particularly when risks of intervention versus no intervention for mother and baby are unclear. Unbiased information and support for decision making may be beneficial in these situations. The management of normal pregnancies at and beyond term is an example of such a situation. In order to determine the need to develop an evidence-based decision aid this paper searches, analyses and appraises patient decision aids and patient information leaflets regarding care options in cases of late term and post-term pregnancies, including complementary and alternative medicine (CAM). A literature search was carried out in a variety of lay and medical databases. written information related to uncomplicated singleton pregnancies and targeted at lay people. Analysis and appraisal of included material by means of quality criteria was set up based on the International Patient Decision Aid Standards accounting for evidence-basing of CAM options. Inclusion of two decision aids and eleven leaflets from four decision aids and sixteen leaflets. One decision aid met the quality criteria almost completely, the other one only insufficiently despite providing some helpful information. Only one leaflet is of good quality, but cannot substitute a decision aid. There is an urgent need for the design of an evidence-based decision aid of good quality for late-term or post-term pregnancy, particularly in German language.

Sensitivity analysis in economic evaluation: an audit of NICE current practice and a review of its use and value in decision-making.

PubMed

Andronis, L; Barton, P; Bryan, S

2009-06-01

To determine how we define good practice in sensitivity analysis in general and probabilistic sensitivity analysis (PSA) in particular, and to what extent it has been adhered to in the independent economic evaluations undertaken for the National Institute for Health and Clinical Excellence (NICE) over recent years; to establish what policy impact sensitivity analysis has in the context of NICE, and policy-makers' views on sensitivity analysis and uncertainty, and what use is made of sensitivity analysis in policy decision-making. Three major electronic databases, MEDLINE, EMBASE and the NHS Economic Evaluation Database, were searched from inception to February 2008. The meaning of 'good practice' in the broad area of sensitivity analysis was explored through a review of the literature. An audit was undertaken of the 15 most recent NICE multiple technology appraisal judgements and their related reports to assess how sensitivity analysis has been undertaken by independent academic teams for NICE. A review of the policy and guidance documents issued by NICE aimed to assess the policy impact of the sensitivity analysis and the PSA in particular. Qualitative interview data from NICE Technology Appraisal Committee members, collected as part of an earlier study, were also analysed to assess the value attached to the sensitivity analysis components of the economic analyses conducted for NICE. All forms of sensitivity analysis, notably both deterministic and probabilistic approaches, have their supporters and their detractors. Practice in relation to univariate sensitivity analysis is highly variable, with considerable lack of clarity in relation to the methods used and the basis of the ranges employed. In relation to PSA, there is a high level of variability in the form of distribution used for similar parameters, and the justification for such choices is rarely given. Virtually all analyses failed to consider correlations within the PSA, and this is an area of concern. Uncertainty is considered explicitly in the process of arriving at a decision by the NICE Technology Appraisal Committee, and a correlation between high levels of uncertainty and negative decisions was indicated. The findings suggest considerable value in deterministic sensitivity analysis. Such analyses serve to highlight which model parameters are critical to driving a decision. Strong support was expressed for PSA, principally because it provides an indication of the parameter uncertainty around the incremental cost-effectiveness ratio. The review and the policy impact assessment focused exclusively on documentary evidence, excluding other sources that might have revealed further insights on this issue. In seeking to address parameter uncertainty, both deterministic and probabilistic sensitivity analyses should be used. It is evident that some cost-effectiveness work, especially around the sensitivity analysis components, represents a challenge in making it accessible to those making decisions. This speaks to the training agenda for those sitting on such decision-making bodies, and to the importance of clear presentation of analyses by the academic community.

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

PubMed

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

2010-02-01

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

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

PubMed Central

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

2010-01-01

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

Climate Risk Informed Decision Analysis: A Hypothetical Application to the Waas Region

NASA Astrophysics Data System (ADS)

Gilroy, Kristin; Mens, Marjolein; Haasnoot, Marjolijn; Jeuken, Ad

2016-04-01

More frequent and intense hydrologic events under climate change are expected to enhance water security and flood risk management challenges worldwide. Traditional planning approaches must be adapted to address climate change and develop solutions with an appropriate level of robustness and flexibility. The Climate Risk Informed Decision Analysis (CRIDA) method is a novel planning approach embodying a suite of complementary methods, including decision scaling and adaptation pathways. Decision scaling offers a bottom-up approach to assess risk and tailors the complexity of the analysis to the problem at hand and the available capacity. Through adaptation pathway,s an array of future strategies towards climate robustness are developed, ranging in flexibility and immediacy of investments. Flexible pathways include transfer points to other strategies to ensure that the system can be adapted if future conditions vary from those expected. CRIDA combines these two approaches in a stakeholder driven process which guides decision makers through the planning and decision process, taking into account how the confidence in the available science, the consequences in the system, and the capacity of institutions should influence strategy selection. In this presentation, we will explain the CRIDA method and compare it to existing planning processes, such as the US Army Corps of Engineers Principles and Guidelines as well as Integrated Water Resources Management Planning. Then, we will apply the approach to a hypothetical case study for the Waas Region, a large downstream river basin facing rapid development threatened by increased flood risks. Through the case study, we will demonstrate how a stakeholder driven process can be used to evaluate system robustness to climate change; develop adaptation pathways for multiple objectives and criteria; and illustrate how varying levels of confidence, consequences, and capacity would play a role in the decision making process, specifically in regards to the level of robustness and flexibility in the selected strategy. This work will equip practitioners and decision makers with an example of a structured process for decision making under climate uncertainty that can be scaled as needed to the problem at hand. This presentation builds further on another submitted abstract "Climate Risk Informed Decision Analysis (CRIDA): A novel practical guidance for Climate Resilient Investments and Planning" by Jeuken et al.

Research | Argonne National Laboratory

Science.gov Websites

, and Decision Analytics Energy Systems Analysis Engines and Fuels Friction, Wear, and Lubrication Vehicle Technologies Buildings and Climate-Environment Energy, Power, and Decision Analytics Energy

32 CFR 855.2 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... authority. All decisions are subject to the environmental impact analysis process as directed by the... instructions. The decision process includes consultation with other affected functional area managers when...

Multiple Criteria Decision Analysis for Health Care Decision Making--Emerging Good Practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force.

PubMed

Marsh, Kevin; IJzerman, Maarten; Thokala, Praveen; Baltussen, Rob; Boysen, Meindert; Kaló, Zoltán; Lönngren, Thomas; Mussen, Filip; Peacock, Stuart; Watkins, John; Devlin, Nancy

2016-01-01

Health care decisions are complex and involve confronting trade-offs between multiple, often conflicting objectives. Using structured, explicit approaches to decisions involving multiple criteria can improve the quality of decision making. A set of techniques, known under the collective heading, multiple criteria decision analysis (MCDA), are useful for this purpose. In 2014, ISPOR established an Emerging Good Practices Task Force. The task force's first report defined MCDA, provided examples of its use in health care, described the key steps, and provided an overview of the principal methods of MCDA. This second task force report provides emerging good-practice guidance on the implementation of MCDA to support health care decisions. The report includes: a checklist to support the design, implementation and review of an MCDA; guidance to support the implementation of the checklist; the order in which the steps should be implemented; illustrates how to incorporate budget constraints into an MCDA; provides an overview of the skills and resources, including available software, required to implement MCDA; and future research directions. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Reward-related decision making in eating and weight disorders: A systematic review and meta-analysis of the evidence from neuropsychological studies.

PubMed

Wu, Mudan; Brockmeyer, Timo; Hartmann, Mechthild; Skunde, Mandy; Herzog, Wolfgang; Friederich, Hans-Christoph

2016-02-01

Eating disorders (EDs) and overweight/obesity (OW/OB) are serious public health concerns that share common neuropsychological features and patterns of disturbed eating. Reward-related decision making as a basic neurocognitive function may trans-diagnostically underlie both pathological overeating and restricted eating. The present meta-analysis synthesizes the evidence from N=82 neuropsychological studies for altered reward-related decision making in all ED subtypes, OW and OB. The overall effect sizes for the differences between currently-ill ED patients and OW/OB people and controls were Hedge's g=-0.49 [CI: -0.63; -0.35], and Hedge's g=-0.39 [CI: -0.53; -0.25], respectively. Decision making was found to be altered to similar degrees in all ED subtypes and OB. Effect sizes, however, diverged for the different measures of decision making. Adolescents appear to be less affected than adults. When foods were used as rewarding stimuli, decision making was found to be intact in OB. The findings support that altered general reward-related decision making is a salient neuropsychological factor across eating and weight disorders in adulthood. Copyright © 2015 Elsevier Ltd. All rights reserved.

ATR evaluation through the synthesis of multiple performance measures

NASA Astrophysics Data System (ADS)

Bassham, Christopher B.; Klimack, William K.; Bauer, Kenneth W., Jr.

2002-07-01

This research demonstrates the application of decision analysis (DA) techniques to decisions made within Automatic Target Recognition (ATR) technology development. This work is accomplished to improve the means by which ATR technologies are evaluated. The first step in this research was to create a flexible decision analysis framework that could be applied to several decisions across different ATR programs evaluated by the Comprehensive ATR Scientific Evaluation (COMPASE) Center of the Air Force Research Laboratory (AFRL). For the purposes of this research, a single COMPASE Center representative provided the value, utility, and preference functions for the DA framework. The DA framework employs performance measures collected during ATR classification system (CS) testing to calculate value and utility scores. The authors gathered data from the Moving and Stationary Target Acquisition and Recognition (MSTAR) program to demonstrate how the decision framework could be used to evaluate three different ATR CSs. A decision-maker may use the resultant scores to gain insight into any of the decisions that occur throughout the lifecycle of ATR technologies. Additionally, a means of evaluating ATR CS self-assessment ability is presented. This represents a new criterion that emerged from this study, and no present evaluation metric is known.

Women's Values and Preferences for Thromboprophylaxis during Pregnancy: A Comparison of Direct-choice and Decision Analysis using Patient Specific Utilities

PubMed Central

Eckman, Mark H.; Alonso-Coello, Pablo; Guyatt, Gordon H.; Ebrahim, Shanil; Tikkinen, Kari A.O.; Lopes, Luciane Cruz; Neumann, Ignacio; McDonald, Sarah D.; Zhang, Yuqing; Zhou, Qi; Akl, Elie A.; Jacobsen, Ann Flem; Santamaría, Amparo; Annichino-Bizzacchi, Joyce Maria; Bitar, Wael; Sandset, Per Morten; Bates, Shannon M.

2016-01-01

Background Women with a history of venous thromboembolism (VTE) have an increased recurrence risk during pregnancy. Low molecular weight heparin (LMWH) reduces this risk, but is costly, burdensome, and may increase risk of bleeding. The decision to start thromboprophylaxis during pregnancy is sensitive to women's values and preferences. Our objective was to compare women's choices using a holistic approach in which they were presented all of the relevant information (direct-choice) versus a personalized decision analysis in which a mathematical model incorporated their preferences and VTE risk to make a treatment recommendation. Methods Multicenter, international study. Structured interviews were on women with a history of VTE who were pregnant, planning, or considering pregnancy. Women indicated their willingness to receive thromboprophylaxis based on scenarios using personalized estimates of VTE recurrence and bleeding risks. We also obtained women's values for health outcomes using a visual analog scale. We performed individualized decision analyses for each participant and compared model recommendations to decisions made when presented with the direct-choice exercise. Results Of the 123 women in the study, the decision model recommended LMWH for 51 women and recommended against LMWH for 72 women. 12% (6/51) of women for whom the decision model recommended thromboprophylaxis chose not to take LMWH; 72% (52/72) of women for whom the decision model recommended against thromboprophylaxis chose LMWH. Conclusions We observed a high degree of discordance between decisions in the direct-choice exercise and decision model recommendations. Although which approach best captures individuals’ true values remains uncertain, personalized decision support tools presenting results based on personalized risks and values may improve decision making. PMID:26033397

Women's values and preferences for thromboprophylaxis during pregnancy: a comparison of direct-choice and decision analysis using patient specific utilities.

PubMed

Eckman, Mark H; Alonso-Coello, Pablo; Guyatt, Gordon H; Ebrahim, Shanil; Tikkinen, Kari A O; Lopes, Luciane Cruz; Neumann, Ignacio; McDonald, Sarah D; Zhang, Yuqing; Zhou, Qi; Akl, Elie A; Jacobsen, Ann Flem; Santamaría, Amparo; Annichino-Bizzacchi, Joyce Maria; Bitar, Wael; Sandset, Per Morten; Bates, Shannon M

2015-08-01

Women with a history of venous thromboembolism (VTE) have an increased recurrence risk during pregnancy. Low molecular weight heparin (LMWH) reduces this risk, but is costly, burdensome, and may increase risk of bleeding. The decision to start thromboprophylaxis during pregnancy is sensitive to women's values and preferences. Our objective was to compare women's choices using a holistic approach in which they were presented all of the relevant information (direct-choice) versus a personalized decision analysis in which a mathematical model incorporated their preferences and VTE risk to make a treatment recommendation. Multicenter, international study. Structured interviews were on women with a history of VTE who were pregnant, planning, or considering pregnancy. Women indicated their willingness to receive thromboprophylaxis based on scenarios using personalized estimates of VTE recurrence and bleeding risks. We also obtained women's values for health outcomes using a visual analog scale. We performed individualized decision analyses for each participant and compared model recommendations to decisions made when presented with the direct-choice exercise. Of the 123 women in the study, the decision model recommended LMWH for 51 women and recommended against LMWH for 72 women. 12% (6/51) of women for whom the decision model recommended thromboprophylaxis chose not to take LMWH; 72% (52/72) of women for whom the decision model recommended against thromboprophylaxis chose LMWH. We observed a high degree of discordance between decisions in the direct-choice exercise and decision model recommendations. Although which approach best captures individuals' true values remains uncertain, personalized decision support tools presenting results based on personalized risks and values may improve decision making. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

PubMed

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

2017-01-01

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

A matter of tradeoffs: reintroduction as a multiple objective decision

USGS Publications Warehouse

Converse, Sarah J.; Moore, Clinton T.; Folk, Martin J.; Runge, Michael C.

2013-01-01

Decision making in guidance of reintroduction efforts is made challenging by the substantial scientific uncertainty typically involved. However, a less recognized challenge is that the management objectives are often numerous and complex. Decision makers managing reintroduction efforts are often concerned with more than just how to maximize the probability of reintroduction success from a population perspective. Decision makers are also weighing other concerns such as budget limitations, public support and/or opposition, impacts on the ecosystem, and the need to consider not just a single reintroduction effort, but conservation of the entire species. Multiple objective decision analysis is a powerful tool for formal analysis of such complex decisions. We demonstrate the use of multiple objective decision analysis in the case of the Florida non-migratory whooping crane reintroduction effort. In this case, the State of Florida was considering whether to resume releases of captive-reared crane chicks into the non-migratory whooping crane population in that state. Management objectives under consideration included maximizing the probability of successful population establishment, minimizing costs, maximizing public relations benefits, maximizing the number of birds available for alternative reintroduction efforts, and maximizing learning about the demographic patterns of reintroduced whooping cranes. The State of Florida engaged in a collaborative process with their management partners, first, to evaluate and characterize important uncertainties about system behavior, and next, to formally evaluate the tradeoffs between objectives using the Simple Multi-Attribute Rating Technique (SMART). The recommendation resulting from this process, to continue releases of cranes at a moderate intensity, was adopted by the State of Florida in late 2008. Although continued releases did not receive support from the International Whooping Crane Recovery Team, this approach does provide a template for the formal, transparent consideration of multiple, potentially competing, objectives in reintroduction decision making.

An Overview of Value, Perspective, and Decision Context-A Health Economics Approach: An ISPOR Special Task Force Report [2].

PubMed

Garrison, Louis P; Pauly, Mark V; Willke, Richard J; Neumann, Peter J

2018-02-01

The second section of our Special Task Force builds on the discussion of value and perspective in the previous article of the report by 1) defining a health economics approach to the concept of value in health care systems; 2) discussing the relationship of value to perspective and decision context, that is, how recently proposed value frameworks vary by the types of decisions being made and by the stakeholders involved; 3) describing the patient perspective on value because the patient is a key stakeholder, but one also wearing the hat of a health insurance purchaser; and 4) discussing how value is relevant in the market-based US system of mixed private and public insurance, and differs from its use in single-payer systems. The five recent value frameworks that motivated this report vary in the types of decisions they intend to inform, ranging from coverage, access, and pricing decisions to those defining appropriate clinical pathways and to supporting provider-clinician shared decision making. Each of these value frameworks must be evaluated in its own decision context for its own objectives. Existing guidelines for cost-effectiveness analysis emphasize the importance of clearly specifying the perspective from which the analysis is undertaken. Relevant perspectives may include, among others, 1) the health plan enrollee, 2) the patient, 3) the health plan manager, 4) the provider, 5) the technology manufacturer, 6) the specialty society, 7) government regulators, or 8) society as a whole. A valid and informative cost-effectiveness analysis could be conducted from the perspective of any of these stakeholders, depending on the decision context. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Walking the line: Understanding pedestrian behaviour and risk at rail level crossings with cognitive work analysis.

PubMed

Read, Gemma J M; Salmon, Paul M; Lenné, Michael G; Stanton, Neville A

2016-03-01

Pedestrian fatalities at rail level crossings (RLXs) are a public safety concern for governments worldwide. There is little literature examining pedestrian behaviour at RLXs and no previous studies have adopted a formative approach to understanding behaviour in this context. In this article, cognitive work analysis is applied to understand the constraints that shape pedestrian behaviour at RLXs in Melbourne, Australia. The five phases of cognitive work analysis were developed using data gathered via document analysis, behavioural observation, walk-throughs and critical decision method interviews. The analysis demonstrates the complex nature of pedestrian decision making at RLXs and the findings are synthesised to provide a model illustrating the influences on pedestrian decision making in this context (i.e. time, effort and social pressures). Further, the CWA outputs are used to inform an analysis of the risks to safety associated with pedestrian behaviour at RLXs and the identification of potential interventions to reduce risk. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

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

PubMed

Lindahl, Jonas; Danell, Rickard

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

Consultant psychiatrists’ experiences of and attitudes towards shared decision making in antipsychotic prescribing, a qualitative study

PubMed Central

2014-01-01

Background Shared decision making represents a clinical consultation model where both clinician and service user are conceptualised as experts; information is shared bilaterally and joint treatment decisions are reached. Little previous research has been conducted to assess experience of this model in psychiatric practice. The current project therefore sought to explore the attitudes and experiences of consultant psychiatrists relating to shared decision making in the prescribing of antipsychotic medications. Methods A qualitative research design allowed the experiences and beliefs of participants in relation to shared decision making to be elicited. Purposive sampling was used to recruit participants from a range of clinical backgrounds and with varying length of clinical experience. A semi-structured interview schedule was utilised and was adapted in subsequent interviews to reflect emergent themes. Data analysis was completed in parallel with interviews in order to guide interview topics and to inform recruitment. A directed analysis method was utilised for interview analysis with themes identified being fitted to a framework identified from the research literature as applicable to the practice of shared decision making. Examples of themes contradictory to, or not adequately explained by, the framework were sought. Results A total of 26 consultant psychiatrists were interviewed. Participants expressed support for the shared decision making model, but also acknowledged that it was necessary to be flexible as the clinical situation dictated. A number of potential barriers to the process were perceived however: The commonest barrier was the clinician’s beliefs regarding the service users’ insight into their mental disorder, presented in some cases as an absolute barrier to shared decision making. In addition factors external to the clinician - service user relationship were identified as impacting on the decision making process, including; environmental factors, financial constraints as well as societal perceptions of mental disorder in general and antipsychotic medication in particular. Conclusions This project has allowed identification of potential barriers to shared decision making in psychiatric practice. Further work is necessary to observe the decision making process in clinical practice and also to identify means in which the identified barriers, in particular ‘lack of insight’, may be more effectively managed. PMID:24886121

Consultant psychiatrists' experiences of and attitudes towards shared decision making in antipsychotic prescribing, a qualitative study.

PubMed

Shepherd, Andrew; Shorthouse, Oliver; Gask, Linda

2014-05-01

Shared decision making represents a clinical consultation model where both clinician and service user are conceptualised as experts; information is shared bilaterally and joint treatment decisions are reached. Little previous research has been conducted to assess experience of this model in psychiatric practice. The current project therefore sought to explore the attitudes and experiences of consultant psychiatrists relating to shared decision making in the prescribing of antipsychotic medications. A qualitative research design allowed the experiences and beliefs of participants in relation to shared decision making to be elicited. Purposive sampling was used to recruit participants from a range of clinical backgrounds and with varying length of clinical experience. A semi-structured interview schedule was utilised and was adapted in subsequent interviews to reflect emergent themes.Data analysis was completed in parallel with interviews in order to guide interview topics and to inform recruitment. A directed analysis method was utilised for interview analysis with themes identified being fitted to a framework identified from the research literature as applicable to the practice of shared decision making. Examples of themes contradictory to, or not adequately explained by, the framework were sought. A total of 26 consultant psychiatrists were interviewed. Participants expressed support for the shared decision making model, but also acknowledged that it was necessary to be flexible as the clinical situation dictated. A number of potential barriers to the process were perceived however: The commonest barrier was the clinician's beliefs regarding the service users' insight into their mental disorder, presented in some cases as an absolute barrier to shared decision making. In addition factors external to the clinician - service user relationship were identified as impacting on the decision making process, including; environmental factors, financial constraints as well as societal perceptions of mental disorder in general and antipsychotic medication in particular. This project has allowed identification of potential barriers to shared decision making in psychiatric practice. Further work is necessary to observe the decision making process in clinical practice and also to identify means in which the identified barriers, in particular 'lack of insight', may be more effectively managed.

Temporal characteristics of decisions in hospital encounters: a threshold for shared decision making? A qualitative study.

PubMed

Ofstad, Eirik H; Frich, Jan C; Schei, Edvin; Frankel, Richard M; Gulbrandsen, Pål

2014-11-01

To identify and characterize physicians' statements that contained evidence of clinically relevant decisions in encounters with patients in different hospital settings. Qualitative analysis of 50 videotaped encounters from wards, the emergency room (ER) and outpatient clinics in a department of internal medicine at a Norwegian university hospital. Clinical decisions could be grouped in a temporal order: decisions which had already been made, and were brought into the encounter by the physician (preformed decisions), decisions made in the present (here-and-now decisions), and decisions prescribing future actions given a certain course of events (conditional decisions). Preformed decisions were a hallmark in the ward and conditional decisions a main feature of ER encounters. Clinical decisions related to a patient-physician encounter spanned a time frame exceeding the duration of the encounter. While a distribution of decisions over time and space fosters sharing and dilution of responsibility between providers, it makes the decision making process hard to access for patients. In order to plan when and how to involve patients in decisions, physicians need increased awareness of when clinical decisions are made, who usually makes them, and who should make them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Diffusion Modelling Reveals the Decision Making Processes Underlying Negative Judgement Bias in Rats.

PubMed

Hales, Claire A; Robinson, Emma S J; Houghton, Conor J

2016-01-01

Human decision making is modified by emotional state. Rodents exhibit similar biases during interpretation of ambiguous cues that can be altered by affective state manipulations. In this study, the impact of negative affective state on judgement bias in rats was measured using an ambiguous-cue interpretation task. Acute treatment with an anxiogenic drug (FG7142), and chronic restraint stress and social isolation both induced a bias towards more negative interpretation of the ambiguous cue. The diffusion model was fit to behavioural data to allow further analysis of the underlying decision making processes. To uncover the way in which parameters vary together in relation to affective state manipulations, independent component analysis was conducted on rate of information accumulation and distances to decision threshold parameters for control data. Results from this analysis were applied to parameters from negative affective state manipulations. These projected components were compared to control components to reveal the changes in decision making processes that are due to affective state manipulations. Negative affective bias in rodents induced by either FG7142 or chronic stress is due to a combination of more negative interpretation of the ambiguous cue, reduced anticipation of the high reward and increased anticipation of the low reward.

Evidence synthesis for decision making 7: a reviewer's checklist.

PubMed

Ades, A E; Caldwell, Deborah M; Reken, Stefanie; Welton, Nicky J; Sutton, Alex J; Dias, Sofia

2013-07-01

This checklist is for the review of evidence syntheses for treatment efficacy used in decision making based on either efficacy or cost-effectiveness. It is intended to be used for pairwise meta-analysis, indirect comparisons, and network meta-analysis, without distinction. It does not generate a quality rating and is not prescriptive. Instead, it focuses on a series of questions aimed at revealing the assumptions that the authors of the synthesis are expecting readers to accept, the adequacy of the arguments authors advance in support of their position, and the need for further analyses or sensitivity analyses. The checklist is intended primarily for those who review evidence syntheses, including indirect comparisons and network meta-analyses, in the context of decision making but will also be of value to those submitting syntheses for review, whether to decision-making bodies or journals. The checklist has 4 main headings: A) definition of the decision problem, B) methods of analysis and presentation of results, C) issues specific to network synthesis, and D) embedding the synthesis in a probabilistic cost-effectiveness model. The headings and implicit advice follow directly from the other tutorials in this series. A simple table is provided that could serve as a pro forma checklist.

[Application of evidence based medicine to the individual patient: the role of decision analysis].

PubMed

Housset, B; Junod, A F

2003-11-01

The objective of evidence based medicine (EBM) is to contribute to medical decision making by providing the best possible information in terms of validity and relevance. This allows evaluation in a specific manner of the benefits and risks of a decision. The limitations and hazards of this approach are discussed in relation to a clinical case where the diagnosis of pulmonary embolism was under consideration. The individual details and the limited availability of some technical procedures illustrate the need to adapt the data of EBM to the circumstances. The choice between two diagnostic tests (d-dimers and ultrasound of the legs) and their optimal timing is analysed with integration of the consequences for the patient of the treatments proposed. This allows discussion of the concept of utility and the use of sensitivity analysis. If EBM is the cornerstone of rational and explicit practise it should also allow for the constraints of real life. Decision analysis, which depends on the same critical demands as EBM but can also take account of the individual features of each patient and test the robustness of a decision, gives a unique opportunity reconcile rigorous reasoning with individualisation of management.

Predictability of the future development of aggressive behavior of cranial dural arteriovenous fistulas based on decision tree analysis.

PubMed

Satomi, Junichiro; Ghaibeh, A Ammar; Moriguchi, Hiroki; Nagahiro, Shinji

2015-07-01

The severity of clinical signs and symptoms of cranial dural arteriovenous fistulas (DAVFs) are well correlated with their pattern of venous drainage. Although the presence of cortical venous drainage can be considered a potential predictor of aggressive DAVF behaviors, such as intracranial hemorrhage or progressive neurological deficits due to venous congestion, accurate statistical analyses are currently not available. Using a decision tree data mining method, the authors aimed at clarifying the predictability of the future development of aggressive behaviors of DAVF and at identifying the main causative factors. Of 266 DAVF patients, 89 were eligible for analysis. Under observational management, 51 patients presented with intracranial hemorrhage/infarction during the follow-up period. The authors created a decision tree able to assess the risk for the development of aggressive DAVF behavior. Evaluated by 10-fold cross-validation, the decision tree's accuracy, sensitivity, and specificity were 85.28%, 88.33%, and 80.83%, respectively. The tree shows that the main factor in symptomatic patients was the presence of cortical venous drainage. In its absence, the lesion location determined the risk of a DAVF developing aggressive behavior. Decision tree analysis accurately predicts the future development of aggressive DAVF behavior.

[Analysis of the characteristics of the older adults with depression using data mining decision tree analysis].

PubMed

Park, Myonghwa; Choi, Sora; Shin, A Mi; Koo, Chul Hoi

2013-02-01

The purpose of this study was to develop a prediction model for the characteristics of older adults with depression using the decision tree method. A large dataset from the 2008 Korean Elderly Survey was used and data of 14,970 elderly people were analyzed. Target variable was depression and 53 input variables were general characteristics, family & social relationship, economic status, health status, health behavior, functional status, leisure & social activity, quality of life, and living environment. Data were analyzed by decision tree analysis, a data mining technique using SPSS Window 19.0 and Clementine 12.0 programs. The decision trees were classified into five different rules to define the characteristics of older adults with depression. Classification & Regression Tree (C&RT) showed the best prediction with an accuracy of 80.81% among data mining models. Factors in the rules were life satisfaction, nutritional status, daily activity difficulty due to pain, functional limitation for basic or instrumental daily activities, number of chronic diseases and daily activity difficulty due to disease. The different rules classified by the decision tree model in this study should contribute as baseline data for discovering informative knowledge and developing interventions tailored to these individual characteristics.

History matching through dynamic decision-making

PubMed Central

Maschio, Célio; Santos, Antonio Alberto; Schiozer, Denis; Rocha, Anderson

2017-01-01

History matching is the process of modifying the uncertain attributes of a reservoir model to reproduce the real reservoir performance. It is a classical reservoir engineering problem and plays an important role in reservoir management since the resulting models are used to support decisions in other tasks such as economic analysis and production strategy. This work introduces a dynamic decision-making optimization framework for history matching problems in which new models are generated based on, and guided by, the dynamic analysis of the data of available solutions. The optimization framework follows a ‘learning-from-data’ approach, and includes two optimizer components that use machine learning techniques, such as unsupervised learning and statistical analysis, to uncover patterns of input attributes that lead to good output responses. These patterns are used to support the decision-making process while generating new, and better, history matched solutions. The proposed framework is applied to a benchmark model (UNISIM-I-H) based on the Namorado field in Brazil. Results show the potential the dynamic decision-making optimization framework has for improving the quality of history matching solutions using a substantial smaller number of simulations when compared with a previous work on the same benchmark. PMID:28582413

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

PubMed

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

2013-01-01

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

Analysis and Design of a Decision Support System for Silas B. Hays Army Community Hospital

DTIC Science & Technology

1988-09-01

develop the DSS. This collaboration allows the user to learn about the power decision support can give to the decision maker and... projects under their control. A DSS is developed to provide decision support for a specific manager or group , and con- sequently falls under the ... It is possible the first iteration could be developed in more than one programming language and results compared . Once the first

M&S Decision/Role-Behavior Decompositions

DTIC Science & Technology

2007-10-17

M &S Decision/Role-Behavior Decompositions Wargaming and Analysis Workshop Military Operations Research Society 17 October 2007 Paul Works, Methods...number. 1. REPORT DATE 17 OCT 2007 2. REPORT TYPE 3. DATES COVERED 00-00-2007 to 00-00-2007 4. TITLE AND SUBTITLE M &S Decision/Role-Behavior...transmission. • Combat models and simulations ( M &S) continue, in most cases, to model “effects-level” representations of SA, decisions, and behaviors. – M &S

Using multiple pharmacoeconomic methods to conduct a cost-effectiveness analysis of histamine H2-receptor antagonists.

PubMed

McCoy, S; Blayney-Chandramouli, J; Mutnick, A

1998-12-15

A formulary decision at a health care institution was studied by using two pharmacoeconomic methods. A pharmacoeconomic study was undertaken to assess the impact of a 1995 formulary decision to designate cimetidine as the primary histamine H2-receptor antagonist (H2RA) and to restrict the use of famotidine. Consecutive patients receiving either i.v. cimetidine or famotidine for stress ulcer prophylaxis were reviewed during a two-month period in 1997, and information on demographics, dosage and duration of H2RA therapy, admission date, laboratory test values, and adverse drug reactions was collected. Data for 62 patients (43 cimetidine recipients and 19 famotidine recipients) were evaluated. Therapy was categorized as successful or failed, and the data were then evaluated by decision analysis to evaluate the cost-effectiveness of the agents and by multiattribute utility theory (MAUT) to incorporate a humanistic evaluation of the treatments, namely, the number of doses administered and the number of times dosages were changed. The decision tree revealed that the average cost of receiving cimetidine was $82.01 and the average cost of famotidine therapy was $92.45. The MAUT analysis showed that cimetidine was the preferred agent as long as cost was valued at greater than 60% of the decision-making process and efficacy remained equal between the two agents. Two pharmacoeconomic methods lent support to a formulary decision at a health care institution.

Despite Best Intentions: A Critical Analysis of Social Justice Leadership and Decision Making

ERIC Educational Resources Information Center

DeMatthews, David E.; Mungal, Angus Shiva; Carrola, Paul A.

2015-01-01

The purpose of this article is to explore the relationship between social justice leadership and organizational decision making in order to make recommendations for how principals can make more socially just decisions in difficult school contexts. This article begins with a discussion of social justice leadership, facets and theories associated…

Interdisciplinary Collaborative Learning: Using Decision Analysts to Enhance Undergraduate International Management Education

ERIC Educational Resources Information Center

Palocsay, Susan W.; White, Marion M.; Zimmerman, D. Kent

2004-01-01

This article describes an experiential learning activity designed to promote the development of decision-making skills in international management students at the undergraduate level. Students from an undergraduate management science course in decision analysis served as consultants on a case assigned to teams in an international management class.…

Inclusion for Students with High-Functioning Autism Spectrum Disorders: Definitions and Decision Making

ERIC Educational Resources Information Center

Sansosti, Jenine M.; Sansosti, Frank J.

2012-01-01

General education placements are believed to offer numerous benefits for students with high-functioning autism spectrum disorders (HFASDs), yet decisions about including students with HFASDs remain controversial. This article presents data from a qualitative analysis of definitions and decision making considerations for a school district with a…

Beyond Relativism to Ethical Decision-Making

ERIC Educational Resources Information Center

Walker, Keith D.; Donlevy, J. Kent

2006-01-01

This article examines the ethical conundrum of educational decision makers when faced with a plethora of conflicting value-based decisions. It offers an analysis of a well-known fable as the foil to demonstrate the problematic nature of ethical relativism and postmodern ethics in resolving that conundrum, while advocating the use of five core…

Analysis of strength-of-preference measures in dichotomous choice models

Treesearch

Donald F. Dennis; Peter Newman; Robert Manning

2008-01-01

Choice models are becoming increasingly useful for soliciting and analyzing multiple objective decisions faced by recreation managers and others interested in decisions involving natural resources. Choice models are used to estimate relative values for multiple aspects of natural resource management, not individually but within the context of other relevant decision...

Unraveling the Role of Curriculum in Teacher Decision Making

ERIC Educational Resources Information Center

Siuty, Molly Baustien; Leko, Melinda M.; Knackstedt, Kimberly M.

2018-01-01

Teachers make numerous decisions each day, yet processes undergirding these decisions are elusive and have not been the subject of many in-depth investigations within special education. The purpose of this qualitative investigation, therefore, was to complete a micro-level analysis of the influence of curriculum on 11 middle school teachers'…

Modeling as a Decision-Making Process

ERIC Educational Resources Information Center

Bleiler-Baxter, Sarah K.; Stephens, D. Christopher; Baxter, Wesley A.; Barlow, Angela T.

2017-01-01

The goal in this article is to support teachers in better understanding what it means to model with mathematics by focusing on three key decision-making processes: Simplification, Relationship Mapping, and Situation Analysis. The authors use the Theme Park task to help teachers develop a vision of how students engage in these three decision-making…

Making Sense of Experienced Teachers' Interactive Decisions: Implications for Expertise in Teaching

ERIC Educational Resources Information Center

Gün, Bahar

2014-01-01

Teachers' decision making has always been an area of curiosity in many studies related to teachers and teaching. One approach to understanding teachers' decisions is through the analysis of their reflection-in-action behaviours. This study, based on the premise that one can gain understanding from examining experienced teachers' classroom…

Child Protection Decision Making: A Factorial Analysis Using Case Vignettes

ERIC Educational Resources Information Center

Stokes, Jacqueline; Schmidt, Glen

2012-01-01

This study explored decision making by child protection social workers in the province of British Columbia, Canada. A factorial survey method was used in which case vignettes were constructed by randomly assigning a number of key characteristics associated with decision making in child protection. Child protection social workers (n = 118) assessed…

Mass Conflagration: An Analysis and Adaptation of the Shipboard Damage Control Organization

DTIC Science & Technology

1991-03-01

the span of control narrows, as each supervisor is able to better monitor the actions and environment of his subordinates. (6) Communciation and... computed decision is reached by the decision makers, often based on a prior formal doctrine or methodology. [Ref. 4:p. 364] While no decision process

Assumptions Underlying Curriculum Decisions in Australia: An American Perspective.

ERIC Educational Resources Information Center

Willis, George

An analysis of the cultural and historical context in which curriculum decisions are made in Australia and a comparison with educational assumptions in the United States is the purpose of this paper. Methodology is based on personal teaching experience and observation in Australia. Seven factors are identified upon which curricular decisions in…

78 FR 76829 - Approval of Application Submitted by Eastern Shoshone Tribe and Northern Arapaho Tribe for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-19

... regulatory authority under the Clean Air Act. DATES: EPA's decision approving the Tribes' TAS application was... Decision Document, Attachment 1 (Legal Analysis of the Wind River Indian Reservation Boundary), Attachment... decision to approve the application does not approve, Tribal authority to implement any Clean Air Act...