Science.gov

Sample records for risk-based decision tool

  1. Selecting a risk-based tool to aid in decision making

    SciTech Connect

    Bendure, A.O.

    1995-03-01

    Selecting a risk-based tool to aid in decision making is as much of a challenge as properly using the tool once it has been selected. Failure to consider customer and stakeholder requirements and the technical bases and differences in risk-based decision making tools will produce confounding and/or politically unacceptable results when the tool is used. Selecting a risk-based decisionmaking tool must therefore be undertaken with the same, if not greater, rigor than the use of the tool once it is selected. This paper presents a process for selecting a risk-based tool appropriate to a set of prioritization or resource allocation tasks, discusses the results of applying the process to four risk-based decision-making tools, and identifies the ``musts`` for successful selection and implementation of a risk-based tool to aid in decision making.

  2. Interactive Decision-Support Tool for Risk-Based Radiation Therapy Plan Comparison for Hodgkin Lymphoma

    SciTech Connect

    Brodin, N. Patrik; Maraldo, Maja V.; Aznar, Marianne C.; Vogelius, Ivan R.; Petersen, Peter M.; Bentzen, Søren M.; Specht, Lena

    2014-02-01

    Purpose: To present a novel tool that allows quantitative estimation and visualization of the risk of various relevant normal tissue endpoints to aid in treatment plan comparison and clinical decision making in radiation therapy (RT) planning for Hodgkin lymphoma (HL). Methods and Materials: A decision-support tool for risk-based, individualized treatment plan comparison is presented. The tool displays dose–response relationships, derived from published clinical data, for a number of relevant side effects and thereby provides direct visualization of the trade-off between these endpoints. The Quantitative Analyses of Normal Tissue Effects in the Clinic reports were applied, complemented with newer data where available. A “relevance score” was assigned to each data source, reflecting how relevant the input data are to current RT for HL. Results: The tool is applied to visualize the local steepness of dose–response curves to drive the reoptimization of a volumetric modulated arc therapy treatment plan for an HL patient with head-and-neck involvement. We also use this decision-support tool to visualize and quantitatively evaluate the trade-off between a 3-dimensional conformal RT plan and a volumetric modulated arc therapy plan for a patient with mediastinal HL. Conclusion: This multiple-endpoint decision-support tool provides quantitative risk estimates to supplement the clinical judgment of the radiation oncologist when comparing different RT options.

  3. A risk-based decision-aiding tool for waste disposal

    SciTech Connect

    Weiner, R.F.; Reiser, A.S.; Elcock, C.G.; Nevins, S.

    1997-10-01

    N-CART (the National Spent Nuclear Fuel Program Cost Analysis and Risk Tool) is being developed to aid in low-risk, cost-effective, timely management of radioactive waste and spent nuclear fuel, and can therefore be used in management of mixed waste. N-CART provides evaluation of multiple alternatives and presents the consequences of proposed waste management activities in a clear and concise format. N-CART`s decision-aiding analyses include comparisons and sensitivity analyses of multiple alternatives and allows the user to perform quick turn-around {open_quotes}what if{close_quotes} studies to investigate various scenarios. Uncertainties in data (such as cost and schedule of various activities) are represented as distributions. N-CART centralizes documentation of the bases of program alternatives and program decisions, thereby supporting responses to stakeholders concerns. The initial N-CART design considers regulatory requirements, costs, and schedules for alternative courses of action. The final design will include risks (public health, occupational, economic, scheduling), economic benefits, and the impacts of secondary waste generation. An optimization tool is being incorporated that allows the user to specify the relative importance of cost, time risks, and other bases for decisions. The N-CART prototype can be used to compare the costs and schedules of disposal alternatives for mixed low-level radioactive waste (MLLW) and greater-than-Class-C (GTCC) waste, as well as spent nuclear fuel (SNF) and related scrap material.

  4. A risk-based decision tool for the management of organic waste in agriculture and farming activities (FARMERS).

    PubMed

    Río, Miguel; Franco-Uría, Amaya; Abad, Emilio; Roca, Enrique

    2011-01-30

    Currently, specific management guidelines must be implemented for guaranteeing the safe reuse of organic waste in agriculture. With that aim, this work was focused on the development of a decision support tool for a safe and sustainable management of cattle manure as fertiliser in pastureland, to control and limit metal accumulation in soil and to reduce metal biotransfer from soil to other compartments. The system was developed on the basis of an environmental risk assessment multi-compartmental model. In contrast to other management tools, a long-term dynamic modelling approach was selected considering the persistence of metals in the environment. A detailed description of the underlying flow equations which accounts for distribution, human exposure and risk characterisation of metals in the assessed scenario was presented, as well as model parameterization. The tool was implemented in Visual C++ and is structured on a data base, where all required data is stored, the risk assessment model and a GIS module for the visualization of the scenario characteristics and the results obtained (risk indexes). The decision support system allows choosing among three estimation options, depending on the needs of the user, which provide information to both farmers and policy makers. The first option is useful for evaluating the adequacy of the current management practices of the different farms, and the remaining ones provides information on the measures that can be taken to carry out a fertilising plan without exceeding risk to human health. Among other results, maximum values of application rates of manure, maximum permissible metal content of manure and maximum application times in a particular scenario can be estimated by this system. To illustrate tool application, a real case study with data corresponding to different farms of a milk production cooperative was presented.

  5. Using exposure prediction tools to link exposure and dosimetry for risk based decisions: a case study with phthalates

    EPA Science Inventory

    The Population Life-course Exposure to Health Effects Modeling (PLETHEM) platform being developed provides a tool that links results from emerging toxicity testing tools to exposure estimates for humans as defined by the USEPA. A reverse dosimetry case study using phthalates was ...

  6. Using exposure prediction tools to link exposure and dosimetry for risk-based decisions: A case study with phthalates

    EPA Science Inventory

    A few different exposure prediction tools were evaluated for use in the new in vitro-based safety assessment paradigm using di-2-ethylhexyl phthalate (DEHP) and dibutyl phthalate (DnBP) as case compounds. Daily intake of each phthalate was estimated using both high-throughput (HT...

  7. Decision making in flood risk based storm sewer network design.

    PubMed

    Sun, S A; Djordjević, S; Khu, S T

    2011-01-01

    It is widely recognised that flood risk needs to be taken into account when designing a storm sewer network. Flood risk is generally a combination of flood consequences and flood probabilities. This paper aims to explore the decision making in flood risk based storm sewer network design. A multiobjective optimization is proposed to find the Pareto front of optimal designs in terms of low construction cost and low flood risk. The decision making process then follows this multi-objective optimization to select a best design from the Pareto front. The traditional way of designing a storm sewer system based on a predefined design storm is used as one of the decision making criteria. Additionally, three commonly used risk based criteria, i.e., the expected flood risk based criterion, the Hurwicz criterion and the stochastic dominance based criterion, are investigated and applied in this paper. Different decisions are made according to different criteria as a result of different concerns represented by the criteria. The proposed procedure is applied to a simple storm sewer network design to demonstrate its effectiveness and the different criteria are compared.

  8. Risk-based decision making for terrorism applications.

    PubMed

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

    2009-03-01

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

  9. Intelligent ship traffic monitoring for oil spill prevention: risk based decision support building on AIS.

    PubMed

    Eide, Magnus S; Endresen, Oyvind; Brett, Per Olaf; Ervik, Jon Leon; Røang, Kjell

    2007-02-01

    The paper describes a model, which estimates the risk levels of individual crude oil tankers. The intended use of the model, which is ready for trial implementation at The Norwegian Coastal Administrations new Vardø VTS (Vessel Traffic Service) centre, is to facilitate the comparison of ships and to support a risk based decision on which ships to focus attention on. For a VTS operator, tasked with monitoring hundreds of ships, this is a valuable decision support tool. The model answers the question, "Which ships are likely to produce an oil spill accident, and how much is it likely to spill?".

  10. A novel risk-based decision-making paradigm.

    PubMed

    Morgado, Pedro; Marques, Fernanda; Silva, Miguel B; Sousa, Nuno; Cerqueira, João J

    2014-01-01

    This paper presents a novel rodent decision-making task that explores uncertainty, independently of expectation and predictability. Using a 5-hole operating box, adult male Wistar rats were given choices between a small certain (safe) food reward and a large uncertain (risk) food reward. We found that animals strongly preferred the safe option when it had a fixed position or was cued with a light in a random placement scheme, but had no preference for safe or risk options when the latter were associated with light. Importantly, when the reward was manipulated animals could perceive alterations in the outcome value and biased their choice pattern to the most profitable option. In addition, we found that the D2/D3 agonist quinpirole biased all decisions toward risk in this paradigm. Finally, a c-fos analysis revealed that several brain areas known to be involved in decision-making mechanisms, including the medial prefrontal cortex, the orbitofrontal cortex, the nucleus accumbens and the striatum, were activated by the task. In summary, this paradigm is a useful and highly reliable tool to explore decision-making processes in contexts of uncertainty.

  11. A novel risk-based decision-making paradigm

    PubMed Central

    Morgado, Pedro; Marques, Fernanda; Silva, Miguel B.; Sousa, Nuno; Cerqueira, João J.

    2014-01-01

    This paper presents a novel rodent decision-making task that explores uncertainty, independently of expectation and predictability. Using a 5-hole operating box, adult male Wistar rats were given choices between a small certain (safe) food reward and a large uncertain (risk) food reward. We found that animals strongly preferred the safe option when it had a fixed position or was cued with a light in a random placement scheme, but had no preference for safe or risk options when the latter were associated with light. Importantly, when the reward was manipulated animals could perceive alterations in the outcome value and biased their choice pattern to the most profitable option. In addition, we found that the D2/D3 agonist quinpirole biased all decisions toward risk in this paradigm. Finally, a c-fos analysis revealed that several brain areas known to be involved in decision-making mechanisms, including the medial prefrontal cortex, the orbitofrontal cortex, the nucleus accumbens and the striatum, were activated by the task. In summary, this paradigm is a useful and highly reliable tool to explore decision-making processes in contexts of uncertainty. PMID:24596547

  12. Holistic risk-based environmental decision making: a Native perspective.

    PubMed Central

    Arquette, Mary; Cole, Maxine; Cook, Katsi; LaFrance, Brenda; Peters, Margaret; Ransom, James; Sargent, Elvera; Smoke, Vivian; Stairs, Arlene

    2002-01-01

    Native American Nations have become increasingly concerned about the impacts of toxic substances. Although risk assessment and risk management processes have been used by government agencies to help estimate and manage risks associated with exposure to toxicants, these tools have many inadequacies and as a result have not served Native people well. In addition, resources have not always been adequate to address the concerns of Native Nations, and involvement of Native decision makers on a government-to-government basis in discussions regarding risk has only recently become common. Finally, because the definitions of health used by Native people are strikingly different from that of risk assessors, there is also a need to expand current definitions and incorporate traditional knowledge into decision making. Examples are discussed from the First Environment Restoration Initiative, a project that is working to address toxicant issues facing the Mohawk territory of Akwesasne. This project is developing a community-defined model in which health is protected at the same time that traditional cultural practices, which have long been the key to individual and community health, are maintained and restored. PMID:11929736

  13. Managing wildfire events: risk-based decision making among a group of federal fire managers

    Treesearch

    Robyn S. Wilson; Patricia L. Winter; Lynn A. Maguire; Timothy. Ascher

    2011-01-01

    Managing wildfire events to achieve multiple management objectives involves a high degree of decision complexity and uncertainty, increasing the likelihood that decisions will be informed by experience-based heuristics triggered by available cues at the time of the decision. The research reported here tests the prevalence of three risk-based biases among 206...

  14. SADA: Ecological Risk Based Decision Support System for Selective Remediation

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

  15. SADA: Ecological Risk Based Decision Support System for Selective Remediation

    EPA Science Inventory

    Spatial Analysis and Decision Assistance (SADA) is freeware that implements terrestrial ecological risk assessment and yields a selective remediation design using its integral geographical information system, based on ecological and risk assessment inputs. Selective remediation ...

  16. Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

    EPA Science Inventory

    A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

  17. Introduction to Decision Support Systems for Risk Based Management of Contaminated Sites

    EPA Science Inventory

    A book on Decision Support Systems for Risk-based Management of contaminated sites is appealing for two reasons. First, it addresses the problem of contaminated sites, which has worldwide importance. Second, it presents Decision Support Systems (DSSs), which are powerful comput...

  18. Partially observable Markov decision processes for risk-based screening

    NASA Astrophysics Data System (ADS)

    Mrozack, Alex; Liao, Xuejun; Skatter, Sondre; Carin, Lawrence

    2016-05-01

    A long-term goal for checked baggage screening in airports has been to include passenger information, or at least a predetermined passenger risk level, in the screening process. One method for including that information could be treating the checked baggage screening process as a system-of-systems. This would allow for an optimized policy builder, such as one trained using the methodology of partially observable Markov decision processes (POMDP), to navigate the different sensors available for screening. In this paper we describe the necessary steps to tailor a POMDP for baggage screening, as well as results of simulations for specific screening scenarios.

  19. Probabilistic Risk Based Decision Support for Oil and Gas Exploration and Production Facilities in Sensitive Ecosystems

    SciTech Connect

    Greg Thoma; John Veil; Fred Limp; Jackson Cothren; Bruce Gorham; Malcolm Williamson; Peter Smith; Bob Sullivan

    2009-05-31

    This report describes work performed during the initial period of the project 'Probabilistic Risk Based Decision Support for Oil and Gas Exploration and Production Facilities in Sensitive Ecosystems.' The specific region that is within the scope of this study is the Fayetteville Shale Play. This is an unconventional, tight formation, natural gas play that currently has approximately 1.5 million acres under lease, primarily to Southwestern Energy Incorporated and Chesapeake Energy Incorporated. The currently active play encompasses a region from approximately Fort Smith, AR east to Little Rock, AR approximately 50 miles wide (from North to South). The initial estimates for this field put it almost on par with the Barnett Shale play in Texas. It is anticipated that thousands of wells will be drilled during the next several years; this will entail installation of massive support infrastructure of roads and pipelines, as well as drilling fluid disposal pits and infrastructure to handle millions of gallons of fracturing fluids. This project focuses on gas production in Arkansas as the test bed for application of proactive risk management decision support system for natural gas exploration and production. The activities covered in this report include meetings with representative stakeholders, development of initial content and design for an educational web site, and development and preliminary testing of an interactive mapping utility designed to provide users with information that will allow avoidance of sensitive areas during the development of the Fayetteville Shale Play. These tools have been presented to both regulatory and industrial stakeholder groups, and their feedback has been incorporated into the project.

  20. EVALUATING ENVIRONMENTAL DECISION SUPPORT TOOLS.

    SciTech Connect

    SULLIVAN, T.

    2004-10-01

    Effective contaminated land management requires a number of decisions addressing a suite of technical, economic, and social concerns. These concerns include human health risks, ecological risks, economic costs, technical feasibility of proposed remedial actions, and the value society places on clean-up and re-use of formerly contaminated lands. Decision making, in the face of uncertainty and multiple and often conflicting objectives, is a vital and challenging role in environmental management that affects a significant economic activity. Although each environmental remediation problem is unique and requires a site-specific analysis, many of the key decisions are similar in structure. This has led many to attempt to develop standard approaches. As part of the standardization process, attempts have been made to codify specialist expertise into decision support tools. This activity is intended to facilitate reproducible and transparent decision making. The process of codifying procedures has also been found to be a useful activity for establishing and rationalizing management processes. This study will have two primary objectives. The first is to develop taxonomy for Decision Support Tools (DST) to provide a framework for understanding the different tools and what they are designed to address in the context of environmental remediation problems. The taxonomy will have a series of subject areas for the DST. From these subjects, a few key areas will be selected for further study and software in these areas will be identified. The second objective, will be to review the existing DST in the selected areas and develop a screening matrix for each software product.

  1. 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

  2. Risk-based systems analysis for emerging technologies: Applications of a technology risk assessment model to public decision making

    SciTech Connect

    Quadrel, M.J.; Fowler, K.M.; Cameron, R.; Treat, R.J.; McCormack, W.D.; Cruse, J.

    1995-04-01

    The risk-based systems analysis model was designed to establish funding priorities among competing technologies for tank waste remediation. The model addresses a gap in the Department of Energy`s (DOE`s) ``toolkit`` for establishing funding priorities among emerging technologies by providing disciplined risk and cost assessments of candidate technologies within the context of a complete remediation system. The model is comprised of a risk and cost assessment and a decision interface. The former assesses the potential reductions in risk and cost offered by new technology relative to the baseline risk and cost of an entire system. The latter places this critical information in context of other values articulated by decision makers and stakeholders in the DOE system. The risk assessment portion of the model is demonstrated for two candidate technologies for tank waste retrieval (arm-based mechanical retrieval -- the ``long reach arm``) and subsurface barriers (close-coupled chemical barriers). Relative changes from the base case in cost and risk are presented for these two technologies to illustrate how the model works. The model and associated software build on previous work performed for DOE`s Office of Technology Development and the former Underground Storage Tank Integrated Demonstration, and complement a decision making tool presented at Waste Management 1994 for integrating technical judgements and non-technical (stakeholder) values when making technology funding decisions.

  3. Risk-based decision-making framework for the selection of sediment dredging option.

    PubMed

    Manap, Norpadzlihatun; Voulvoulis, Nikolaos

    2014-10-15

    The aim of this study was to develop a risk-based decision-making framework for the selection of sediment dredging option. Descriptions using case studies of the newly integrated, holistic and staged framework were followed. The first stage utilized the historical dredging monitoring data and the contamination level in media data into Ecological Risk Assessment phases, which have been altered for benefits in cost, time and simplicity. How Multi-Criteria Decision Analysis (MCDA) can be used to analyze and prioritize dredging areas based on environmental, socio-economic and managerial criteria was described for the next stage. The results from MCDA will be integrated into Ecological Risk Assessment to characterize the degree of contamination in the prioritized areas. The last stage was later described using these findings and analyzed using MCDA, in order to identify the best sediment dredging option, accounting for the economic, environmental and technical aspects of dredging, which is beneficial for dredging and sediment management industries.

  4. Rational risk-based decision support for drinking water well managers by optimized monitoring designs

    NASA Astrophysics Data System (ADS)

    Enzenhöfer, R.; Geiges, A.; Nowak, W.

    2011-12-01

    Advection-based well-head protection zones are commonly used to manage the contamination risk of drinking water wells. Considering the insufficient knowledge about hazards and transport properties within the catchment, current Water Safety Plans recommend that catchment managers and stakeholders know, control and monitor all possible hazards within the catchments and perform rational risk-based decisions. Our goal is to supply catchment managers with the required probabilistic risk information, and to generate tools that allow for optimal and rational allocation of resources between improved monitoring versus extended safety margins and risk mitigation measures. To support risk managers with the indispensable information, we address the epistemic uncertainty of advective-dispersive solute transport and well vulnerability (Enzenhoefer et al., 2011) within a stochastic simulation framework. Our framework can separate between uncertainty of contaminant location and actual dilution of peak concentrations by resolving heterogeneity with high-resolution Monte-Carlo simulation. To keep computational costs low, we solve the reverse temporal moment transport equation. Only in post-processing, we recover the time-dependent solute breakthrough curves and the deduced well vulnerability criteria from temporal moments by non-linear optimization. Our first step towards optimal risk management is optimal positioning of sampling locations and optimal choice of data types to reduce best the epistemic prediction uncertainty for well-head delineation, using the cross-bred Likelihood Uncertainty Estimator (CLUE, Leube et al., 2011) for optimal sampling design. Better monitoring leads to more reliable and realistic protection zones and thus helps catchment managers to better justify smaller, yet conservative safety margins. In order to allow an optimal choice in sampling strategies, we compare the trade-off in monitoring versus the delineation costs by accounting for ill

  5. Fire behavior modeling-a decision tool

    Treesearch

    Jack Cohen; Bill Bradshaw

    1986-01-01

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

  6. Risk-based analysis and decision making in multi-disciplinary environments

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

    A risk-based decision-making process conceived of and developed at JPL and NASA, has been used to help plan and guide novel technology applications for use on spacecraft. These applications exemplify key challenges inherent in multi-disciplinary design of novel technologies deployed in mission-critical settings. 1) Cross-disciplinary concerns are numerous (e.g., spacecraft involve navigation, propulsion, telecommunications). These concems are cross-coupled and interact in multiple ways (e.g., electromagnetic interference, heat transfer). 2) Time and budget pressures constrain development, operational resources constrain the resulting system (e.g., mass, volume, power). 3) Spacecraft are critical systems that must operate correctly the first time in only partially understood environments, with no chance for repair. 4) Past experience provides only a partial guide: New mission concepts are enhanced and enabled by new technologies, for which past experience is lacking. The decision-making process rests on quantitative assessments of the relationships between three classes of information - objectives (the things the system is to accomplish and constraints on its operation and development), risks (whose occurrence detracts from objectives), and mitigations (options for reducing the likelihood and or severity of risks). The process successfully guides experts to pool their knowledge, using custom-built software to support information gathering and decision-making.

  7. Health economics and outcomes methods in risk-based decision-making for blood safety.

    PubMed

    Custer, Brian; Janssen, Mart P

    2015-08-01

    Analytical methods appropriate for health economic assessments of transfusion safety interventions have not previously been described in ways that facilitate their use. Within the context of risk-based decision-making (RBDM), health economics can be important for optimizing decisions among competing interventions. The objective of this review is to address key considerations and limitations of current methods as they apply to blood safety. Because a voluntary blood supply is an example of a public good, analyses should be conducted from the societal perspective when possible. Two primary study designs are recommended for most blood safety intervention assessments: budget impact analysis (BIA), which measures the cost to implement an intervention both to the blood operator but also in a broader context, and cost-utility analysis (CUA), which measures the ratio between costs and health gain achieved, in terms of reduced morbidity and mortality, by use of an intervention. These analyses often have important limitations because data that reflect specific aspects, for example, blood recipient population characteristics or complication rates, are not available. Sensitivity analyses play an important role. The impact of various uncertain factors can be studied conjointly in probabilistic sensitivity analyses. The use of BIA and CUA together provides a comprehensive assessment of the costs and benefits from implementing (or not) specific interventions. RBDM is multifaceted and impacts a broad spectrum of stakeholders. Gathering and analyzing health economic evidence as part of the RBDM process enhances the quality, completeness, and transparency of decision-making.

  8. Risk-based analysis and decision making in multi-disciplinary environments

    NASA Technical Reports Server (NTRS)

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

    2003-01-01

    A risk-based decision-making process conceived of and developed at JPL and NASA, has been used to help plan and guide novel technology applications for use on spacecraft. These applications exemplify key challenges inherent in multi-disciplinary design of novel technologies deployed in mission-critical settings. 1) Cross-disciplinary concerns are numerous (e.g., spacecraft involve navigation, propulsion, telecommunications). These concems are cross-coupled and interact in multiple ways (e.g., electromagnetic interference, heat transfer). 2) Time and budget pressures constrain development, operational resources constrain the resulting system (e.g., mass, volume, power). 3) Spacecraft are critical systems that must operate correctly the first time in only partially understood environments, with no chance for repair. 4) Past experience provides only a partial guide: New mission concepts are enhanced and enabled by new technologies, for which past experience is lacking. The decision-making process rests on quantitative assessments of the relationships between three classes of information - objectives (the things the system is to accomplish and constraints on its operation and development), risks (whose occurrence detracts from objectives), and mitigations (options for reducing the likelihood and or severity of risks). The process successfully guides experts to pool their knowledge, using custom-built software to support information gathering and decision-making.

  9. Receptor-Specific Modulation of Risk-Based Decision Making by Nucleus Accumbens Dopamine

    PubMed Central

    Stopper, Colin M; Khayambashi, Shahin; Floresco, Stan B

    2013-01-01

    The nucleus accumbens (NAc) serves as an integral node within cortico-limbic circuitry that regulates various forms of cost–benefit decision making. The dopamine (DA) system has also been implicated in enabling organisms to overcome a variety of costs to obtain more valuable rewards. However, it remains unclear how DA activity within the NAc may regulate decision making involving reward uncertainty. This study investigated the contribution of different DA receptor subtypes in the NAc to risk-based decision making, assessed with a probabilistic discounting task. In well-trained rats, D1 receptor blockade with SCH 23 390 decreased preference for larger, uncertain rewards, which was associated with enhanced negative-feedback sensitivity (ie, an increased tendency to select a smaller/certain option after an unrewarded risky choice). Treatment with a D1 agonist (SKF 81 297) optimized decision making, increasing choice of the risky option when reward probability was high, and decreasing preference under low probability conditions. In stark contrast, neither blockade of NAc D2 receptors with eticlopride, nor stimulation of these receptors with quinpirole or bromocriptine influenced risky choice. In comparison, infusion of the D3-preferring agonist PD 128 907 decreased reward sensitivity and risky choice. Collectively, these results show that mesoaccumbens DA refines risk–reward decision biases via dissociable mechanisms recruiting D1 and D3, but not D2 receptors. D1 receptor activity mitigates the effect of reward omissions on subsequent choices to promote selection of reward options that may have greater long-term utility, whereas excessive D3 receptor activity blunts the impact that larger/uncertain rewards have in promoting riskier choices. PMID:23303055

  10. Managing wildfire events: risk-based decision making among a group of federal fire managers.

    PubMed

    Wilson, Robyn S; Winter, Patricia L; Maguire, Lynn A; Ascher, Timothy

    2011-05-01

    Managing wildfire events to achieve multiple management objectives involves a high degree of decision complexity and uncertainty, increasing the likelihood that decisions will be informed by experience-based heuristics triggered by available cues at the time of the decision. The research reported here tests the prevalence of three risk-based biases among 206 individuals in the USDA Forest Service with authority to choose how to manage a wildfire event (i.e., line officers and incident command personnel). The results indicate that the subjects exhibited loss aversion, choosing the safe option more often when the consequences of the choice were framed as potential gains, but this tendency was less pronounced among those with risk seeking attitudes. The subjects also exhibited discounting, choosing to minimize short-term over long-term risk due to a belief that future risk could be controlled, but this tendency was less pronounced among those with more experience. Finally, the subjects, in particular those with more experience, demonstrated a status quo bias, choosing suppression more often when their reported status quo was suppression. The results of this study point to a need to carefully construct the decision process to ensure that the uncertainty and conflicting objectives inherent in wildfire management do not result in the overuse of common heuristics. Individual attitudes toward risk or an agency culture of risk aversion may counterbalance such heuristics, whereas increased experience may lead to overconfident intuitive judgments and a failure to incorporate new and relevant information into the decision. © 2010 Society for Risk Analysis.

  11. 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.

  12. Analysis of Model Uncertainties to Support Risk-Based Decisions Regarding Groundwater Contamination

    NASA Astrophysics Data System (ADS)

    Birdsell, K. H.; Vesselinov, V. V.; Davis, P.; Hollis, D.; Newman, B. D.; Echohawk, J. C.

    2005-12-01

    Model simulations are widely used in environmental management decision processes. However, there are various sources of uncertainty that commonly impact the model results. Consequently, it is crucial to account for all the possible model uncertainties that impact the model results so that they are adequately considered in the management decision process. Here we discuss an uncertainty analysis of model simulations related to a contamination site located within Los Alamos National Laboratory, NM. We describe how uncertainties are quantified and propagated through a series of coupled groundwater models and then used in a risk-based decision analysis to identify and rank alternative actions to protect the environment and water users from potential impacts of groundwater contamination from former liquid-effluent discharges. Uncertainties in the contaminant source, infiltration distribution, and transport through the unsaturated and saturated zones are analyzed using a series of alternative conceptual models and stochastic model parameters. Alternative conceptual models and uncertain model parameters are defined to encompass a large range of possible uncertainties associated with potential groundwater flow and transport based on existing data and expert knowledge about the system. In all, eight alternative conceptual models using 38 uncertain parameters were analyzed. For each conceptual model and related stochastic parameter realization, we simulate contaminant transport from the contaminant outfall to water-supply wells over the next 1000 years. Based on the simulated contaminant concentrations in the groundwater pumped by water-supply wells, we evaluate health risk for the receptors. Based on the model results, sensitivity analysis is applied to identify the parameters and conceptual model elements causing high concentrations at the water-supply wells. Decision analysis is applied to define the optimal course(s) of action, which may include clean-up, stabilization

  13. Risk-Based Decision Process for Accelerated Closure of a Nuclear Weapons Facility

    SciTech Connect

    Butler, L.; Norland, R. L.; DiSalvo, R.; Anderson, M.

    2003-02-25

    Nearly 40 years of nuclear weapons production at the Rocky Flats Environmental Technology Site (RFETS or Site) resulted in contamination of soil and underground systems and structures with hazardous substances, including plutonium, uranium and hazardous waste constituents. The Site was placed on the National Priority List in 1989. There are more than 370 Individual Hazardous Substance Sites (IHSSs) at RFETS. Accelerated cleanup and closure of RFETS is being achieved through implementation and refinement of a regulatory framework that fosters programmatic and technical innovations: (1) extensive use of ''accelerated actions'' to remediate IHSSs, (2) development of a risk-based screening process that triggers and helps define the scope of accelerated actions consistent with the final remedial action objectives for the Site, (3) use of field instrumentation for real time data collection, (4) a data management system that renders near real time field data assessment, and (5) a regulatory agency consultative process to facilitate timely decisions. This paper presents the process and interim results for these aspects of the accelerated closure program applied to Environmental Restoration activities at the Site.

  14. "People Can Go against the Government": Risk-Based Decision Making and High School Students' Concepts of Society

    ERIC Educational Resources Information Center

    Radakovic, Nenad

    2015-01-01

    Research in mathematics education stresses the importance of content knowledge in solving authentic tasks in statistics and in risk-based decision making. Existing research supports the claim that students rely on content knowledge and context expertise to make sense of data. In this article, however, I present evidence that the relationship…

  15. "People Can Go against the Government": Risk-Based Decision Making and High School Students' Concepts of Society

    ERIC Educational Resources Information Center

    Radakovic, Nenad

    2015-01-01

    Research in mathematics education stresses the importance of content knowledge in solving authentic tasks in statistics and in risk-based decision making. Existing research supports the claim that students rely on content knowledge and context expertise to make sense of data. In this article, however, I present evidence that the relationship…

  16. A Multiple Objective Decision Support Tool (MODS)

    SciTech Connect

    2003-12-14

    The Multiple Objective Decision Support (MODS) tool is an automated tool used to assist decision makers and policy analysts with multiple-objective decision problems. The classes of problems that this decision support tool addresses have both multiple objectives and multiple stakeholders. Decision problems, which have multiple objectives that in general cannot be maximized simultaneously, and multiple stakeholders, who have different perspectives about the relative importance of the objectives, require analytic approaches and tools that can provide flexible support to decision makers. This tool provides capabilities for the management, analysis, and graphical display for these types of decision problems drawn from diverse problem domains. The MODS tool is a unique integration of analysis algorithms, an information database, and a graphical user interface. This collection of algorithms, the combination of an information database with the analysis into a single tool, and the graphical user interface provides a technically advanced tool to decision makers and policy analysts. There are two main issues when addressing problems of this type: what set of attributes should be used to characterize the tokens in the domain of interest, and how should the values of these attributes and their weights be determined and combined to provide a relative ordering to the tokens. This tool addresses both of these issues. This decision support tool provides a flexible way to derive and use a chosen set of attributes. For example, the tool could be used to first perform a paired comparison of a large set of attributes and from this evaluation select those attributes that have the highest weights. The flexibility of the tool allows experimentation with various attribute sets and this capability, along with domain expertise, addresses the first issue. To address the second issue, several algorithms have been implemented. For example, two algorithms that have been implemented are the

  17. GET SMARTE: DECISION TOOLS TO REVITALIZE BROWNFIELDS

    EPA Science Inventory

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

  18. GET SMARTE: DECISION TOOLS TO REVITALIZE BROWNFIELDS

    EPA Science Inventory

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

  19. Risk-based decision-making: A reality at the INEL

    SciTech Connect

    Halford, V.E.; Nitschke, R.L.; Hula, G.A.

    1994-12-31

    Risk Analysis and Risk Management are major components of the Idaho National Engineering Laboratory`s (INEL`s) environmental restoration and waste management program. These tools help define responsible and cost-effective approaches to address potential human health and environmental risks from past operational practices. These techniques along with stake holder involvement, play a key role in the decision-making process which involves the US Department of Energy Idaho Operations Office (DOE), the US Environmental Protection Agency Region 10 (EPA), and the State of Idaho Department of Health and Welfare (IDHW), hereafter referred to as the agencies. An example of how this process works is Pad A, an above-ground mixed waste disposal site composed mainly of transuranic-contaminated evaporation pond salts. The site was constructed in 1972 for the disposal of solid radioactive wastes. A Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) baseline risk assessment was conducted to determine the incremental cancer risk and potential for adverse health effects to the public and the impacts to the environment if no action was performed. The risk characterization indicated that the carcinogenic risk for current and future hypothetical scenarios was below or within the NCP acceptable risk range. There was a potential 10 year window for an adverse health effect to an infant from nitrate contamination of the groundwater in about 250 years. Based on these results, a responsible and sound decision was reached to maintain and recontour the existing soil cover and to perform monitoring to confirm modeling assumptions.

  20. A risk-based decision support framework for selection of appropriate safety measure system for underground coal mines.

    PubMed

    Samantra, Chitrasen; Datta, Saurav; Mahapatra, Siba Sankar

    2017-03-01

    In the context of underground coal mining industry, the increased economic issues regarding implementation of additional safety measure systems, along with growing public awareness to ensure high level of workers safety, have put great pressure on the managers towards finding the best solution to ensure safe as well as economically viable alternative selection. Risk-based decision support system plays an important role in finding such solutions amongst candidate alternatives with respect to multiple decision criteria. Therefore, in this paper, a unified risk-based decision-making methodology has been proposed for selecting an appropriate safety measure system in relation to an underground coal mining industry with respect to multiple risk criteria such as financial risk, operating risk, and maintenance risk. The proposed methodology uses interval-valued fuzzy set theory for modelling vagueness and subjectivity in the estimates of fuzzy risk ratings for making appropriate decision. The methodology is based on the aggregative fuzzy risk analysis and multi-criteria decision making. The selection decisions are made within the context of understanding the total integrated risk that is likely to incur while adapting the particular safety system alternative. Effectiveness of the proposed methodology has been validated through a real-time case study. The result in the context of final priority ranking is seemed fairly consistent.

  1. Application of risk-based multiple criteria decision analysis for selection of the best agricultural scenario for effective watershed management.

    PubMed

    Javidi Sabbaghian, Reza; Zarghami, Mahdi; Nejadhashemi, A Pouyan; Sharifi, Mohammad Bagher; Herman, Matthew R; Daneshvar, Fariborz

    2016-03-01

    Effective watershed management requires the evaluation of agricultural best management practice (BMP) scenarios which carefully consider the relevant environmental, economic, and social criteria involved. In the Multiple Criteria Decision-Making (MCDM) process, scenarios are first evaluated and then ranked to determine the most desirable outcome for the particular watershed. The main challenge of this process is the accurate identification of the best solution for the watershed in question, despite the various risk attitudes presented by the associated decision-makers (DMs). This paper introduces a novel approach for implementation of the MCDM process based on a comparative neutral risk/risk-based decision analysis, which results in the selection of the most desirable scenario for use in the entire watershed. At the sub-basin level, each scenario includes multiple BMPs with scores that have been calculated using the criteria derived from two cases of neutral risk and risk-based decision-making. The simple additive weighting (SAW) operator is applied for use in neutral risk decision-making, while the ordered weighted averaging (OWA) and induced OWA (IOWA) operators are effective for risk-based decision-making. At the watershed level, the BMP scores of the sub-basins are aggregated to calculate each scenarios' combined goodness measurements; the most desirable scenario for the entire watershed is then selected based on the combined goodness measurements. Our final results illustrate the type of operator and risk attitudes needed to satisfy the relevant criteria within the number of sub-basins, and how they ultimately affect the final ranking of the given scenarios. The methodology proposed here has been successfully applied to the Honeyoey Creek-Pine Creek watershed in Michigan, USA to evaluate various BMP scenarios and determine the best solution for both the stakeholders and the overall stream health. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Decision generation tools and Bayesian inference

    NASA Astrophysics Data System (ADS)

    Jannson, Tomasz; Wang, Wenjian; Forrester, Thomas; Kostrzewski, Andrew; Veeris, Christian; Nielsen, Thomas

    2014-05-01

    Digital Decision Generation (DDG) tools are important software sub-systems of Command and Control (C2) systems and technologies. In this paper, we present a special type of DDGs based on Bayesian Inference, related to adverse (hostile) networks, including such important applications as terrorism-related networks and organized crime ones.

  3. A decision support tool for antibiotic therapy.

    PubMed Central

    Evans, R. S.; Classen, D. C.; Pestotnik, S. L.; Clemmer, T. P.; Weaver, L. K.; Burke, J. P.

    1995-01-01

    We developed a decision support tool to assist physicians anticipating the need for antibiotic therapy. The initial screen alerts physicians of pertinent patient information, provides direct access to other essential medical information, and stimulates clinical judgment by suggesting an antibiotic regimen. The decision support tool also suggests the dose and interval for any ordered antibiotics selected by the physicians. During a 7-month pilot study, all antibiotics for patients admitted to the Shock/Trauma/Respiratory Intensive Care Unit (STRICU) were ordered using the decision support tool. Clinical data from the study period and a 12-month control period (the previous year) were collected and compared. The decision support tool was used to order antibiotics 588 times during the study period and the suggested antibiotics were used 218 (37%) times. The computer suggested dosages were used over 90% of the time. The mean cost of antibiotics was $87.00 (p < 0.04) less per patient during the study period as compared to the control period. Prospective assessment revealed only 3 antibiotic adverse drug events (ADEs) (0.9%) among 336 study patients as compared to 15 ADEs (2.4%) among 626 control patients (p = 0.164). PMID:8563367

  4. User Centered Clinical Decision Support Tools

    PubMed Central

    Sofianou, A.; Kannry, J.; Mann, D.M.; McGinn, T.G.

    2014-01-01

    Summary Background Dissemination and adoption of clinical decision support (CDS) tools is a major initiative of the Affordable Care Act’s Meaningful Use program. Adoption of CDS tools is multipronged with personal, organizational, and clinical settings factoring into the successful utilization rates. Specifically, the diffusion of innovation theory implies that ‘early adopters’ are more inclined to use CDS tools and younger physicians tend to be ranked in this category. Objective This study examined the differences in adoption of CDS tools across providers’ training level. Participants From November 2010 to 2011, 168 residents and attendings from an academic medical institution were enrolled into a randomized controlled trial. Intervention The intervention arm had access to the CDS tool through the electronic health record (EHR) system during strep and pneumonia patient visits. Main Measures The EHR system recorded details on how intervention arm interacted with the CDS tool including acceptance of the initial CDS alert, completion of risk-score calculators and the signing of medication order sets. Using the EHR data, the study performed bivariate tests and general estimating equation (GEE) modeling to examine the differences in adoption of the CDS tool across residents and attendings. Key Results The completion rates of the CDS calculator and medication order sets were higher amongst first year residents compared to all other training levels. Attendings were the less likely to accept the initial step of the CDS tool (29.3%) or complete the medication order sets (22.4%) that guided their prescription decisions, resulting in attendings ordering more antibiotics (37.1%) during an CDS encounter compared to residents. Conclusion There is variation in adoption of CDS tools across training levels. Attendings tended to accept the tool less but ordered more medications. CDS tools should be tailored to clinicians’ training levels. PMID:25589914

  5. Altered Risk-Based Decision Making following Adolescent Alcohol Use Results from an Imbalance in Reinforcement Learning in Rats

    PubMed Central

    Hart, Andrew S.; Collins, Anne L.; Bernstein, Ilene L.; Phillips, Paul E. M.

    2012-01-01

    Alcohol use during adolescence has profound and enduring consequences on decision-making under risk. However, the fundamental psychological processes underlying these changes are unknown. Here, we show that alcohol use produces over-fast learning for better-than-expected, but not worse-than-expected, outcomes without altering subjective reward valuation. We constructed a simple reinforcement learning model to simulate altered decision making using behavioral parameters extracted from rats with a history of adolescent alcohol use. Remarkably, the learning imbalance alone was sufficient to simulate the divergence in choice behavior observed between these groups of animals. These findings identify a selective alteration in reinforcement learning following adolescent alcohol use that can account for a robust change in risk-based decision making persisting into later life. PMID:22615989

  6. Decision Analysis Tools for Volcano Observatories

    NASA Astrophysics Data System (ADS)

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

    2005-12-01

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

  7. An evaluation of the role of risk-based decision-making in a former manufactured gas plant site remediation.

    PubMed

    Vyas, Vikram M; Gochfeld, Michael G; Georgopoulos, Panos G; Lioy, Paul J; Sussman, Nancy R

    2006-02-01

    Environmental remediation decisions are driven by the need to minimize human health and ecological risks posed by environmental releases. The Risk Assessment Guidance for Superfund Sites enunciates the principles of exposure and risk assessment that are to be used for reaching remediation decisions for sites under Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). Experience with remediation management under CERCLA has led to recognition of some crucial infirmities in the processes for managing remediation: cleanup management policies are ad hoc in character, mandates and practices are strongly conservative, and contaminant risk management occurs in an artificially narrow context. The purpose of this case study is to show how a policy of risk-based decision-making was used to avoid customary pitfalls in site remediation. This case study describes the risk-based decision-making process in a remedial action program at a former manufactured gas plant site that successfully achieved timely and effective cleanup. The remediation process operated outside the confines of the CERCLA process under an administrative consent order between the utility and the New Jersey Department of Environmental Protection. A residential use end state was negotiated as part of this agreement. The attendant uncertainties, complications, and unexpected contingencies were overcome by using the likely exposures associated with the desired end state to structure all of the remediation management decisions and by collecting site-specific information from the very outset to obtain a detailed and realistic characterization of human health risks that needed to be mitigated. The lessons from this case study are generalizable to more complicated remediation cases, when supported by correspondingly sophisticated technical approaches.

  8. Gila San Francisco Decision Support Tool - 2010

    SciTech Connect

    Sun, Amy Cha-Tien; Tidwell, Vincent C.; Klisa, Geoff; Poplionski, Will

    2014-12-01

    The Gila-San Francisco Decision Support Tool analyzes the water demand and supply for the Gila San Francisco region spanning four counties in southwestern New Mexico (Catron, Hidalgo, Luna and Grant). Catalyzed by the 2004 Arizona Water Settlement Act and prompted by a keen awareness for the unique ecology in the region, the model was developed by Sandia with a collaborative modeling team from federal, state, local, and public stakeholders

  9. Willingness-to-pay for a probabilistic flood forecast: a risk-based decision-making game

    NASA Astrophysics Data System (ADS)

    Arnal, Louise; Ramos, Maria-Helena; Coughlan de Perez, Erin; Cloke, Hannah Louise; Stephens, Elisabeth; Wetterhall, Fredrik; van Andel, Schalk Jan; Pappenberger, Florian

    2016-08-01

    Probabilistic hydro-meteorological forecasts have over the last decades been used more frequently to communicate forecast uncertainty. This uncertainty is twofold, as it constitutes both an added value and a challenge for the forecaster and the user of the forecasts. Many authors have demonstrated the added (economic) value of probabilistic over deterministic forecasts across the water sector (e.g. flood protection, hydroelectric power management and navigation). However, the richness of the information is also a source of challenges for operational uses, due partially to the difficulty in transforming the probability of occurrence of an event into a binary decision. This paper presents the results of a risk-based decision-making game on the topic of flood protection mitigation, called "How much are you prepared to pay for a forecast?". The game was played at several workshops in 2015, which were attended by operational forecasters and academics working in the field of hydro-meteorology. The aim of this game was to better understand the role of probabilistic forecasts in decision-making processes and their perceived value by decision-makers. Based on the participants' willingness-to-pay for a forecast, the results of the game show that the value (or the usefulness) of a forecast depends on several factors, including the way users perceive the quality of their forecasts and link it to the perception of their own performances as decision-makers.

  10. CO2-PENS: A CO2 Sequestration Systems Model Supporting Risk-Based Decisions

    NASA Astrophysics Data System (ADS)

    Stauffer, P. H.; Viswanathan, H. S.; Guthrie, G. D.; Pawar, R. J.; Kaszuba, J. P.; Carey, J. W.; Lichtner, P. C.; Ziock, H. J.; Dubey, M. K.; Olsen, S. C.; Chipera, S. J.; Fessenden-Rahn, J. E.

    2005-12-01

    The Zero Emissions Research and Technology (ZERT) project at the Los Alamos National Laboratory is studying the injection of CO2 into geologic repositories. We are formulating the problem as science based decision framework that can address issues of risk, cost, and technical requirements at all stages of the sequestration process. The framework is implemented in a system model that is capable of performing stochastic simulations to address uncertainty in different geologic sequestration scenarios, including injection into poorly characterized brine aquifers. Processes level laboratory experiments, field experiments, modeling, economic data, and risk theory are used to support the system level model that will be the basis for decision making. The current system model, CO2-PENS, is already proving to be useful in showing complex interactions between the different components of the framework. The system model also provides a consistent platform to document decisions made during the site selection, implementation, and closure periods.

  11. Decision-Support Tool for Prevention and Control of Rift Valley Fever Epizootics in the Greater Horn of Africa

    PubMed Central

    2010-01-01

    Abstract: In East Africa, Rift Valley fever (RVF) usually occurs as explosive epizootics with prolonged inter-epidemic periods on the order of 8 to 10 years. The episodic nature of the disease and the rapid evolution of outbreaks create special challenges for its mitigation and control. Following the events of the 2006 and 2007 RVF outbreak in East Africa, decision-makers assembled their collective experiences in the form of a risk-based decision support tool to help guide responses in future emergencies. The premise of the tool is that a series of natural events are indicative of the increasing risk of an outbreak and that actions should be matched to this evolving risk profile. In this manner, investment in prevention and control can be qualitatively optimized. The decision support tool is a living document written through stakeholder input. This publication captures the current tool as an example of risk-based decision support. PMID:20682910

  12. Willingness-to-pay for a probabilistic flood forecast: a risk-based decision-making game

    NASA Astrophysics Data System (ADS)

    Arnal, Louise; Ramos, Maria-Helena; Coughlan, Erin; Cloke, Hannah L.; Stephens, Elisabeth; Wetterhall, Fredrik; van Andel, Schalk-Jan; Pappenberger, Florian

    2016-04-01

    Forecast uncertainty is a twofold issue, as it constitutes both an added value and a challenge for the forecaster and the user of the forecasts. Many authors have demonstrated the added (economic) value of probabilistic forecasts over deterministic forecasts for a diversity of activities in the water sector (e.g. flood protection, hydroelectric power management and navigation). However, the richness of the information is also a source of challenges for operational uses, due partially to the difficulty to transform the probability of occurrence of an event into a binary decision. The setup and the results of a risk-based decision-making experiment, designed as a game on the topic of flood protection mitigation, called ``How much are you prepared to pay for a forecast?'', will be presented. The game was played at several workshops in 2015, including during this session at the EGU conference in 2015, and a total of 129 worksheets were collected and analysed. The aim of this experiment was to contribute to the understanding of the role of probabilistic forecasts in decision-making processes and their perceived value by decision-makers. Based on the participants' willingness-to-pay for a forecast, the results of the game showed that the value (or the usefulness) of a forecast depends on several factors, including the way users perceive the quality of their forecasts and link it to the perception of their own performances as decision-makers. Balancing avoided costs and the cost (or the benefit) of having forecasts available for making decisions is not straightforward, even in a simplified game situation, and is a topic that deserves more attention from the hydrological forecasting community in the future.

  13. Risk-based decision analysis of atmospheric emission alternatives to reduce ground water degradation on the European scale

    SciTech Connect

    Wladis, D.; Rosen, L.; Kros, H.

    1999-12-01

    Environmental degradation due to emissions of sulfur dioxide, nitrate oxides, and ammonia from diffuse sources amounts to substantial costs to society and so do the alternatives to protect and restore the environment. Damage to ground water includes acidification, aluminum leaching, elevated concentrations of nitrate, and eutrophication. Monetary risk-based decision analysis (on a national scale) is applied to compare alternative actions designed to protect ground water from further degradation. This decision analysis uses simulations of nitrate and aluminum concentrations over a 15 year period with two reduction scenarios for sulfur dioxide, nitrate oxides, and ammonia, and results in estimates of economic uncertainty. For each alternative, an objective function is estimated including the implementation costs, the economic risk associated with failure according to the selected decision criteria, and the economic benefits related to the implementation. The decision criteria are based on the European Community drinking water quality standards for nitrate and aluminum. The study aims at incorporating the hydrogeologic uncertainty resulting from the propagation of errors from data input to model out put. A range of economic values has been applied to the ground water resource to study the sensitivity of the decision analysis to valuing ground water. The results indicate that higher reduction rates of the studied pollutants reduce the economic uncertainty but also lead to larger total costs. The study also indicates that the economic uncertainty may be equal to the total cost provided by the objective function. The contamination level of nitrate is much more responsive to the reduction scenarios than the aluminum concentration. For high, but not unrealistic, ground water valuing, the economic uncertainty makes the decision between the studied alternatives unclear.

  14. The Study: A Tool for Decision?

    DTIC Science & Technology

    2014-09-26

    ABSTRACT AUTHOR(S): John H. Van Zant, Jr., COL, AR TITLE: THE SID : A Tool For Decision? F~HAT: Individual Study Project DATE: 22 April 1985 PAGES...the CSA and HQ,USMC. Thus, while the questions were answered, the larger effort turned out to be almost anti- climatic . WHAT DID IT PROVIDE? The ACVT... change in the threat, the Army leadership became impatient for an answer. As a result, a side study was conducted between January and October 1980 which

  15. A Conceptual Framework for Decision-making Support in Uncertainty- and Risk-based Diagnosis of Rare Clinical Cases by Specialist Physicians.

    PubMed

    Santos, Adriano A; Moura, J Antão B; de Araújo, Joseana Macêdo Fechine Régis

    2015-01-01

    Mitigating uncertainty and risks faced by specialist physicians in analysis of rare clinical cases is something desired by anyone who needs health services. The number of clinical cases never seen by these experts, with little documentation, may introduce errors in decision-making. Such errors negatively affect well-being of patients, increase procedure costs, rework, health insurance premiums, and impair the reputation of specialists and medical systems involved. In this context, IT and Clinical Decision Support Systems (CDSS) play a fundamental role, supporting decision-making process, making it more efficient and effective, reducing a number of avoidable medical errors and enhancing quality of treatment given to patients. An investigation has been initiated to look into characteristics and solution requirements of this problem, model it, propose a general solution in terms of a conceptual risk-based, automated framework to support rare-case medical diagnostics and validate it by means of case studies. A preliminary validation study of the proposed framework has been carried out by interviews conducted with experts who are practicing professionals, academics, and researchers in health care. This paper summarizes the investigation and its positive results. These results motivate continuation of research towards development of the conceptual framework and of a software tool that implements the proposed model.

  16. Incident Waste Decision Support Tool - Waste Materials ...

    EPA Pesticide Factsheets

    Report This is the technical documentation to the waste materials estimator module of I-WASTE. This document outlines the methodology and data used to develop the Waste Materials Estimator (WME) contained in the Incident Waste Decision Support Tool (I-WASTE DST). Specifically, this document reflects version 6.4 of the I-WASTE DST. The WME is one of four primary features of the I-WASTE DST. The WME is both a standalone calculator that generates waste estimates in terms of broad waste categories, and is also integrated into the Incident Planning and Response section of the tool where default inventories of specific waste items are provided in addition to the estimates for the broader waste categories. The WME can generate waste estimates for both common materials found in open spaces (soil, vegetation, concrete, and asphalt) and for a vast array of items and materials found in common structures.

  17. Risk-based economic decision analysis of remediation options at a PCE-contaminated site.

    PubMed

    Lemming, Gitte; Friis-Hansen, Peter; Bjerg, Poul L

    2010-05-01

    Remediation methods for contaminated sites cover a wide range of technical solutions with different remedial efficiencies and costs. Additionally, they may vary in their secondary impacts on the environment i.e. the potential impacts generated due to emissions and resource use caused by the remediation activities. More attention is increasingly being given to these secondary environmental impacts when evaluating remediation options. This paper presents a methodology for an integrated economic decision analysis which combines assessments of remediation costs, health risk costs and potential environmental costs. The health risks costs are associated with the residual contamination left at the site and its migration to groundwater used for drinking water. A probabilistic exposure model using first- and second-order reliability methods (FORM/SORM) is used to estimate the contaminant concentrations at a downstream groundwater well. Potential environmental impacts on the local, regional and global scales due to the site remediation activities are evaluated using life cycle assessments (LCA). The potential impacts on health and environment are converted to monetary units using a simplified cost model. A case study based upon the developed methodology is presented in which the following remediation scenarios are analyzed and compared: (a) no action, (b) excavation and off-site treatment of soil, (c) soil vapor extraction and (d) thermally enhanced soil vapor extraction by electrical heating of the soil. Ultimately, the developed methodology facilitates societal cost estimations of remediation scenarios which can be used for internal ranking of the analyzed options. Despite the inherent uncertainties of placing a value on health and environmental impacts, the presented methodology is believed to be valuable in supporting decisions on remedial interventions.

  18. Neural Substrates Underlying Effort, Time, and Risk-Based Decision Making in Motivated Behavior

    PubMed Central

    Bailey, Matthew R.; Simpson, Eleanor H.; Balsam, Peter D

    2016-01-01

    All mobile organisms rely on adaptive motivated behavior to overcome the challenges of living in an environment in which essential resources may be limited. A variety of influences ranging from an organism’s environment, experiential history, and physiological state all influence a cost-benefit analysis which allows motivation to energize behavior and direct it toward specific goals. Here we review the substantial amount of research aimed at discovering the interconnected neural circuits which allow organisms to carry-out the cost-benefit computations which allow them to behave in adaptive ways. We specifically focus on how the brain deals with different types of costs, including effort requirements, delays to reward and payoff riskiness. An examination of this broad literature highlights the importance of the extended neural circuits which enable organisms to make decisions about these different types of costs. This involves Cortical Structures, including the Anterior Cingulate Cortex (ACC), the Orbital Frontal Cortex (OFC), the Infralimbic Cortex (IL), and prelimbic Cortex (PL), as well as the Baso-Lateral Amygdala (BLA), the Nucleus Accumbens (Nacc), the Ventral Pallidal (VP), the Sub Thalamic Nucleus (STN) among others. Some regions are involved in multiple aspects of cost-benefit computations while the involvement of other regions is restricted to information relating to specific types of costs. PMID:27427327

  19. ISHM Decision Analysis Tool: Operations Concept

    NASA Technical Reports Server (NTRS)

    2006-01-01

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

  20. Graphic Representations as Tools for Decision Making.

    ERIC Educational Resources Information Center

    Howard, Judith

    2001-01-01

    Focuses on the use of graphic representations to enable students to improve their decision making skills in the social studies. Explores three visual aids used in assisting students with decision making: (1) the force field; (2) the decision tree; and (3) the decision making grid. (CMK)

  1. Influence diagrams as oil spill decision science tools

    EPA Science Inventory

    Making inferences on risks to ecosystem services (ES) from ecological crises can be more reliably handled using decision science tools. Influence diagrams (IDs) are probabilistic networks that explicitly represent the decisions related to a problem and evidence of their influence...

  2. Influence diagrams as oil spill decision science tools

    EPA Science Inventory

    Making inferences on risks to ecosystem services (ES) from ecological crises can be more reliably handled using decision science tools. Influence diagrams (IDs) are probabilistic networks that explicitly represent the decisions related to a problem and evidence of their influence...

  3. Updated Decision Support Tool for the Management of Waste ...

    EPA Pesticide Factsheets

    Symposium Paper EPA's Office of Research and Development has developed a suite of web-based decision support tools that will assist in the decision making process for the disposal of debris resulting from incidents of national significance.

  4. Tools to Promote Shared Decision Making in Serious Illness

    PubMed Central

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

    2016-01-01

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

  5. Visual Decision Support Tool for Supporting Asset ...

    EPA Pesticide Factsheets

    Abstract:Managing urban water infrastructures faces the challenge of jointly dealing with assets of diverse types, useful life, cost, ages and condition. Service quality and sustainability require sound long-term planning, well aligned with tactical and operational planning and management. In summary, the objective of an integrated approach to infrastructure asset management is to assist utilities answer the following questions:•Who are we at present?•What service do we deliver?•What do we own?•Where do we want to be in the long-term?•How do we get there?The AWARE-P approach (www.aware-p.org) offers a coherent methodological framework and a valuable portfolio of software tools. It is designed to assist water supply and wastewater utility decision-makers in their analyses and planning processes. It is based on a Plan-Do-Check-Act process and is in accordance with the key principles of the International Standards Organization (ISO) 55000 standards on asset management. It is compatible with, and complementary to WERF’s SIMPLE framework. The software assists in strategic, tactical, and operational planning, through a non-intrusive, web-based, collaborative environment where objectives and metrics drive IAM planning. It is aimed at industry professionals and managers, as well as at the consultants and technical experts that support them. It is easy to use and maximizes the value of information from multiple existing data sources, both in da

  6. Decision blocks: A tool for automating decision making in CLIPS

    NASA Technical Reports Server (NTRS)

    Eick, Christoph F.; Mehta, Nikhil N.

    1991-01-01

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

  7. A GIS tool to estimate West Nile virus risk based on a degree-day model.

    PubMed

    Zou, Li; Miller, Scott N; Schmidtmann, Edward T

    2007-06-01

    West Nile virus (Flaviviridae: Flavivirus) is a serious infectious disease that recently spread across the North America continent. A spatial analysis tool was developed on the ArcMap 9.x platform to estimate potential West Nile virus activity using a spatially explicit degree-day model. The model identifies when the virus Extrinsic Incubation Period (EIP) is completed within the vector longevity during mid-summer months. The EIP is treated as a threshold indicator of the potential for virus emergence and activity. Comparing the number of West Nile virus cases in Wyoming reported from 2003 to 2005 with model results, actual cases and predicted events of West Nile virus activity match relatively well. The model represents a useful method for estimating potential West Nile virus activity in a large spatial scale.

  8. A risk-based predictive tool to prevent accidental introductions of nonindigenous marine species.

    PubMed

    Floerl, Oliver; Inglis, Graeme J; Hayden, Barbara J

    2005-06-01

    Preventing the introduction of nonindigenous species (NIS) is the most efficient way to avoid the costs and impacts of biological invasions. The transport of fouling species on ship hulls is an important vector for the introduction of marine NIS. We use quantitative risk screening techniques to develop a predictive tool of the abundance and variety of organisms being transported by ocean-going yachts. We developed and calibrated an ordinal rank scale of the abundance of fouling assemblages on the hulls of international yacht hulls arriving in New Zealand. Fouling ranks were allocated to 783 international yachts that arrived in New Zealand between 2002 and 2004. Classification tree analysis was used to identify relationships between the fouling ranks and predictor variables that described the maintenance and travel history of the yachts. The fouling ranks provided reliable indications of the actual abundance and variety of fouling assemblages on the yachts and identified most (60%) yachts that had fouling on their hulls. However, classification tree models explained comparatively little of the variation in the distribution of fouling ranks (22.1%), had high misclassification rates (approximately 43%), and low predictive power. In agreement with other studies, the best model selected the age of the toxic antifouling paint on yacht hulls as the principal risk factor for hull fouling. Our study shows that the transport probability of fouling organisms is the result of a complex suite of interacting factors and that large sample sizes will be needed for calibration of robust risk models.

  9. Decision Matrices: Tools to Enhance Middle School Engineering Instruction

    ERIC Educational Resources Information Center

    Gonczi, Amanda L.; Bergman, Brenda G.; Huntoon, Jackie; Allen, Robin; McIntyre, Barb; Turner, Sheri; Davis, Jen; Handler, Rob

    2017-01-01

    Decision matrices are valuable engineering tools. They allow engineers to objectively examine solution options. Decision matrices can be incorporated in K-12 classrooms to support authentic engineering instruction. In this article we provide examples of how decision matrices have been incorporated into 6th and 7th grade classrooms as part of an…

  10. Decision Matrices: Tools to Enhance Middle School Engineering Instruction

    ERIC Educational Resources Information Center

    Gonczi, Amanda L.; Bergman, Brenda G.; Huntoon, Jackie; Allen, Robin; McIntyre, Barb; Turner, Sheri; Davis, Jen; Handler, Rob

    2017-01-01

    Decision matrices are valuable engineering tools. They allow engineers to objectively examine solution options. Decision matrices can be incorporated in K-12 classrooms to support authentic engineering instruction. In this article we provide examples of how decision matrices have been incorporated into 6th and 7th grade classrooms as part of an…

  11. Development of Asset Management Decision Support Tools for Power Equipment

    NASA Astrophysics Data System (ADS)

    Okamoto, Tatsuki; Takahashi, Tsuguhiro

    Development of asset management decision support tools become very intensive in order to reduce maintenance cost of power equipment due to the liberalization of power business. This article reviews some aspects of present status of asset management decision support tools development for power equipment based on the papers published in international conferences, domestic conventions, and several journals.

  12. Virtual Beach: Decision Support Tools for Beach Pathogen Prediction

    EPA Science Inventory

    The Virtual Beach Managers Tool (VB) is decision-making software developed to help local beach managers make decisions as to when beaches should be closed due to predicted high levels of water borne pathogens. The tool is being developed under the umbrella of EPA's Advanced Monit...

  13. Virtual Beach: Decision Support Tools for Beach Pathogen Prediction

    EPA Science Inventory

    The Virtual Beach Managers Tool (VB) is decision-making software developed to help local beach managers make decisions as to when beaches should be closed due to predicted high levels of water borne pathogens. The tool is being developed under the umbrella of EPA's Advanced Monit...

  14. 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...

  15. 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...

  16. [Economic studies and decision analysis as tools for decision making].

    PubMed

    Rodríguez-Pimentel, Leticia; Silva-Romo, Rodolfo; Wacher-Rodarte, Niels

    2007-01-01

    Management implies decision-making and economics deals with efficiency which means to obtain the best possible results with the available resources, and to compare such results with those that were foreseen. The economic evaluation comprises a set of techniques aimed at comparing resource allocation on alternate courses of action and its consequences. In health care, these results are the overall well-being of the society. This paper summarizes the techniques that are customarily used in economic evaluation, and intends to serve as an introductory text to increasing the ability of the readers to grasp original articles in the field of health economics.

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

    PubMed

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

    2014-07-18

    Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the 'actionable message(s)' from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing and sustaining evidence

  18. Evaluation as a Decision-Making Tool.

    ERIC Educational Resources Information Center

    Guba, Egon G.

    This speech examines three traditional definitions of evaluation, presents a new definition, and describes how this new concept of evaluation functions. The new definition calls educational evaluation "the process of delineating, obtaining, and providing useful information for judging decision alternatives." Practical applications of this new…

  19. Ultrasound technology: A decision-making tool

    USDA-ARS?s Scientific Manuscript database

    An ultrasound demonstration was conducted for participants (~ 110 people) of the Arkansas Cattle Grower’s Conference, Hope, AR. Evaluation of live animals with ultrasound technology allows beef producers the ability to make selection and management decisions. Specifically, ultrasound at the conclu...

  20. A risk-based focused decision-management approach for justifying characterization of Hanford tank waste. June 1996, Revision 1; April 1997, Revision 2

    SciTech Connect

    Colson, S.D.; Gephart, R.E.; Hunter, V.L.; Janata, J.; Morgan, L.G.

    1997-12-31

    This report describes a disciplined, risk-based decision-making approach for determining characterization needs and resolving safety issues during the storage and remediation of radioactive waste stored in Hanford tanks. The strategy recommended uses interactive problem evaluation and decision analysis methods commonly used in industry to solve problems under conditions of uncertainty (i.e., lack of perfect knowledge). It acknowledges that problem resolution comes through both the application of high-quality science and human decisions based upon preferences and sometimes hard-to-compare choices. It recognizes that to firmly resolve a safety problem, the controlling waste characteristics and chemical phenomena must be measurable or estimated to an acceptable level of confidence tailored to the decision being made.

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

    PubMed Central

    2014-01-01

    Background Public health professionals are increasingly expected to engage in evidence-informed decision making to inform practice and policy decisions. Evidence-informed decision making involves the use of research evidence along with expertise, existing public health resources, knowledge about community health issues, the local context and community, and the political climate. The National Collaborating Centre for Methods and Tools has identified a seven step process for evidence-informed decision making. Tools have been developed to support public health professionals as they work through each of these steps. This paper provides an overview of tools used in three Canadian public health departments involved in a study to develop capacity for evidence-informed decision making. Methods As part of a knowledge translation and exchange intervention, a Knowledge Broker worked with public health professionals to identify and apply tools for use with each of the steps of evidence-informed decision making. The Knowledge Broker maintained a reflective journal and interviews were conducted with a purposive sample of decision makers and public health professionals. This paper presents qualitative analysis of the perceived usefulness and usability of the tools. Results Tools were used in the health departments to assist in: question identification and clarification; searching for the best available research evidence; assessing the research evidence for quality through critical appraisal; deciphering the ‘actionable message(s)’ from the research evidence; tailoring messages to the local context to ensure their relevance and suitability; deciding whether and planning how to implement research evidence in the local context; and evaluating the effectiveness of implementation efforts. Decision makers provided descriptions of how the tools were used within the health departments and made suggestions for improvement. Overall, the tools were perceived as valuable for advancing

  2. TBell: A mathematical tool for analyzing decision tables

    NASA Technical Reports Server (NTRS)

    Hoover, D. N.; Chen, Zewei

    1994-01-01

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

  3. Integrated decision support tools for Puget Sound salmon recovery planning

    EPA Science Inventory

    We developed a set of tools to provide decision support for community-based salmon recovery planning in Salish Sea watersheds. Here we describe how these tools are being integrated and applied in collaboration with Puget Sound tribes and community stakeholders to address restora...

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

    EPA Science Inventory

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

  5. Integrated decision support tools for Puget Sound salmon recovery planning

    EPA Science Inventory

    We developed a set of tools to provide decision support for community-based salmon recovery planning in Salish Sea watersheds. Here we describe how these tools are being integrated and applied in collaboration with Puget Sound tribes and community stakeholders to address restora...

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

    EPA Science Inventory

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

  7. Integrating decision tools for the sustainable management of land contamination.

    PubMed

    Pollard, S J T; Brookes, A; Earl, N; Lowe, J; Kearney, T; Nathanail, C P

    2004-06-05

    The approach to taking decisions on the management of land contamination has changed markedly over 30 years. Change has been rapid with policy makers and regulators, practitioners and researchers having to keep pace with new technologies, assessment criteria and diagnostic methods for their measurement, techniques for risk analysis and the frameworks that support decision-makers in their efforts to regenerate historically contaminated land. Having progressed from simple hazard assessment through to 'sustainability appraisal' we might now consider piecing together the experience of decision-making for managing land contamination. Here, we critically review recent developments with a view to considering how better decisions can be made by integrating the decision tools available. We are concerned with the practicality of approach and the issues that arise for practitioners as decision criteria are broadened.

  8. Assessing the predictive performance of risk-based water quality criteria using decision error estimates from receiver operating characteristics (ROC) analysis.

    PubMed

    McLaughlin, Douglas B

    2012-10-01

    Field data relating aquatic ecosystem responses with water quality constituents that are potential ecosystem stressors are being used increasingly in the United States in the derivation of water quality criteria to protect aquatic life. In light of this trend, there is a need for transparent quantitative methods to assess the performance of models that predict ecological conditions using a stressor-response relationship, a response variable threshold, and a stressor variable criterion. Analysis of receiver operating characteristics (ROC analysis) has a considerable history of successful use in medical diagnostic, industrial, and other fields for similarly structured decision problems, but its use for informing water quality management decisions involving risk-based environmental criteria is less common. In this article, ROC analysis is used to evaluate predictions of ecological response variable status for 3 water quality stressor-response data sets. Information on error rates is emphasized due in part to their common use in environmental studies to describe uncertainty. One data set is comprised of simulated data, and 2 involve field measurements described previously in the literature. These data sets are also analyzed using linear regression and conditional probability analysis for comparison. Results indicate that of the methods studied, ROC analysis provides the most comprehensive characterization of prediction error rates including false positive, false negative, positive predictive, and negative predictive errors. This information may be used along with other data analysis procedures to set quality objectives for and assess the predictive performance of risk-based criteria to support water quality management decisions.

  9. ClinicalAccess: a clinical decision support tool.

    PubMed

    Crowell, Karen; Vardell, Emily

    2015-01-01

    ClinicalAccess is a new clinical decision support tool that uses a question-and-answer format to mirror clinical decision-making strategies. The unique format of ClinicalAccess delivers concise, authoritative answers to more than 120,000 clinical questions. This column presents a review of the product, a sample search, and a comparison with other point-of-care search engines.

  10. A Decision Support Model and Tool to Assist Financial Decision-Making in Universities

    ERIC Educational Resources Information Center

    Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive

    2015-01-01

    In this paper, a model and tool is proposed to assist universities and other mission-based organisations to ascertain systematically the optimal portfolio of projects, in any year, meeting the organisations risk tolerances and available funds. The model and tool presented build on previous work on university operations and decision support systems…

  11. A Decision Support Model and Tool to Assist Financial Decision-Making in Universities

    ERIC Educational Resources Information Center

    Bhayat, Imtiaz; Manuguerra, Maurizio; Baldock, Clive

    2015-01-01

    In this paper, a model and tool is proposed to assist universities and other mission-based organisations to ascertain systematically the optimal portfolio of projects, in any year, meeting the organisations risk tolerances and available funds. The model and tool presented build on previous work on university operations and decision support systems…

  12. Promoting Shared Decision Making in Disorders of Sex Development (DSD): Decision Aids and Support Tools.

    PubMed

    Siminoff, L A; Sandberg, D E

    2015-05-01

    Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach.

  13. Impact of a decision-support tool on decision making at the district level in Kenya

    PubMed Central

    2013-01-01

    Background In many countries, the responsibility for planning and delivery of health services is devolved to the subnational level. Health programs, however, often fall short of efficient use of data to inform decisions. As a result, programs are not as effective as they can be at meeting the health needs of the populations they serve. In Kenya, a decision-support tool, the District Health Profile (DHP) tool was developed to integrate data from health programs, primarily HIV, at the district level and to enable district health management teams to review and monitor program progress for specific health issues to make informed service delivery decisions. Methods Thirteen in-depth interviews were conducted with ten tool users and three non-users in six districts to qualitatively assess the process of implementing the tool and its effect on data-informed decision making at the district level. The factors that affected use or non-use of the tool were also investigated. Respondents were selected via convenience sample from among those that had been trained to use the DHP tool except for one user who was self-taught to use the tool. Selection criteria also included respondents from urban districts with significant resources as well as respondents from more remote, under-resourced districts. Results Findings from the in-depth interviews suggest that among those who used it, the DHP tool had a positive effect on data analysis, review, interpretation, and sharing at the district level. The automated function of the tool allowed for faster data sharing and immediate observation of trends that facilitated data-informed decision making. All respondents stated that the DHP tool assisted them to better target existing services in need of improvement and to plan future services, thus positively influencing program improvement. Conclusions This paper stresses the central role that a targeted decision-support tool can play in making data aggregation, analysis, and presentation

  14. Investigating the Heart Pump Implant Decision Process: Opportunities for Decision Support Tools to Help.

    PubMed

    Yang, Qian; Zimmerman, John; Steinfeld, Aaron; Carey, Lisa; Antaki, James F

    2016-05-01

    Clinical decision support tools (DSTs) are computational systems that aid healthcare decision-making. While effective in labs, almost all these systems failed when they moved into clinical practice. Healthcare researchers speculated it is most likely due to a lack of user-centered HCI considerations in the design of these systems. This paper describes a field study investigating how clinicians make a heart pump implant decision with a focus on how to best integrate an intelligent DST into their work process. Our findings reveal a lack of perceived need for and trust of machine intelligence, as well as many barriers to computer use at the point of clinical decision-making. These findings suggest an alternative perspective to the traditional use models, in which clinicians engage with DSTs at the point of making a decision. We identify situations across patients' healthcare trajectories when decision supports would help, and we discuss new forms it might take in these situations.

  15. Investigating the Heart Pump Implant Decision Process: Opportunities for Decision Support Tools to Help

    PubMed Central

    Yang, Qian; Zimmerman, John; Steinfeld, Aaron; Carey, Lisa; Antaki, James F.

    2016-01-01

    Clinical decision support tools (DSTs) are computational systems that aid healthcare decision-making. While effective in labs, almost all these systems failed when they moved into clinical practice. Healthcare researchers speculated it is most likely due to a lack of user-centered HCI considerations in the design of these systems. This paper describes a field study investigating how clinicians make a heart pump implant decision with a focus on how to best integrate an intelligent DST into their work process. Our findings reveal a lack of perceived need for and trust of machine intelligence, as well as many barriers to computer use at the point of clinical decision-making. These findings suggest an alternative perspective to the traditional use models, in which clinicians engage with DSTs at the point of making a decision. We identify situations across patients’ healthcare trajectories when decision supports would help, and we discuss new forms it might take in these situations. PMID:27833397

  16. Developing a Decision Support System: The Software and Hardware Tools.

    ERIC Educational Resources Information Center

    Clark, Phillip M.

    1989-01-01

    Describes some of the available software and hardware tools that can be used to develop a decision support system implemented on microcomputers. Activities that should be supported by software are discussed, including data entry, data coding, finding and combining data, and data compatibility. Hardware considerations include speed, storage…

  17. A Web-Based Decision Support Tool for Academic Advising

    ERIC Educational Resources Information Center

    Feghali, Tony; Zbib, Imad; Hallal, Sophia

    2011-01-01

    Student advising is an important and time-consuming effort in academic life. This paper attempts to solve a technology-based "last mile" problem by developing and evaluating a web-based decision support tool (the Online Advisor) that helps advisors and students make better use of an already present university student information system. Two…

  18. Renting cropland: choosing the best option using a decision tool

    USDA-ARS?s Scientific Manuscript database

    Agricultural producers are faced with a variety of cropland rental options, such as cash rent, share rent, and flexible cash rent. While there are decision tools available for use by producers to compare rental options, most are for specific crops, such as corn, soybeans, and wheat. The Cropland Ren...

  19. A Decision Support Tool for Determining Army Enlistment Initiatives

    DTIC Science & Technology

    2001-09-01

    the Personnel Command (PERSCOM) meet to form the Enlisted Incentive Review Board ( EIRB ). The task of the EIRB is to determine the enlistment...it evaluate the effects of new incentives. The EIRB requires a quantitative decision support tool that will assist the members in doing the following

  20. A network model of basal ganglia for understanding the roles of dopamine and serotonin in reward-punishment-risk based decision making.

    PubMed

    Balasubramani, Pragathi P; Chakravarthy, V Srinivasa; Ravindran, Balaraman; Moustafa, Ahmed A

    2015-01-01

    There is significant evidence that in addition to reward-punishment based decision making, the Basal Ganglia (BG) contributes to risk-based decision making (Balasubramani et al., 2014). Despite this evidence, little is known about the computational principles and neural correlates of risk computation in this subcortical system. We have previously proposed a reinforcement learning (RL)-based model of the BG that simulates the interactions between dopamine (DA) and serotonin (5HT) in a diverse set of experimental studies including reward, punishment and risk based decision making (Balasubramani et al., 2014). Starting with the classical idea that the activity of mesencephalic DA represents reward prediction error, the model posits that serotoninergic activity in the striatum controls risk-prediction error. Our prior model of the BG was an abstract model that did not incorporate anatomical and cellular-level data. In this work, we expand the earlier model into a detailed network model of the BG and demonstrate the joint contributions of DA-5HT in risk and reward-punishment sensitivity. At the core of the proposed network model is the following insight regarding cellular correlates of value and risk computation. Just as DA D1 receptor (D1R) expressing medium spiny neurons (MSNs) of the striatum were thought to be the neural substrates for value computation, we propose that DA D1R and D2R co-expressing MSNs are capable of computing risk. Though the existence of MSNs that co-express D1R and D2R are reported by various experimental studies, prior existing computational models did not include them. Ours is the first model that accounts for the computational possibilities of these co-expressing D1R-D2R MSNs, and describes how DA and 5HT mediate activity in these classes of neurons (D1R-, D2R-, D1R-D2R- MSNs). Starting from the assumption that 5HT modulates all MSNs, our study predicts significant modulatory effects of 5HT on D2R and co-expressing D1R-D2R MSNs which in turn

  1. Water flow algorithm decision support tool for travelling salesman problem

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

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

  2. Fatigue models as practical tools: diagnostic accuracy and decision thresholds.

    PubMed

    Raslear, Thomas G; Coplen, Michael

    2004-03-01

    Human fatigue models are increasingly being used in a variety of industrial settings, both civilian and military. Current uses include education, awareness, and analysis of individual or group work schedules. Perhaps the ultimate and potentially most beneficial use of human fatigue models is to diagnose if an individual is sufficiently rested to perform a period of duty safely or effectively. When used in this way, two important questions should be asked: 1) What is the accuracy of the diagnosis for duty-specific performance in this application; and 2) What decision threshold is appropriate for this application (i.e., how "fatigued" does an individual have to be to be considered "not safe"). In the simplest situation, a diagnostic fatigue test must distinguish between two states: "fatigued" and "not fatigued," and the diagnostic decisions are "safe" (or "effective") and "not safe" (or "not effective"). The resulting four decision outcomes include diagnostic errors because diagnostic tests are not perfectly accurate. Moreover, since all outcomes have costs and benefits associated with them that differ between applications, the choice of a decision criterion is extremely important. Signal Detection Theory (SDT) has demonstrated usefulness in measuring the accuracy of diagnostic tests and optimizing diagnostic decisions. This paper describes how SDT can be applied to foster the development of fatigue models as practical diagnostic and decision-making tools. By clarifying the difference between accuracy (or sensitivity) and decision criterion (or bias) in the use of fatigue models as diagnostic and decision-making tools, the SDT framework focuses on such critical issues as duty-specific performance, variability (model and performance), and model sensitivity, efficacy, and utility. As fatigue models become increasingly used in a variety of different applications, it is important that end-users understand the interplay of these factors for their particular application.

  3. Guidance Tools for Use in Nuclear Material Management Decisions Making

    SciTech Connect

    Johnson, G. V.; Baker, D. J.; Sorenson, K. B.; Boeke, S. G.

    2002-02-26

    This paper describes the results of Recommendation 14 of the Integrated Nuclear Materials Management Plan (INMMP) which was the product of a management initiative at the highest levels of the Department of Energy responding to a congressional directive to accelerate the work of achieving integration and cutting long-term costs associated with the management of nuclear materials, with the principal focus on excess materials. The INMMP provided direction to ''Develop policy-level decision support tools to support long-term planning and decision making.'' To accomplish this goal a team from the Savannah River Site, Sandia National Laboratories, Idaho National Engineering and Environmental Laboratory (INEEL), and the U.S. Department of Energy experienced in the decision-making process developed a Guidebook to Decision-Making Methods. The goal of the team organized to implement Recommendation 14 was to instill transparency, consistency, rigor, and discipline in the DOE decision process. The guidebook introduces a process and a selection of proven methods for disciplined decision-making so that the results are clearer, more transparent, and easier for reviewers to understand and accept. It was written to set a standard for a consistent decision process.

  4. OPENING COMMENTS TO THE SPECIAL SESSION ON DECISION SUPPORT TOOLS.

    SciTech Connect

    SULLIVAN,T.; BARDOS,P.

    2000-06-01

    The emphasis of the session was on the use of decision support tools for actual remediation decisions. It considered two perspectives: site-specific decision making for example choosing a particular remediation system; and remediation in terms of a risk management/risk reduction process as part of a wider process of site management. These were addressed both as general topics and as case studies. Case studies were included to provide information on decision support techniques for specific contamination problems such as remedy selection. In the case studies, the authors present the general process to provide decision support and then discuss the application to a specific problem. The intent of this approach is to provide the interested reader with enough knowledge to determine if the process could be used on their specific set of problems. The general topics included broader issues that are not directly tied to a specific problem. The general topics included papers on the role of stakeholders in the decision process and decision support approaches for sustainable development.

  5. Online Produced Water Treatment Catalog and Decision Tool

    SciTech Connect

    J. Arthur

    2012-03-31

    The objective of this project was to create an internet-based Water Treatment Technology Catalog and Decision Tool that will increase production, decrease costs and enhance environmental protection. This is to be accomplished by pairing an operator's water treatment cost and capacity needs to specific water treatments. This project cataloged existing and emerging produced water treatment technologies and allows operators to identify the most cost-effective approaches for managing their produced water. The tool captures the cost and capabilities of each technology and the disposal and beneficial use options for each region. The tool then takes location, chemical composition, and volumetric data for the operator's water and identifies the most cost effective treatment options for that water. Regulatory requirements or limitations for each location are also addressed. The Produced Water Treatment Catalog and Decision Tool efficiently matches industry decision makers in unconventional natural gas basins with: 1) appropriate and applicable water treatment technologies for their project, 2) relevant information on regulatory and legal issues that may impact the success of their project, and 3) potential beneficial use demands specific to their project area. To ensure the success of this project, it was segmented into seven tasks conducted in three phases over a three year period. The tasks were overseen by a Project Advisory Council (PAC) made up of stakeholders including state and federal agency representatives and industry representatives. ALL Consulting has made the catalog and decision tool available on the Internet for the final year of the project. The second quarter of the second budget period, work was halted based on the February 18, 2011 budget availability; however previous project deliverables were submitted on time and the deliverables for Task 6 and 7 were completed ahead of schedule. Thus the application and catalog were deployed to the public Internet

  6. Decision support tool for diagnosing the source of variation

    NASA Astrophysics Data System (ADS)

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

    2017-08-01

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

  7. Markov Decision Processes: A Tool for Sequential Decision Making under Uncertainty

    PubMed Central

    Alagoz, Oguzhan; Hsu, Heather; Schaefer, Andrew J.; Roberts, Mark S.

    2011-01-01

    We provide a tutorial on the construction and evaluation of Markov decision processes (MDPs), which are powerful analytical tools used for sequential decision making under uncertainty that have been widely used in many industrial and manufacturing applications but are underutilized in medical decision making (MDM). We demonstrate the use of an MDP to solve a sequential clinical treatment problem under uncertainty. Markov decision processes generalize standard Markov models in that a decision process is embedded in the model and multiple decisions are made over time. Furthermore, they have significant advantages over standard decision analysis. We compare MDPs to standard Markov-based simulation models by solving the problem of the optimal timing of living-donor liver transplantation using both methods. Both models result in the same optimal transplantation policy and the same total life expectancies for the same patient and living donor. The computation time for solving the MDP model is significantly smaller than that for solving the Markov model. We briefly describe the growing literature of MDPs applied to medical decisions. PMID:20044582

  8. Markov decision processes: a tool for sequential decision making under uncertainty.

    PubMed

    Alagoz, Oguzhan; Hsu, Heather; Schaefer, Andrew J; Roberts, Mark S

    2010-01-01

    We provide a tutorial on the construction and evaluation of Markov decision processes (MDPs), which are powerful analytical tools used for sequential decision making under uncertainty that have been widely used in many industrial and manufacturing applications but are underutilized in medical decision making (MDM). We demonstrate the use of an MDP to solve a sequential clinical treatment problem under uncertainty. Markov decision processes generalize standard Markov models in that a decision process is embedded in the model and multiple decisions are made over time. Furthermore, they have significant advantages over standard decision analysis. We compare MDPs to standard Markov-based simulation models by solving the problem of the optimal timing of living-donor liver transplantation using both methods. Both models result in the same optimal transplantation policy and the same total life expectancies for the same patient and living donor. The computation time for solving the MDP model is significantly smaller than that for solving the Markov model. We briefly describe the growing literature of MDPs applied to medical decisions.

  9. Building a Decision Support Tool for Adaptation to Extreme Heat

    NASA Astrophysics Data System (ADS)

    Steinberg, N.

    2016-12-01

    Human vulnerability to extreme heat can be a difficult measure to assess and effectively "operationalize" for key decision-makers. Existing heat alerts are sensitive to scale and context, often leaving public officials with insufficient forecast data, lack of coherent guidance, and an absence of tools that can accurately represent local heat-health risks. While local forecast data and extreme weather outlooks continue to improve, stakeholders are asking for decision support about interoperability and appropriate interventions to reduce heat-health risks for vulnerable populations. This presentation will discuss the information needs determined by public health officials in California with funding from California's Fourth Climate Change Assessment. Findings from a user needs assessment will be followed by a discussion of methods for communicating heat vulnerability and developing user-centric tools that can help public health professionals and planners prepare their communities for extreme heat.

  10. Cognitive Judgment Bias Interacts with Risk Based Decision Making and Sensitivity to Dopaminergic Challenge in Male Rats

    PubMed Central

    Drozd, Robert; Cieslak, Przemyslaw E.; Rychlik, Michal; Rodriguez Parkitna, Jan; Rygula, Rafal

    2016-01-01

    Although the cognitive theory has implicated judgment bias in various psychopathologies, its role in decision making under risk remains relatively unexplored. In the present study, we assessed the effects of cognitive judgment bias on risky choices in rats. First, we trained and tested the animals on the rat version of the probability-discounting (PD) task. During discrete trials, the rats chose between two levers; a press on the “small/certain” lever always resulted in the delivery of one reward pellet, whereas a press on the “large/risky” lever resulted in the delivery of four pellets. However, the probability of receiving a reward from the “large/risky” lever gradually decreased over the four trial blocks. Subsequently, the rats were re-trained and evaluated on a series of ambiguous-cue interpretation (ACI) tests, which permitted their classification according to the display of “optimistic” or “pessimistic” traits. Because dopamine (DA) has been implicated in both: risky choices and optimism, in the last experiment, we compared the reactivity of the dopaminergic system in the “optimistic” and “pessimistic” animals using the apomorphine (APO; 2 mg/kg s.c.) sensitivity test. We demonstrated that as risk increased, the proportion of risky lever choices decreased significantly slower in “optimists” compared with “pessimists” and that these differences between the two groups of rats were associated with different levels of dopaminergic system reactivity. Our findings suggest that cognitive judgment bias, risky decision-making and DA are linked, and they provide a foundation for further investigation of the behavioral traits and cognitive processes that influence risky choices in animal models. PMID:27601984

  11. Cognitive Judgment Bias Interacts with Risk Based Decision Making and Sensitivity to Dopaminergic Challenge in Male Rats.

    PubMed

    Drozd, Robert; Cieslak, Przemyslaw E; Rychlik, Michal; Rodriguez Parkitna, Jan; Rygula, Rafal

    2016-01-01

    Although the cognitive theory has implicated judgment bias in various psychopathologies, its role in decision making under risk remains relatively unexplored. In the present study, we assessed the effects of cognitive judgment bias on risky choices in rats. First, we trained and tested the animals on the rat version of the probability-discounting (PD) task. During discrete trials, the rats chose between two levers; a press on the "small/certain" lever always resulted in the delivery of one reward pellet, whereas a press on the "large/risky" lever resulted in the delivery of four pellets. However, the probability of receiving a reward from the "large/risky" lever gradually decreased over the four trial blocks. Subsequently, the rats were re-trained and evaluated on a series of ambiguous-cue interpretation (ACI) tests, which permitted their classification according to the display of "optimistic" or "pessimistic" traits. Because dopamine (DA) has been implicated in both: risky choices and optimism, in the last experiment, we compared the reactivity of the dopaminergic system in the "optimistic" and "pessimistic" animals using the apomorphine (APO; 2 mg/kg s.c.) sensitivity test. We demonstrated that as risk increased, the proportion of risky lever choices decreased significantly slower in "optimists" compared with "pessimists" and that these differences between the two groups of rats were associated with different levels of dopaminergic system reactivity. Our findings suggest that cognitive judgment bias, risky decision-making and DA are linked, and they provide a foundation for further investigation of the behavioral traits and cognitive processes that influence risky choices in animal models.

  12. An Advanced Decision Support Tool for Electricity Infrastructure Operations

    SciTech Connect

    Chen, Yousu; Huang, Zhenyu; Wong, Pak C.; Mackey, Patrick S.; Allwardt, Craig H.; Ma, Jian; Greitzer, Frank L.

    2010-01-31

    Electricity infrastructure, as one of the most critical infrastructures in the U.S., plays an important role in modern societies. Its failure would lead to significant disruption of people’s lives, industry and commercial activities, and result in massive economic losses. Reliable operation of electricity infrastructure is an extremely challenging task because human operators need to consider thousands of possible configurations in near real-time to choose the best option and operate the network effectively. In today’s practice, electricity infrastructure operation is largely based on operators’ experience with very limited real-time decision support, resulting in inadequate management of complex predictions and the inability to anticipate, recognize, and respond to situations caused by human errors, natural disasters, or cyber attacks. Therefore, a systematic approach is needed to manage the complex operational paradigms and choose the best option in a near-real-time manner. This paper proposes an advanced decision support tool for electricity infrastructure operations. The tool has the functions of turning large amount of data into actionable information to help operators monitor power grid status in real time; performing trend analysis to indentify system trend at the regional level or system level to help the operator to foresee and discern emergencies, studying clustering analysis to assist operators to identify the relationships between system configurations and affected assets, and interactively evaluating the alternative remedial actions to aid operators to make effective and timely decisions. This tool can provide significant decision support on electricity infrastructure operations and lead to better reliability in power grids. This paper presents examples with actual electricity infrastructure data to demonstrate the capability of this tool.

  13. Demonstration of Decision Support Tools for Sustainable Development

    SciTech Connect

    Shropshire, David Earl; Jacobson, Jacob Jordan; Berrett, Sharon; Cobb, D. A.; Worhach, P.

    2000-11-01

    The Demonstration of Decision Support Tools for Sustainable Development project integrated the Bechtel/Nexant Industrial Materials Exchange Planner and the Idaho National Engineering and Environmental Laboratory System Dynamic models, demonstrating their capabilities on alternative fuel applications in the Greater Yellowstone-Teton Park system. The combined model, called the Dynamic Industrial Material Exchange, was used on selected test cases in the Greater Yellow Teton Parks region to evaluate economic, environmental, and social implications of alternative fuel applications, and identifying primary and secondary industries. The test cases included looking at compressed natural gas applications in Teton National Park and Jackson, Wyoming, and studying ethanol use in Yellowstone National Park and gateway cities in Montana. With further development, the system could be used to assist decision-makers (local government, planners, vehicle purchasers, and fuel suppliers) in selecting alternative fuels, vehicles, and developing AF infrastructures. The system could become a regional AF market assessment tool that could help decision-makers understand the behavior of the AF market and conditions in which the market would grow. Based on this high level market assessment, investors and decision-makers would become more knowledgeable of the AF market opportunity before developing detailed plans and preparing financial analysis.

  14. The possibilities for the EU-wide use of similar ecological risk-based soil contamination assessment tools.

    PubMed

    Swartjes, Frank A; Carlon, Claudio; de Wit, Niek H S M

    2008-12-01

    Soil degradation, e.g. due to soil contamination, is a serious problem in Europe. Therefore, the European Commission believes that a comprehensive EU strategy for soil protection is required. With the purpose of supporting the European soil policy, the possibilities for a common approach in the EU-wide use of ecological risks assessment methodologies are explored. For over ten years now, ecological procedures used in different countries have been discussed in international fora. More recently, within the framework of the HERACLES network a review of ecological risk assessment tools was performed, among other things. From this study it can be concluded that the inclusion of ecological risk assessment in soil quality standards shows an increasing interest in many EU Member States. The study also shows that there are many procedures for ecological risk assessment readily available in several EU countries and will be readily available in even more Member States in the nearby future. Besides, this study clearly shows quite some variation in the ecological risk assessment tools and in the resulting soil quality standards in the different countries. Therefore, an effort was made to look for potential harmonisation of these tools within the European Union. Risk assessment tools used in soil quality assessment include both political and scientific elements, which are often interwoven. Insofar differences in the existing tools originate from geographical or cultural differences between Member States or from political choices, harmonisation is not at all regarded an option. Nevertheless, several differences between existing ecological risk assessment tools have been identified, that merely originate from scientific or technical aspects. These tools could be standardized, which means that there could be a uniform tool to be used everywhere throughout the EU. The development of these harmonised risk assessment tools will imply an intensive international cooperation, with the

  15. Human Decision Processes: Implications for SSA Support Tools

    NASA Astrophysics Data System (ADS)

    Picciano, P.

    2013-09-01

    Despite significant advances in computing power and artificial intelligence (AI), few critical decisions are made without a human decision maker in the loop. Space Situational Awareness (SSA) missions are both critical and complex, typically adhering to the human-in-the-loop (HITL) model. The collection of human operators injects a needed diversity of expert knowledge, experience, and authority required to successfully fulfill SSA tasking. A wealth of literature on human decision making exists citing myriad empirical studies and offering a varied set of prescriptive and descriptive models of judgment and decision making (Hastie & Dawes, 2001; Baron, 2000). Many findings have been proven sufficiently robust to allow information architects or system/interface designers to take action to improve decision processes. For the purpose of discussion, these concepts are bifurcated in two groups: 1) vulnerabilities to mitigate, and 2) capabilities to augment. These vulnerabilities and capabilities refer specifically to the decision process and should not be confused with a shortcoming or skill of a specific human operator. Thus the framing of questions and orders, the automated tools with which to collaborate, priming and contextual data, and the delivery of information all play a critical role in human judgment and choice. Evaluating the merits of any decision can be elusive; in order to constrain this discussion, ‘rational choice' will tend toward the economic model characteristics such as maximizing utility and selection consistency (e.g., if A preferred to B, and B preferred to C, than A should be preferred to C). Simple decision models often encourage one to list the pros and cons of a decision, perhaps use a weighting schema, but one way or another weigh the future benefit (or harm) of making a selection. The result (sought by the rationalist models) should drive toward higher utility. Despite notable differences in researchers' theses (to be discussed in the full

  16. Conceptual air sparging decision tool in support of the development of an air sparging optimization decision tool

    SciTech Connect

    1995-09-01

    The enclosed document describes a conceptual decision tool (hereinafter, Tool) for determining applicability of and for optimizing air sparging systems. The Tool was developed by a multi-disciplinary team of internationally recognized experts in air sparging technology, lead by a group of project and task managers at Parsons Engineering Science, Inc. (Parsons ES). The team included Mr. Douglas Downey and Dr. Robert Hinchee of Parsons ES, Dr. Paul Johnson of Arizona State University, Dr. Richard Johnson of Oregon Graduate Institute, and Mr. Michael Marley of Envirogen, Inc. User Community Panel Review was coordinated by Dr. Robert Siegrist of Colorado School of Mines (also of Oak Ridge National Laboratory) and Dr. Thomas Brouns of Battelle/Pacific Northwest Laboratory. The Tool is intended to provide guidance to field practitioners and environmental managers for evaluating the applicability and optimization of air sparging as remedial action technique.

  17. Contributions of the nucleus accumbens and its subregions to different aspects of risk-based decision making.

    PubMed

    Stopper, Colin M; Floresco, Stan B

    2011-03-01

    The nucleus accumbens (NAc) has been implicated in mediating different forms of decision making in humans and animals. In the present study, we observed that inactivation of the rat NAc, via infusion of GABA agonists, reduced preference for a large/risky option and increased response latencies on a probabilistic discounting task. Discrete inactivations of the NAc shell and core revealed further differences between these regions in mediating choice and response latencies, respectively. The effect on choice was attributable to reduced win-stay performance (i.e., choosing risky after a being rewarded for a risky choice on a preceding trial). Moreover, NAc inactivation altered choice only when the large/risky option had greater long-term value, in terms of the amount of food that could be obtained over multiple trials relative to the small/certain option. Inactivation of the NAc or the shell subregion also slightly reduced preference for larger rewards on a reward magnitude discrimination. Thus, the NAc seems to play a small role in biasing choice toward larger rewards, but its contribution to behavior is amplified when delivery of these rewards is uncertain, helping to direct response selection toward more favorable outcomes.

  18. Decision-support tools for foot and mouth disease control.

    PubMed

    Morris, R S; Sanson, R L; Stern, M W; Stevenson, M; Wilesmith, J W

    2002-12-01

    Recent experience with foot and mouth disease (FMD) has shown that large and very costly epidemics can occur in countries considered extremely unlikely to experience the disease. The consequences of an introduction are much more severe than in the past and effective control is more difficult to achieve. Few countries have developed effective risk management strategies and information-based response systems to respond to these developments. The authors describe the tools which can be employed to minimise the impact of a disease incursion, using the example of FMD. To make such systems effective, the development of a national farms database in advance, including geo-referencing, is highly desirable. This greatly enhances the power of the decision-support tools, which can then be applied as soon as a serious disease incursion has been detected. These tools include procedures to detect infected farms promptly, to protect as yet uninfected farms against exposure to virus and to manage control policies. Epidemiological evaluation and prediction tools have advanced particularly rapidly and can guide the choice of control policies during an outbreak. Integrated decision-support systems offer the best method of managing FMD outbreaks to minimise the cost and size of the epidemics.

  19. Adaptation for Planting and Irrigation Decisions to Changing Monsoon Regime in Northeast India: Risk-based Hydro-economic Optimization

    NASA Astrophysics Data System (ADS)

    Zhu, T.; Cai, X.

    2013-12-01

    Delay in onset of Indian summer monsoon becomes increasingly frequent. Delayed monsoon and occasional monsoon failures seriously affect agricultural production in the northeast as well as other parts of India. In the Vaishali district of the Bihar State, Monsoon rainfall is very skewed and erratic, often concentrating in shorter durations. Farmers in Vaishali reported that delayed Monsoon affected paddy planting and, consequently delayed cropping cycle, putting crops under the risks of 'terminal heat.' Canal system in the district does not function due to lack of maintenance; irrigation relies almost entirely on groundwater. Many small farmers choose not to irrigate when monsoon onset is delayed due to high diesel price, leading to reduced production or even crop failure. Some farmers adapt to delayed onset of Monsoon by planting short-duration rice, which gives the flexibility for planting the next season crops. Other sporadic autonomous adaptation activities were observed as well, with various levels of success. Adaptation recommendations and effective policy interventions are much needed. To explore robust options to adapt to the changing Monsoon regime, we build a stochastic programming model to optimize revenues of farmer groups categorized by landholding size, subject to stochastic Monsoon onset and rainfall amount. Imperfect probabilistic long-range forecast is used to inform the model onset and rainfall amount probabilities; the 'skill' of the forecasting is measured using probabilities of correctly predicting events in the past derived through hindcasting. Crop production functions are determined using self-calibrating Positive Mathematical Programming approach. The stochastic programming model aims to emulate decision-making behaviors of representative farmer agents through making choices in adaptation, including crop mix, planting dates, irrigation, and use of weather information. A set of technological and policy intervention scenarios are tested

  20. An extended reinforcement learning model of basal ganglia to understand the contributions of serotonin and dopamine in risk-based decision making, reward prediction, and punishment learning.

    PubMed

    Balasubramani, Pragathi P; Chakravarthy, V Srinivasa; Ravindran, Balaraman; Moustafa, Ahmed A

    2014-01-01

    Although empirical and neural studies show that serotonin (5HT) plays many functional roles in the brain, prior computational models mostly focus on its role in behavioral inhibition. In this study, we present a model of risk based decision making in a modified Reinforcement Learning (RL)-framework. The model depicts the roles of dopamine (DA) and serotonin (5HT) in Basal Ganglia (BG). In this model, the DA signal is represented by the temporal difference error (δ), while the 5HT signal is represented by a parameter (α) that controls risk prediction error. This formulation that accommodates both 5HT and DA reconciles some of the diverse roles of 5HT particularly in connection with the BG system. We apply the model to different experimental paradigms used to study the role of 5HT: (1) Risk-sensitive decision making, where 5HT controls risk assessment, (2) Temporal reward prediction, where 5HT controls time-scale of reward prediction, and (3) Reward/Punishment sensitivity, in which the punishment prediction error depends on 5HT levels. Thus the proposed integrated RL model reconciles several existing theories of 5HT and DA in the BG.

  1. A Customized Drought Decision Support Tool for Hsinchu Science Park

    NASA Astrophysics Data System (ADS)

    Huang, Jung; Tien, Yu-Chuan; Lin, Hsuan-Te; Liu, Tzu-Ming; Tung, Ching-Pin

    2016-04-01

    Climate change creates more challenges for water resources management. Due to the lack of sufficient precipitation in Taiwan in fall of 2014, many cities and counties suffered from water shortage during early 2015. Many companies in Hsinchu Science Park were significantly influenced and realized that they need a decision support tool to help them managing water resources. Therefore, a customized computer program was developed, which is capable of predicting the future status of public water supply system and water storage of factories when the water rationing is announced by the government. This program presented in this study for drought decision support (DDSS) is a customized model for a semiconductor company in the Hsinchu Science Park. The DDSS is programmed in Java which is a platform-independent language. System requirements are any PC with the operating system above Windows XP and an installed Java SE Runtime Environment 7. The DDSS serves two main functions. First function is to predict the future storage of Baoshan Reservoir and Second Baoshan Reservoir, so to determine the time point of water use restriction in Hsinchu Science Park. Second function is to use the results to help the company to make decisions to trigger their response plans. The DDSS can conduct real-time scenario simulations calculating the possible storage of water tank for each factory with pre-implementation and post-implementation of those response plans. In addition, DDSS can create reports in Excel to help decision makers to compare results between different scenarios.

  2. A Flight Deck Decision Support Tool for Autonomous Airborne Operations

    NASA Technical Reports Server (NTRS)

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

    2002-01-01

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

  3. Air Traffic Control Decision Support Tools for Noise Mitigation

    NASA Technical Reports Server (NTRS)

    Tobias, Leonard

    2001-01-01

    NASA has initiated a new five year program this year, the Quiet Aircraft Technology (QAT) Program, a program which will investigate airframe and engine system noise reduction. QAT will also address community noise impact. As part of this community noise impact component, NASA will investigate air traffic management (ATM) challenges in reducing noise. In particular, controller advisory automation aids will be developed to aid the air traffic controller in addressing noise concerns as he/she manages traffic in busy terminal areas. NASA has developed controller automation tools to address capacity concerns and the QAT strategy for ATM Low Noise Operations is to build upon this tool set to create added advisories for noise mitigation. The tools developed for capacity will be briefly reviewed, followed by the QAT plans to address ATM noise concerns. A major NASA goal in global civil aviation is to triple the aviation system throughput in all-weather conditions while maintaining safety. A centerpiece of this activity is the Center/TRACON Automation System (CTAS), an evolving suite of air traffic controller decision support tools (DSTs) to enhance capacity of arrivals and departures in both the enroute center and the TRACON. Two of these DSTs, the Traffic Management Advisor (TMA) and the passive Final approach Spacing Tool (pFAST), are in daily use at the Fort Worth Center and the Dallas/Fort Worth (DFW) TRACON, respectively, where capacity gains of 5-13% have been reported in recent NASA evaluations. Under the Federal Aviation Administration's (FAA) Free Flight Phase One Program, TMA and pFAST are each being implemented at six to eight additional sites. In addition, other DSTs are being developed by NASA under the umbrella of CTAS. This means that new software will be built upon CTAS, and the paradigm of real-time simulation evaluation followed by field site development and evaluation will be the pathway for the new tools. Additional information is included in the

  4. Air Traffic Control Decision Support Tools for Noise Mitigation

    NASA Technical Reports Server (NTRS)

    Tobias, Leonard

    2001-01-01

    NASA has initiated a new five year program this year, the Quiet Aircraft Technology (QAT) Program, a program which will investigate airframe and engine system noise reduction. QAT will also address community noise impact. As part of this community noise impact component, NASA will investigate air traffic management (ATM) challenges in reducing noise. In particular, controller advisory automation aids will be developed to aid the air traffic controller in addressing noise concerns as he/she manages traffic in busy terminal areas. NASA has developed controller automation tools to address capacity concerns and the QAT strategy for ATM Low Noise Operations is to build upon this tool set to create added advisories for noise mitigation. The tools developed for capacity will be briefly reviewed, followed by the QAT plans to address ATM noise concerns. A major NASA goal in global civil aviation is to triple the aviation system throughput in all-weather conditions while maintaining safety. A centerpiece of this activity is the Center/TRACON Automation System (CTAS), an evolving suite of air traffic controller decision support tools (DSTs) to enhance capacity of arrivals and departures in both the enroute center and the TRACON. Two of these DSTs, the Traffic Management Advisor (TMA) and the passive Final approach Spacing Tool (pFAST), are in daily use at the Fort Worth Center and the Dallas/Fort Worth (DFW) TRACON, respectively, where capacity gains of 5-13% have been reported in recent NASA evaluations. Under the Federal Aviation Administration's (FAA) Free Flight Phase One Program, TMA and pFAST are each being implemented at six to eight additional sites. In addition, other DSTs are being developed by NASA under the umbrella of CTAS. This means that new software will be built upon CTAS, and the paradigm of real-time simulation evaluation followed by field site development and evaluation will be the pathway for the new tools. Additional information is included in the

  5. Decision tool for the early diagnosis of trauma patient hypovolemia.

    PubMed

    Chen, Liangyou; McKenna, Thomas M; Reisner, Andrew T; Gribok, Andrei; Reifman, Jaques

    2008-06-01

    We present a classifier for use as a decision assist tool to identify a hypovolemic state in trauma patients during helicopter transport to a hospital, when reliable acquisition of vital-sign data may be difficult. The decision tool uses basic vital-sign variables as input into linear classifiers, which are then combined into an ensemble classifier. The classifier identifies hypovolemic patients with an area under a receiver operating characteristic curve (AUC) of 0.76 (standard deviation 0.05, for 100 randomly-reselected patient subsets). The ensemble classifier is robust; classification performance degrades only slowly as variables are dropped, and the ensemble structure does not require identification of a set of variables for use as best-feature inputs into the classifier. The ensemble classifier consistently outperforms best-features-based linear classifiers (the classification AUC is greater, and the standard deviation is smaller, p<0.05). The simple computational requirements of ensemble classifiers will permit them to function in small fieldable devices for continuous monitoring of trauma patients.

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

    SciTech Connect

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

    2016-01-01

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

  7. Enhancing Drought Risk Management: Tools and Services for Decision Support

    NASA Astrophysics Data System (ADS)

    Svoboda, M. D.; Hayes, M. J.

    2011-12-01

    The National Drought Mitigation Center (NDMC) (http://drought.unl.edu) has been working with the National Integrated Drought Information System (NIDIS) (http://drought.gov) and other partners with a goal of developing tools, products, services and outreach with a goal of contributing to a U.S. drought early warning system (DEWS) as well as contributing to efforts underway toward building a virtual and collaborative global drought early warning system (GDEWS). The NDMC's mission is to work to reduce societal vulnerability to drought by helping decision makers at all levels to: develop and implement DEWS, understand and prevent drought impacts and increase long-term resilience to drought through proactive risk management planning. The NDMC is a national center founded in 1995 and located at the University of Nebraska-Lincoln. The NDMC conducts basic and applied research, services and decision support applications, along with the maintaining of a number of operational drought-related tools, products and outreach activities, including the U.S. Drought Monitor (USDM), Drought Impact Reporter (DIR), Vegetation Drought Response Index (VegDRI) along with the newly developed and enhanced National Drought Atlas, Drought Ready Communities Guide to Community Drought Preparedness and our Managing Drought Risk on the Ranch planning section on our newly revamped web site at http://drought.unl.edu. This presentation will describe in more detail the various drought resources, tools, research efforts, services and collaborations already being provided by the NDMC and its partners toward developing a collaborative DEWS in the U.S. and around the world.

  8. DPSIR Framework - A Decision - Making Tool for Municipalities

    NASA Astrophysics Data System (ADS)

    Majorošová, M.

    2016-12-01

    Many municipalities in Central Europe deal with the problem of invasive species in their natural ecosystems. Invasive vegetation eradicates native species and causes dense stands that damage the natural environment. This work shows how important it is to have an informative tool for municipalities to be successful in their struggles with invasive species. A Driver - Pressure - State - Impact - Response (DPSIR) framework is a decision - making tool, and this one is particularly applied to the species Fallopia japonica. Fallopia japonica is an extremely invasive and aggressive weed, and it is very often found in riverbank vegetation. This specific framework can be used as a tool for municipal managers to highlight all the problems with Fallopia japonica and define all the responses that should be provided by the municipalities. The work points out the steps that show how important it is to have a strategy or a clear concept of how to begin with such a serious issue as the presence of Fallopia japonica in riverbank vegetation and its eradication. This framework provides simple steps that cannot be excluded when a municipality start actions against Fallopia japonica. All the indicators used in the model are based on the information known about Fallopia japonica that are presented in the literature.

  9. Facilitating knowledge transfer: decision support tools in environment and health.

    PubMed

    Liu, Hai-Ying; Bartonova, Alena; Neofytou, Panagiotis; Yang, Aileen; Kobernus, Michael J; Negrenti, Emanuele; Housiadas, Christos

    2012-06-28

    The HENVINET Health and Environment Network aimed to enhance the use of scientific knowledge in environmental health for policy making. One of the goals was to identify and evaluate Decision Support Tools (DST) in current use. Special attention was paid to four "priority" health issues: asthma and allergies, cancer, neurodevelopment disorders, and endocrine disruptors.We identified a variety of tools that are used for decision making at various levels and by various stakeholders. We developed a common framework for information acquisition about DSTs, translated this to a database structure and collected the information in an online Metadata Base (MDB).The primary product is an open access web-based MDB currently filled with 67 DSTs, accessible through the HENVINET networking portal http://www.henvinet.eu and http://henvinet.nilu.no. Quality assurance and control of the entries and evaluation of requirements to use the DSTs were also a focus of the work. The HENVINET DST MDB is an open product that enables the public to get basic information about the DSTs, and to search the DSTs using pre-designed attributes or free text. Registered users are able to 1) review and comment on existing DSTs; 2) evaluate each DST's functionalities, and 3) add new DSTs, or change the entry for their own DSTs. Assessment of the available 67 DSTs showed: 1) more than 25% of the DSTs address only one pollution source; 2) 25% of the DSTs address only one environmental stressor; 3) almost 50% of the DSTs are only applied to one disease; 4) 41% of the DSTs can only be applied to one decision making area; 5) 60% of the DSTs' results are used only by national authority and/or municipality/urban level administration; 6) almost half of the DSTs are used only by environmental professionals and researchers. This indicates that there is a need to develop DSTs covering an increasing number of pollution sources, environmental stressors and health end points, and considering links to other 'Driving

  10. Decision Analysis Tool to Compare Energy Pathways for Transportation

    SciTech Connect

    Bloyd, Cary N.

    2010-06-30

    With the goals of reducing greenhouse gas emissions, oil imports, and energy costs, a wide variety of automotive technologies are proposed to replace the traditional gasoline-powered internal combustion engine (g-ICE). Biomass is seen as an important domestic energy feedstock, and there are multiple pathways in which it can be linked to the transport sector. Contenders include the use of cellulosic ethanol from biomass to replace gasoline or the use of a biomass-fueled combined cycle electrical power generation facility in conjunction plug-in hybrid electric vehicles (PHEVs). This paper reviews a project that is developing a scenario decision analysis tool to assist policy makers, program managers, and others to obtain a better understanding of these uncertain possibilities and how they may interact over time.

  11. New decision support tool for acute lymphoblastic leukemia classification

    NASA Astrophysics Data System (ADS)

    Madhukar, Monica; Agaian, Sos; Chronopoulos, Anthony T.

    2012-03-01

    In this paper, we build up a new decision support tool to improve treatment intensity choice in childhood ALL. The developed system includes different methods to accurately measure furthermore cell properties in microscope blood film images. The blood images are exposed to series of pre-processing steps which include color correlation, and contrast enhancement. By performing K-means clustering on the resultant images, the nuclei of the cells under consideration are obtained. Shape features and texture features are then extracted for classification. The system is further tested on the classification of spectra measured from the cell nuclei in blood samples in order to distinguish normal cells from those affected by Acute Lymphoblastic Leukemia. The results show that the proposed system robustly segments and classifies acute lymphoblastic leukemia based on complete microscopic blood images.

  12. Clinical decision support tools: analysis of online drug information databases

    PubMed Central

    Clauson, Kevin A; Marsh, Wallace A; Polen, Hyla H; Seamon, Matthew J; Ortiz, Blanca I

    2007-01-01

    Background Online drug information databases are used to assist in enhancing clinical decision support. However, the choice of which online database to consult, purchase or subscribe to is likely made based on subjective elements such as history of use, familiarity, or availability during professional training. The purpose of this study was to evaluate clinical decision support tools for drug information by systematically comparing the most commonly used online drug information databases. Methods Five commercially available and two freely available online drug information databases were evaluated according to scope (presence or absence of answer), completeness (the comprehensiveness of the answers), and ease of use. Additionally, a composite score integrating all three criteria was utilized. Fifteen weighted categories comprised of 158 questions were used to conduct the analysis. Descriptive statistics and Chi-square were used to summarize the evaluation components and make comparisons between databases. Scheffe's multiple comparison procedure was used to determine statistically different scope and completeness scores. The composite score was subjected to sensitivity analysis to investigate the effect of the choice of percentages for scope and completeness. Results The rankings for the databases from highest to lowest, based on composite scores were Clinical Pharmacology, Micromedex, Lexi-Comp Online, Facts & Comparisons 4.0, Epocrates Online Premium, RxList.com, and Epocrates Online Free. Differences in scope produced three statistical groupings with Group 1 (best) performers being: Clinical Pharmacology, Micromedex, Facts & Comparisons 4.0, Lexi-Comp Online, Group 2: Epocrates Premium and RxList.com and Group 3: Epocrates Free (p < 0.05). Completeness scores were similarly stratified. Collapsing the databases into two groups by access (subscription or free), showed the subscription databases performed better than the free databases in the measured criteria (p < 0

  13. Clinical decision support tools: analysis of online drug information databases.

    PubMed

    Clauson, Kevin A; Marsh, Wallace A; Polen, Hyla H; Seamon, Matthew J; Ortiz, Blanca I

    2007-03-08

    Online drug information databases are used to assist in enhancing clinical decision support. However, the choice of which online database to consult, purchase or subscribe to is likely made based on subjective elements such as history of use, familiarity, or availability during professional training. The purpose of this study was to evaluate clinical decision support tools for drug information by systematically comparing the most commonly used online drug information databases. Five commercially available and two freely available online drug information databases were evaluated according to scope (presence or absence of answer), completeness (the comprehensiveness of the answers), and ease of use. Additionally, a composite score integrating all three criteria was utilized. Fifteen weighted categories comprised of 158 questions were used to conduct the analysis. Descriptive statistics and Chi-square were used to summarize the evaluation components and make comparisons between databases. Scheffe's multiple comparison procedure was used to determine statistically different scope and completeness scores. The composite score was subjected to sensitivity analysis to investigate the effect of the choice of percentages for scope and completeness. The rankings for the databases from highest to lowest, based on composite scores were Clinical Pharmacology, Micromedex, Lexi-Comp Online, Facts & Comparisons 4.0, Epocrates Online Premium, RxList.com, and Epocrates Online Free. Differences in scope produced three statistical groupings with Group 1 (best) performers being: Clinical Pharmacology, Micromedex, Facts & Comparisons 4.0, Lexi-Comp Online, Group 2: Epocrates Premium and RxList.com and Group 3: Epocrates Free (p < 0.05). Completeness scores were similarly stratified. Collapsing the databases into two groups by access (subscription or free), showed the subscription databases performed better than the free databases in the measured criteria (p < 0.001). Online drug

  14. Email recruitment to use web decision support tools for pneumonia.

    PubMed Central

    Flanagan, James R.; Peterson, Michael; Dayton, Charles; Strommer Pace, Lori; Plank, Andrew; Walker, Kristy; Carlson, William S.

    2002-01-01

    Application of guidelines to improve clinical decisions for Community Acquired Pneumonia (CAP) patients depends on accurate information about specific facts of each case and on presenting guideline support at the time decisions are being made. We report here on a system designed to solicit information from physicians about their CAP patients in order to classify CAP and present appropriate guidelines for type of care, length of stay, and use of antibiotics. We used elements of three existing information systems to create a achieve these goals: professionals coding diagnoses captured by the existing clinical information system (CIS), email, and web-based decision support tools including a pneumonia severity evaluation tool (SET). The non-secure IS components (email and web) were able to link to information in the CIS using tokens that do not reveal confidential patient-identifiable information. We examined their response to this strategy and the accuracy of pneumonia classification using this approach compared to chart review as a gold standard. On average physicians responded to email solicitations 50% of the time over the 14 month study. Also using this standard, we examined various information triggers for case finding. Professional coding of the primary reason for admission as pneumonia was fairly sensitive as an indicator of CAP. Physician use of the web SET was insensitive but fairly specific. Pneumonia classification using the SET was very reliable compared to experts' chart review using the same algorithm. We examined the distribution of severity of pneumonia for cases of pneumonia found by the various information triggers and for each severity the average length of stay. The distribution found by both chart review and by SET has demonstrated a shift toward more severe cases being admitted compared to only 3 years ago. The length of stay for level of severity is above expectations published by guidelines even for cases of true CAP by chart review. We suggest

  15. NOAA Climate Information and Tools for Decision Support Services

    NASA Astrophysics Data System (ADS)

    Timofeyeva, M. M.; Higgins, W.; Strager, C.; Horsfall, F. M.

    2013-12-01

    provision of information that will help guide long-term preparedness for severe weather events and extreme conditions as well as climate variability and change GFCS recently summarized examples of existing initiatives to advance provision of climate services in the 2012 publication Climate ExChange. In this publication, NWS introduced the new Local Climate Analysis Tool (LCAT), a tool that is used to conduct local climate studies that are needed to create efficient and reliable guidance for DSS. LCAT allows for analyzing trends in local climate variables and identifying local impacts of climate variability (e.g., ENSO) on weather and water conditions. In addition to LCAT, NWS, working in partnership with the North East Regional Climate center, released xmACIS version 2, a climate data mining tool, for NWS field operations. During this talk we will demonstrate LCAT and xmACIS as well as outline several examples of their application to DSS and its potential use for achieving GFCS goals. The examples include LCAT-based temperature analysis for energy decisions, guidance on weather and water events leading to increased algal blooms and red tide months in advance, local climate sensitivities to droughts, probabilities of hot/cold conditions and their potential impacts on agriculture and fish kills or fish stress.

  16. [An ethical decision-making tool. Training for decision-making in crisis or end-of-life situations].

    PubMed

    Gomas, J M

    We developed a patient-centered decision making tool to help healthcare teams make ethical decisions in crisis or end-of-life situations. This tool is the fruit of 15 years of healthcare experience and discussions on ethical issues with patients suffering from cancer, severe handicaps or terminal disease. It has been enriched by experience acquired since the publication of earlier work in the nineties. A three-step decision-making process is proposed providing a methodic aid for management decisions which remain unique for each individual patient.

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

    PubMed

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

    2017-07-01

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

  18. Teaching the Tools of Pharmaceutical Care Decision-Analysis.

    ERIC Educational Resources Information Center

    Rittenhouse, Brian E.

    1994-01-01

    A method of decision-analysis in pharmaceutical care that integrates epidemiology and economics is presented, including an example illustrating both the deceptive nature of medical decision making and the power of decision analysis. Principles in determining both general and specific probabilities of interest and use of decision trees for…

  19. Teaching the Tools of Pharmaceutical Care Decision-Analysis.

    ERIC Educational Resources Information Center

    Rittenhouse, Brian E.

    1994-01-01

    A method of decision-analysis in pharmaceutical care that integrates epidemiology and economics is presented, including an example illustrating both the deceptive nature of medical decision making and the power of decision analysis. Principles in determining both general and specific probabilities of interest and use of decision trees for…

  20. Development and description of a decision analysis based decision support tool for stroke prevention in atrial fibrillation

    PubMed Central

    Thomson, R.; Robinson, A.; Greenaway, J.; Lowe, P.

    2002-01-01

    Background: There is an increasing move towards clinical decision making that engages the patient, which has led to the development and use of decision aids to support better decisions. The treatment of patients in atrial fibrillation (AF) with warfarin to prevent stroke is a decision that is sensitive to patient preferences as shown by a previous decision analysis. Aim: To develop a computerised decision support tool, building upon a previous decision analysis, which would engage individual patient preferences in reaching a shared decision on whether to take warfarin to prevent stroke. Methods: The development process had two main phases: (1) the development phase which employed focus groups and repeated interviews with GPs/practice nurses and patients alongside an iterative development of a computerised tool; (2) the training and testing phase in which GPs and practice nurses underwent training in the use of the tool, including the use of simulated patients. The tool was then used in a feasibility study in a small number of patients with AF to inform the design of a subsequent randomised controlled trial. Results: The prototype tool had three components: (1) derivation of an individual patient's values for relevant health states using a standard gamble; (2) presentation/discussion of a patient's risks of stroke using the Framingham equation and the benefits/risks of warfarin from a systematic literature review; and (3) decision making component incorporating the outcome of a Markov decision analysis model. Older patients could be taken through the decision analysis based computerised tool, and patients and clinicians welcomed information on risks and benefits of treatments. The tool required time and training to use. Patients' decisions in the feasibility phase did not necessarily coincide with the output of the decision analysis model, but decision conflict appeared to be reduced and both patients and GPs were satisfied with the process. Conclusions: It is

  1. Decision graphs: a tool for developing real-time software

    SciTech Connect

    Kozubal, A.J.

    1981-01-01

    The use of decision graphs in the preparation of, in particular, real-time software is briefly described. The usefulness of decision graphs in software design, testing, and maintenance is pointed out. 2 figures. (RWR)

  2. A DECISION SUPPORT TOOL (DST) FOR DISPOSAL OF ...

    EPA Pesticide Factsheets

    Symposium Paper AFTER A BUILDING OR WATER TREATMENT/DISTRIBUTION FACILITY HAS GONE THROUGH DECONTAMINATION ACTIVITIES FOLLOWING A CONTAMINATION EVENT WITH CHEMICAL/BIOLOGICAL WARFARE AGENTS OR TOXIC INDUSTRIAL CHEMICAL, THERE WILL BE A SIGNIFICANT AMOUNT OF RESIDUAL MATERIAL AND WASTE TO BE DISPOSED. A CONTAMINATION EVENT COULD OCCUR FROM TERRORIST ACTIVITY OR FROM A NATURAL DISASTER SUCH AS THE RECENT HURRICANE EVENTS IN THE GULF COAST WHERE MOLD AND POLLUTANTS FROM DAMAGED CHEMICAL AND INDUSTRIAL FACILITIES HAVE RESULTED IN SIGNIFICANT QUANTITIES OF CONTAMINATED MATERIALS. IT iS LIKELY THAT MUCH OF THIS MATERIAL WILL BE DISPOSED OF IN PERMITTED LANDFILLS OR HIGH TEMPERATURE THERMAL INCINERATION FACILITIES. DATA HAS BEEN COLLECTED FROM THE OPEN LITERATURE, FROM STATE AND FEDERAL REGULATORY AGENCIES, AND FROM WASTE MANAGEMENT AND WATER UTILITY INDUSTRY STAKEHOLDER GROUPS, TO DEVELOP TECHNICAL GUIDANCE FOR DISPOSAL OF THESe RESIDUES. THE INFORMATION BECOMES AVAILABLE, AND OLD INFORMATION (SUCH AS CONTACT INFORMATION FOR KEY PERSONNEL) CHANGES. THE PRiMARY AUDIENCE FOR THIS TOOL WILL BE: 1) EMERGENCY RESPONSE AUTHORITIES WHO HAVE TO DECIDE THE MOST APPROPRIATE DECONTAMINATION METHODS AND DISPOSAL OF THE RESULTING RESIDUES; 2)STATE AND LOCAL PERMITTING AGENCIES, WHO HAVE TO MAKE DECISIONS ABOUT WHICH FACILITIES WILL BE ALLOWED TO DISPOSE OF THE MATERIALS: AND 3) THE WASTE MANAGEMENT AND WATER UTILITY INDUSTRY, THAT NEEDS TO SAFELY DISPOSE OF DECONTAMINATION RESIDUE

  3. A DECISION SUPPORT TOOL (DST) FOR DISPOSAL OF ...

    EPA Pesticide Factsheets

    Symposium Paper AFTER A BUILDING OR WATER TREATMENT/DISTRIBUTION FACILITY HAS GONE THROUGH DECONTAMINATION ACTIVITIES FOLLOWING A CONTAMINATION EVENT WITH CHEMICAL/BIOLOGICAL WARFARE AGENTS OR TOXIC INDUSTRIAL CHEMICAL, THERE WILL BE A SIGNIFICANT AMOUNT OF RESIDUAL MATERIAL AND WASTE TO BE DISPOSED. A CONTAMINATION EVENT COULD OCCUR FROM TERRORIST ACTIVITY OR FROM A NATURAL DISASTER SUCH AS THE RECENT HURRICANE EVENTS IN THE GULF COAST WHERE MOLD AND POLLUTANTS FROM DAMAGED CHEMICAL AND INDUSTRIAL FACILITIES HAVE RESULTED IN SIGNIFICANT QUANTITIES OF CONTAMINATED MATERIALS. IT iS LIKELY THAT MUCH OF THIS MATERIAL WILL BE DISPOSED OF IN PERMITTED LANDFILLS OR HIGH TEMPERATURE THERMAL INCINERATION FACILITIES. DATA HAS BEEN COLLECTED FROM THE OPEN LITERATURE, FROM STATE AND FEDERAL REGULATORY AGENCIES, AND FROM WASTE MANAGEMENT AND WATER UTILITY INDUSTRY STAKEHOLDER GROUPS, TO DEVELOP TECHNICAL GUIDANCE FOR DISPOSAL OF THESe RESIDUES. THE INFORMATION BECOMES AVAILABLE, AND OLD INFORMATION (SUCH AS CONTACT INFORMATION FOR KEY PERSONNEL) CHANGES. THE PRiMARY AUDIENCE FOR THIS TOOL WILL BE: 1) EMERGENCY RESPONSE AUTHORITIES WHO HAVE TO DECIDE THE MOST APPROPRIATE DECONTAMINATION METHODS AND DISPOSAL OF THE RESULTING RESIDUES; 2)STATE AND LOCAL PERMITTING AGENCIES, WHO HAVE TO MAKE DECISIONS ABOUT WHICH FACILITIES WILL BE ALLOWED TO DISPOSE OF THE MATERIALS: AND 3) THE WASTE MANAGEMENT AND WATER UTILITY INDUSTRY, THAT NEEDS TO SAFELY DISPOSE OF DECONTAMINATION RESIDUE

  4. Development and commissioning of decision support tools for sewerage management.

    PubMed

    Manic, G; Printemps, C; Zug, M; Lemoine, C

    2006-01-01

    Managing sewerage systems is a highly complex task due to the dynamic nature of the facilities. Their performance strongly depends on the know-how applied by the operators. In order to define optimal operational settings, two decision support tools based on mathematical models have been developed. Moreover, easy-to-use interfaces have been created as well, aiding operators who presumably do not have the necessary skills to use modelling software. The two developed programs simulate the behaviour of both wastewater treatment plants (WWTP) and sewer network systems, respectively. They have essentially the same structure, including raw data management and statistical analysis, a simulation layer using the application programming interface of the applied software and a layer responsible for the representation of the obtained results. Four user modes are provided in the two software including the simulation of historical data using the applied and novel operational settings, as well as modes concerning prediction of possible operation periods and updates. Concerning the WWTP software, it was successfully installed in Nantes (France) in June 2004. Moreover, the one managing sewer networks has been deployed in Saint-Malo (France) in January 2005. This paper presents the structure of the developed software and the first results obtained during the commissioning phase.

  5. Decision support and data warehousing tools boost competitive advantage.

    PubMed

    Waldo, B H

    1998-01-01

    The ability to communicate across the care continuum is fast becoming an integral component of the successful health enterprise. As integrated delivery systems are formed and patient care delivery is restructured, health care professionals must be able to distribute, access, and evaluate information across departments and care settings. The Aberdeen Group, a computer and communications research and consulting organization, believes that "the single biggest challenge for next-generation health care providers is to improve on how they consolidate and manage information across the continuum of care. This involves building a strategic warehouse of clinical and financial information that can be shared and leveraged by health care professionals, regardless of the location or type of care setting" (Aberdeen Group, Inc., 1997). The value and importance of data and systems integration are growing. Organizations that create a strategy and implement DSS tools to provide decision-makers with the critical information they need to face the competition and maintain quality and costs will have the advantage.

  6. The development of a personalized patient education tool for decision making for postmenopausal women with osteoporosis.

    PubMed

    Hiligsmann, M; Ronda, G; van der Weijden, T; Boonen, A

    2016-08-01

    A personalized patient education tool for decision making (PET) for postmenopausal women with osteoporosis was developed by means of a systematic development approach. A prototype was constructed and refined by involving various professionals and patients. Professionals and patients expressed a positive attitude towards the use of the PET. The purpose was to systematically develop a paper-based personalized PET to assist postmenopausal women with osteoporosis in selecting a treatment in line with their personal values and preferences. The development of the PET was based on a systematic process including scope, design, development of a prototype, and alpha testing among professionals and patients by semi-structured interviews. The design and development resulted in a four-page PET prototype together with a one-page fact sheet of the different drug options. The prototype PET provided the personal risk factors, the estimated individualized risk for a future major osteoporotic fracture and potential reduction with drugs, and a summary of advantages and disadvantages whether or not to start drugs. The drug fact sheet presents five attributes of seven drugs in a tabular format. The alpha testing with professionals resulted in some adaptations, e.g., inclusion of the possibility to calculate fracture risk based on various individual risk scoring methods. Important results from the alpha testing with patients were differences in the fracture risk percentage which was seen as worthwhile to start drugs, the importance of an overview of side effects, and of the timing of the PET into the patient pathway. All women indicated that the PET could be helpful for their decision to select a treatment. Physicians and patients expressed a positive attitude towards the use of the proposed PET. Further research would be needed to test the effects of the PET on feasibility in clinical workflow and on patient outcomes.

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

    PubMed

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

    2013-01-01

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

  8. Risk-based maintenance--techniques and applications.

    PubMed

    Arunraj, N S; Maiti, J

    2007-04-11

    Plant and equipment, however well designed, will not remain safe or reliable if it is not maintained. The general objective of the maintenance process is to make use of the knowledge of failures and accidents to achieve the possible safety with the lowest possible cost. The concept of risk-based maintenance was developed to inspect the high-risk components usually with greater frequency and thoroughness and to maintain in a greater manner, to achieve tolerable risk criteria. Risk-based maintenance methodology provides a tool for maintenance planning and decision making to reduce the probability of failure of equipment and the consequences of failure. In this paper, the risk analysis and risk-based maintenance methodologies were identified and classified into suitable classes. The factors affecting the quality of risk analysis were identified and analyzed. The applications, input data and output data were studied to understand their functioning and efficiency. The review showed that there is no unique way to perform risk analysis and risk-based maintenance. The use of suitable techniques and methodologies, careful investigation during the risk analysis phase, and its detailed and structured results are necessary to make proper risk-based maintenance decisions.

  9. 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...

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  12. 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...

  13. Small-group decision making can be effective management tool.

    PubMed

    Kennedy, R

    1978-01-01

    One of the key components of effective management is the ability to make decisions. To more effectively assist hospital supervisors and managers in dealing with and making appropriate judgments, educators need to examine carefully the processes involved in decision making and how they impact on both the individual and the group. The following discussion of structured small-group decision making is adapted from an independent study of the literature undertaken by this author to dissect these processes and how they impact on the decisions made.

  14. Career toolbox - the decision paper: A tool to facilitate decision-making

    SciTech Connect

    Williams, J.L.; Petersen, T.P.

    1996-11-12

    Guidelines for writing a decision paper are presented. The purpose of the decision paper is to present complex issues in an organized format; it is especially helpful when timeliness is important. The writing style and format of the decision paper are described. The format for a decision paper includes the issue or problem statement, relevant background material, options or alternatives, discussion, recommendation, coordination/endorsement, and record of decision.

  15. Information and Decision Superiority: Right Concept, Right Tools, Right Training

    DTIC Science & Technology

    2007-01-01

    individual services, and numerous defense contractors have spoken of " information dominance " and "information superiority." Both, particularly the former...technologies will offer an unimaginable level of information to decision makers and operators. Ideas of information dominance , however, are fundamentally...other futuristic sensors will offer an unimaginable level of information to decision makers and operators. Ideas of information dominance , however

  16. A decision tool for selecting trench cap designs

    SciTech Connect

    Paige, G.B.; Stone, J.J.; Lane, L.J.

    1995-12-31

    A computer based prototype decision support system (PDSS) is being developed to assist the risk manager in selecting an appropriate trench cap design for waste disposal sites. The selection of the {open_quote}best{close_quote} design among feasible alternatives requires consideration of multiple and often conflicting objectives. The methodology used in the selection process consists of: selecting and parameterizing decision variables using data, simulation models, or expert opinion; selecting feasible trench cap design alternatives; ordering the decision variables and ranking the design alternatives. The decision model is based on multi-objective decision theory and uses a unique approach to order the decision variables and rank the design alternatives. Trench cap designs are evaluated based on federal regulations, hydrologic performance, cover stability and cost. Four trench cap designs, which were monitored for a four year period at Hill Air Force Base in Utah, are used to demonstrate the application of the PDSS and evaluate the results of the decision model. The results of the PDSS, using both data and simulations, illustrate the relative advantages of each of the cap designs and which cap is the {open_quotes}best{close_quotes} alternative for a given set of criteria and a particular importance order of those decision criteria.

  17. Developing a decision tool to identify patients with personality disorders in need of highly specialized care.

    PubMed

    Goorden, M; Willemsen, E M C; Bouwmans-Frijters, C A M; Busschbach, J J V; Noomx, M J; van der Feltz-Cornelis, C M; Uyl-de Groot, C A; Hakkaart-van Roijen, L

    2017-08-31

    Current guidelines recommend referral to highly specialized care for patients with severe personality disorders. However, criteria for allocation to highly specialized care are not clearly defined. The aim of the present study was to develop a decision tool that can support clinicians to identify patients with a personality disorder in need of highly specialized care. Steps taken to develop a decision tool were a literature search, concept mapping, a meeting with experts and a validation study. The concept mapping method resulted in six criteria for the decision tool. The model used in concept mapping provided a good fit (stress value = 0.30) and reasonable reliability (ρ = 0.49). The bridging values were low, indicating homogeneity. The decision tool was subsequently validated by enrolling 368 patients from seven centers. A multilevel model with a Receiver Operating Characteristic Curve (ROC) was applied. In this way, an easily implementable decision tool with relatively high sensitivity (0.74) and specificity (0.69) was developed. A decision tool to identify patients with personality disorders for highly specialized care was developed using advanced methods to combine the input of experts with currently available scientific knowledge. The tool appeared to be able to accurately identify this group of patients. Clinicians can use this decision tool to identify patients who are in need of highly specialized treatment.

  18. Wind Prediction Accuracy for Air Traffic Management Decision Support Tools

    NASA Technical Reports Server (NTRS)

    Cole, Rod; Green, Steve; Jardin, Matt; Schwartz, Barry; Benjamin, Stan

    2000-01-01

    The performance of Air Traffic Management and flight deck decision support tools depends in large part on the accuracy of the supporting 4D trajectory predictions. This is particularly relevant to conflict prediction and active advisories for the resolution of conflicts and the conformance with of traffic-flow management flow-rate constraints (e.g., arrival metering / required time of arrival). Flight test results have indicated that wind prediction errors may represent the largest source of trajectory prediction error. The tests also discovered relatively large errors (e.g., greater than 20 knots), existing in pockets of space and time critical to ATM DST performance (one or more sectors, greater than 20 minutes), are inadequately represented by the classic RMS aggregate prediction-accuracy studies of the past. To facilitate the identification and reduction of DST-critical wind-prediction errors, NASA has lead a collaborative research and development activity with MIT Lincoln Laboratories and the Forecast Systems Lab of the National Oceanographic and Atmospheric Administration (NOAA). This activity, begun in 1996, has focussed on the development of key metrics for ATM DST performance, assessment of wind-prediction skill for state of the art systems, and development/validation of system enhancements to improve skill. A 13 month study was conducted for the Denver Center airspace in 1997. Two complementary wind-prediction systems were analyzed and compared to the forecast performance of the then standard 60 km Rapid Update Cycle - version 1 (RUC-1). One system, developed by NOAA, was the prototype 40-km RUC-2 that became operational at NCEP in 1999. RUC-2 introduced a faster cycle (1 hr vs. 3 hr) and improved mesoscale physics. The second system, Augmented Winds (AW), is a prototype en route wind application developed by MITLL based on the Integrated Terminal Wind System (ITWS). AW is run at a local facility (Center) level, and updates RUC predictions based on an

  19. Wind Prediction Accuracy for Air Traffic Management Decision Support Tools

    NASA Technical Reports Server (NTRS)

    Cole, Rod; Green, Steve; Jardin, Matt; Schwartz, Barry; Benjamin, Stan

    2000-01-01

    The performance of Air Traffic Management and flight deck decision support tools depends in large part on the accuracy of the supporting 4D trajectory predictions. This is particularly relevant to conflict prediction and active advisories for the resolution of conflicts and the conformance with of traffic-flow management flow-rate constraints (e.g., arrival metering / required time of arrival). Flight test results have indicated that wind prediction errors may represent the largest source of trajectory prediction error. The tests also discovered relatively large errors (e.g., greater than 20 knots), existing in pockets of space and time critical to ATM DST performance (one or more sectors, greater than 20 minutes), are inadequately represented by the classic RMS aggregate prediction-accuracy studies of the past. To facilitate the identification and reduction of DST-critical wind-prediction errors, NASA has lead a collaborative research and development activity with MIT Lincoln Laboratories and the Forecast Systems Lab of the National Oceanographic and Atmospheric Administration (NOAA). This activity, begun in 1996, has focussed on the development of key metrics for ATM DST performance, assessment of wind-prediction skill for state of the art systems, and development/validation of system enhancements to improve skill. A 13 month study was conducted for the Denver Center airspace in 1997. Two complementary wind-prediction systems were analyzed and compared to the forecast performance of the then standard 60 km Rapid Update Cycle - version 1 (RUC-1). One system, developed by NOAA, was the prototype 40-km RUC-2 that became operational at NCEP in 1999. RUC-2 introduced a faster cycle (1 hr vs. 3 hr) and improved mesoscale physics. The second system, Augmented Winds (AW), is a prototype en route wind application developed by MITLL based on the Integrated Terminal Wind System (ITWS). AW is run at a local facility (Center) level, and updates RUC predictions based on an

  20. Using ITP Decision Tools to Save Energy Now

    SciTech Connect

    Not Available

    2006-02-01

    This DOE Industrial Technologies Program fact sheet describes how the program's software tools and information help manufacturers save energy and money, increase productivity, and improve reliability.

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

    NASA Astrophysics Data System (ADS)

    Sutcliffe, Alistair; Al-Qaed, Faisal

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

  2. System and method for integrating hazard-based decision making tools and processes

    DOEpatents

    Hodgin, C Reed [Westminster, CO

    2012-03-20

    A system and method for inputting, analyzing, and disseminating information necessary for identified decision-makers to respond to emergency situations. This system and method provides consistency and integration among multiple groups, and may be used for both initial consequence-based decisions and follow-on consequence-based decisions. The system and method in a preferred embodiment also provides tools for accessing and manipulating information that are appropriate for each decision-maker, in order to achieve more reasoned and timely consequence-based decisions. The invention includes processes for designing and implementing a system or method for responding to emergency situations.

  3. In search of tools to aid logical thinking and communicating about medical decision making.

    PubMed

    Hunink, M G

    2001-01-01

    To have real-time impact on medical decision making, decision analysts need a wide variety of tools to aid logical thinking and communication. Decision models provide a formal framework to integrate evidence and values, but they are commonly perceived as complex and difficult to understand by those unfamiliar with the methods, especially in the context of clinical decision making. The theory of constraints, introduced by Eliyahu Goldratt in the business world, provides a set of tools for logical thinking and communication that could potentially be useful in medical decision making. The author used the concept of a conflict resolution diagram to analyze the decision to perform carotid endarterectomy prior to coronary artery bypass grafting in a patient with both symptomatic coronary and asymptomatic carotid artery disease. The method enabled clinicians to visualize and analyze the issues, identify and discuss the underlying assumptions, search for the best available evidence, and use the evidence to make a well-founded decision. The method also facilitated communication among those involved in the care of the patient. Techniques from fields other than decision analysis can potentially expand the repertoire of tools available to support medical decision making and to facilitate communication in decision consults.

  4. Framework for use of toxicity screening tools in context-based decision-making.

    PubMed

    Doull, John; Borzelleca, Joseph F; Becker, Richard; Daston, George; DeSesso, John; Fan, Anna; Fenner-Crisp, Penelope; Holsapple, Michael; Holson, Joseph; Craig Llewellyn, G; MacGregor, James; Seed, Jennifer; Walls, Isabel; Woo, Yin-tak; Olin, Stephen

    2007-05-01

    One of the principal applications of toxicology data is to inform risk assessments and support risk management decisions that are protective of human health. Ideally, a risk assessor would have available all of the relevant information on (a) the toxicity profile of the agent of interest; (b) its interactions with living systems; and (c) the known or projected exposure scenarios: to whom, how much, by which route(s), and how often. In practice, however, complete information is seldom available. Nonetheless, decisions still must be made. Screening-level assays and tools can provide support for many aspects of the risk assessment process, as long as the limitations of the tools are understood and to the extent that the added uncertainty the tools introduce into the process can be characterized and managed. Use of these tools for decision-making may be an end in itself for risk assessment and decision-making or a preliminary step to more extensive data collection and evaluation before assessments are undertaken or completed and risk management decisions made. This paper describes a framework for the application of screening tools for human health decision-making, although with some modest modification, it could be made applicable to environmental settings as well. The framework consists of problem formulation, development of a screening strategy based on an assessment of critical data needs, and a data analysis phase that employs weight-of-evidence criteria and uncertainty analyses, and leads to context-based decisions. Criteria for determining the appropriate screening tool(s) have been identified. The choice and use of the tool(s) will depend on the question and the level of uncertainty that may be appropriate for the context in which the decision is being made. The framework is iterative, in that users may refine the question(s) as they proceed. Several case studies illustrate how the framework may be used effectively to address specific questions for any endpoint

  5. Computer-based tools for decision support at the Hanford Site

    SciTech Connect

    Doctor, P.G.; Mahaffey, J.A.; Cowley, P.J.; Freshley, M.D.; Hassig, N.L.; Brothers, J.W.; Glantz, C.S.; Strachan, D.M.

    1992-11-01

    To help integrate activities in the environmental restoration and waste management mission of the Hanford Site, the Hanford Integrated Planning Project (HIPP) was established and funded by the US Department of Energy. The project is divided into three key program elements, the first focusing on an explicit, defensible and comprehensive method for evaluating technical options. Based on the premise that computer technology can be used to support the decision-making process and facilitate integration among programs and activities, the Decision Support Tools Task was charged with assessing the status of computer technology for those purposes at the Site. The task addressed two types of tools: tools need to provide technical information and management support tools. Technical tools include performance and risk assessment models, information management systems, data and the computer infrastructure to supports models, data, and information management systems. Management decision support tools are used to synthesize information at a high` level to assist with making decisions. The major conclusions resulting from the assessment are that there is much technical information available, but it is not reaching the decision-makers in a form to be used. Many existing tools provide components that are needed to integrate site activities; however, some components are missing and, more importantly, the ``glue`` or connections to tie the components together to answer decision-makers questions is largely absent. Top priority should be given to decision support tools that support activities given in the TPA. Other decision tools are needed to facilitate and support the environmental restoration and waste management mission.

  6. Computer-based tools for decision support at the Hanford Site

    SciTech Connect

    Doctor, P.G.; Mahaffey, J.A.; Cowley, P.J.; Freshley, M.D.; Hassig, N.L.; Brothers, J.W.; Glantz, C.S.; Strachan, D.M.

    1992-11-01

    To help integrate activities in the environmental restoration and waste management mission of the Hanford Site, the Hanford Integrated Planning Project (HIPP) was established and funded by the US Department of Energy. The project is divided into three key program elements, the first focusing on an explicit, defensible and comprehensive method for evaluating technical options. Based on the premise that computer technology can be used to support the decision-making process and facilitate integration among programs and activities, the Decision Support Tools Task was charged with assessing the status of computer technology for those purposes at the Site. The task addressed two types of tools: tools need to provide technical information and management support tools. Technical tools include performance and risk assessment models, information management systems, data and the computer infrastructure to supports models, data, and information management systems. Management decision support tools are used to synthesize information at a high' level to assist with making decisions. The major conclusions resulting from the assessment are that there is much technical information available, but it is not reaching the decision-makers in a form to be used. Many existing tools provide components that are needed to integrate site activities; however, some components are missing and, more importantly, the glue'' or connections to tie the components together to answer decision-makers questions is largely absent. Top priority should be given to decision support tools that support activities given in the TPA. Other decision tools are needed to facilitate and support the environmental restoration and waste management mission.

  7. A tool for corporate decision making about cognitive pharmaceutical services.

    PubMed

    Tipton, D J

    2001-01-01

    To present and discuss the models, theories, ideas, and frameworks that corporate decision makers would apply to the implementation of cognitive pharmaceutical services. Large chains and integrated delivery networks dominate the pharmacy marketplace. As a result, in many instances implementing cognitive pharmaceutical services, or expanding their delivery, first requires approval of a corporate decision maker, often not a pharmacist, who is schooled in marketing, management, and finance, and who necessarily views proposals for cognitive pharmaceutical services from those frames of reference. This article focuses on the following six marketing and management questions that corporate decision makers likely want answered before approving and funding the implementation of cognitive pharmaceutical services: (1) What is our product? (2) Who will pay, and what is the price? (3) Is there a market, and can it be reached? (4) What procedures must be put in place? (5) Who will deliver the service? (6) Where are the services to be delivered, and how is the facility to be presented? For a pharmacy manager charged with bringing cognitive pharmaceutical services to the marketplace, consideration of the issues detailed here meets a reasonable test of due diligence in committing human, financial, and organizational resources. It is natural for a pharmacist to look at cognitive pharmaceutical services through a professional lens. It is just as natural for a corporate decision marker to look at cognitive pharmaceutical services through a marketing and management lens. Unless both lenses are put together, one gets only half the picture.

  8. ENVIRONMENTAL FEATURE FINDER: A REMOTE SENSING DECISION SUPPORT TOOL

    EPA Science Inventory

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

  9. ENVIRONMENTAL FEATURE FINDER: A REMOTE SENSING DECISION SUPPORT TOOL

    EPA Science Inventory

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

  10. Data access and decision tools for coastal water resources management

    EPA Science Inventory

    US EPA has supported the development of numerous models and tools to support implementation of environmental regulations. However, transfer of knowledge and methods from detailed technical models to support practical problem solving by local communities and watershed or coastal ...

  11. Data access and decision tools for coastal water resources management

    EPA Science Inventory

    US EPA has supported the development of numerous models and tools to support implementation of environmental regulations. However, transfer of knowledge and methods from detailed technical models to support practical problem solving by local communities and watershed or coastal ...

  12. The Integrated Medical Model: A Decision Support Tool for In-flight Crew Health Care

    NASA Technical Reports Server (NTRS)

    Butler, Doug

    2009-01-01

    This viewgraph presentation reviews the development of an Integrated Medical Model (IMM) decision support tool for in-flight crew health care safety. Clinical methods, resources, and case scenarios are also addressed.

  13. Distance-Based and Distributed Learning: A Decision Tool for Education Leaders.

    ERIC Educational Resources Information Center

    McGraw, Tammy M.; Ross, John D.

    This decision tool presents a progression of data collection and decision-making strategies that can increase the effectiveness of distance-based or distributed learning instruction. A narrative and flow chart cover the following steps: (1) basic assumptions, including purpose of instruction, market scan, and financial resources; (2) needs…

  14. Assessing Sustainability of Coral Reef Ecosystem Services using a Spatially-Explicit Decision Support Tool

    EPA Science Inventory

    Forecasting and communicating the potential outcomes of decision options requires support tools that aid in evaluating alternative scenarios in a user-friendly context and that highlight variables relevant to the decision options and valuable stakeholders. Envision is a GIS-base...

  15. ACED IT: A Tool for Improved Ethical and Moral Decision-Making

    ERIC Educational Resources Information Center

    Kreitler, Crystal Mata; Stenmark, Cheryl K.; Rodarte, Allen M.; Piñón DuMond, Rebecca

    2014-01-01

    Numerous examples of unethical organizational decision-making highlighted in the media have led many to question the general moral perception and ethical judgments of individuals. The present study examined two forms of a straightforward ethical decision-making (EDM) tool (ACED IT cognitive map) that could be a relatively simple instrument for…

  16. Linking climate change and fish conservation efforts using spatially explicit decision support tools

    Treesearch

    Douglas P. Peterson; Seth J. Wenger; Bruce E. Rieman; Daniel J. Isaak

    2013-01-01

    Fisheries professionals are increasingly tasked with incorporating climate change projections into their decisions. Here we demonstrate how a structured decision framework, coupled with analytical tools and spatial data sets, can help integrate climate and biological information to evaluate management alternatives. We present examples that link downscaled climate...

  17. ACED IT: A Tool for Improved Ethical and Moral Decision-Making

    ERIC Educational Resources Information Center

    Kreitler, Crystal Mata; Stenmark, Cheryl K.; Rodarte, Allen M.; Piñón DuMond, Rebecca

    2014-01-01

    Numerous examples of unethical organizational decision-making highlighted in the media have led many to question the general moral perception and ethical judgments of individuals. The present study examined two forms of a straightforward ethical decision-making (EDM) tool (ACED IT cognitive map) that could be a relatively simple instrument for…

  18. Assessing Sustainability of Coral Reef Ecosystem Services using a Spatially-Explicit Decision Support Tool

    EPA Science Inventory

    Forecasting and communicating the potential outcomes of decision options requires support tools that aid in evaluating alternative scenarios in a user-friendly context and that highlight variables relevant to the decision options and valuable stakeholders. Envision is a GIS-base...

  19. A Web-Based Tool to Support Data-Based Early Intervention Decision Making

    ERIC Educational Resources Information Center

    Buzhardt, Jay; Greenwood, Charles; Walker, Dale; Carta, Judith; Terry, Barbara; Garrett, Matthew

    2010-01-01

    Progress monitoring and data-based intervention decision making have become key components of providing evidence-based early childhood special education services. Unfortunately, there is a lack of tools to support early childhood service providers' decision-making efforts. The authors describe a Web-based system that guides service providers…

  20. A Web-Based Tool to Support Data-Based Early Intervention Decision Making

    ERIC Educational Resources Information Center

    Buzhardt, Jay; Greenwood, Charles; Walker, Dale; Carta, Judith; Terry, Barbara; Garrett, Matthew

    2010-01-01

    Progress monitoring and data-based intervention decision making have become key components of providing evidence-based early childhood special education services. Unfortunately, there is a lack of tools to support early childhood service providers' decision-making efforts. The authors describe a Web-based system that guides service providers…

  1. A new tool for analysis of cleanup criteria decisions.

    SciTech Connect

    Klemic, G. A.; Bailey, P.; Elcock, D.; Environmental Assessment; USDOE

    2003-08-01

    Radionuclides and other hazardous materials resulting from processes used in nuclear weapons production contaminate soil, groundwater, and buildings around the United States. Cleanup criteria for environmental contaminants are agreed on prior to remediation and underpin the scope and legacy of the cleanup process. Analysis of cleanup criteria can be relevant for future agreements and may also provide insight into a complex decision making process where science and policy issues converge. An Internet accessible database has been established to summarize cleanup criteria and related factors involved in U.S. Department of Energy remediation decisions. This paper reports on a new user interface for the database that is designed to integrate related information into graphic displays and tables with interactive features that allow exploratory data analysis of cleanup criteria. Analysis of 137Cs in surface soil is presented as an example.

  2. A Decision Analysis Tool for the Source Selection Process

    DTIC Science & Technology

    2006-03-01

    contractor for the Air Force. The rational for this type of source selection is based on the guidelines of a Lowest Priced Technically Acceptable...casual empiricism (Weir, 2005; Kirkwood, 1997). This method is usually accomplished by holding large group sessions. The groups will consist of... rational of a decision under the current process is extremely difficult without quantifying numbers – VFT provides quantifying results and clearly

  3. Decision Analysis Tool to Compare Energy Pathways for Transportation

    SciTech Connect

    Bloyd, Cary N.; Stork, Kevin

    2011-02-01

    With the goals of reducing greenhouse gas emissions, oil imports, and energy costs, a wide variety of automotive technologies are proposed to replace the traditional gasoline-powered internal combustion engine (g-ICE). A prototype model, Analytica Transportation Energy Analysis Model (ATEAM), has been developed using the Analytica decision modeling environment, visualizing the structure as a hierarchy of influence diagrams. The report summarized the FY2010 ATEAM accomplishments.

  4. Evaluating clinical decision support tools for medication administration safety in a simulated environment.

    PubMed

    Moss, Jacqueline; Berner, Eta S

    2015-05-01

    The specific aims of this study were to develop a methodology and tools for the design of clinical decision support systems to decrease the incidence of medication administration errors. A mixed-methods design was utilized in this study. First, observations of medication administration practice were used to inform the design of a simulated information system with a variety of decision support tools. Then, nurses were observed administering medications in a simulated environment using the simulated system. Finally, the nurses participated in focus groups to provide input into system tools design. Observations of nurses' use of the decision support tools as well as semi-structured focus groups were used to evaluate nurses' use and perceptions of the utility of the system decision support tools. Nurses' evaluation of the medication administration decision support tools as well as their actual performance revealed a tendency to underestimate their need for support. Their preferences were for decision support that was short, color coded, and easily accessed. Observations of medication administration showed that nurses exhibit a variety of work processes to prepare and administer medications to patients and access system decision support tools at a variety of points in this process. System design should allow flexibility of multiple points and types of information delivery to accommodate variations in workflow to minimize the tendency for system workarounds. This study was performed in one hospital and results may not generalize beyond this setting. However, this method used to design and test decision support could be transferred to other settings. Using simulation in this study provided a method for testing new information system design, related to a potentially dangerous procedure, in a manner that eliminated the hazards of potential unintended consequences for patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. THE COATINGS GUIDE: AN INTEGRATED TOOL FOR COATINGS DECISIONS

    EPA Science Inventory

    The Coatings Guide, formerly known as the Coatings Alternative Guide (CAGE), is a free Internet pollution prevention tool designed to help small-business coaters of metal and plastic substrates identify alternatives as potential drop-in replacements for existing operations. As sh...

  6. Doing Academic Planning: Effective Tools for Decision Making.

    ERIC Educational Resources Information Center

    Nedwek, Brian P., Ed.

    This sourcebook was designed to provide academic planners with the tools to perform core functions and activities that facilitate the transformation of higher education institutions from provider-centered cultures and organizations to learner-centered franchises. The readings examine partnerships and alliances needed for higher education to…

  7. THE COATINGS GUIDE: AN INTEGRATED TOOL FOR COATINGS DECISIONS

    EPA Science Inventory

    The Coatings Guide, formerly known as the Coatings Alternative Guide (CAGE), is a free Internet pollution prevention tool designed to help small-business coaters of metal and plastic substrates identify alternatives as potential drop-in replacements for existing operations. As sh...

  8. Interrogating cellular perception and decision making with optogenetic tools

    PubMed Central

    Bugaj, Lukasz J.; O’Donoghue, Geoff P.

    2017-01-01

    Optogenetics promises to deepen our understanding of how cells perceive and respond to complex and dynamic signals and how this perception regulates normal and abnormal function. In this study, we present our vision for how these nascent tools may transform our view of fundamental cell biological processes. PMID:28003330

  9. Developing shape analysis tools to assist complex spatial decision making

    SciTech Connect

    Mackey, H.E.; Ehler, G.B.; Cowen, D.

    1996-05-31

    The objective of this research was to develop and implement a shape identification measure within a geographic information system, specifically one that incorporates analytical modeling for site location planning. The application that was developed incorporated a location model within a raster-based GIS, which helped address critical performance issues for the decision support system. Binary matrices, which approximate the object`s geometrical form, are passed over the grided data structure and allow identification of irregular and regularly shaped objects. Lastly, the issue of shape rotation is addressed and is resolved by constructing unique matrices corresponding to the object`s orientation

  10. Use of decision support systems as a drought management tool

    USGS Publications Warehouse

    Frevert, D.; Lins, H.; ,

    2005-01-01

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  17. 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.

  18. The utility of clinical decision tools for diagnosing osteoporosis in postmenopausal women with rheumatoid arthritis.

    PubMed

    Brand, Caroline; Lowe, Adrian; Hall, Stephen

    2008-01-29

    Patients with rheumatoid arthritis have a higher risk of low bone mineral density than normal age matched populations. There is limited evidence to support cost effectiveness of population screening in rheumatoid arthritis and case finding strategies have been proposed as a means to increase cost effectiveness of diagnostic screening for osteoporosis. This study aimed to assess the performance attributes of generic and rheumatoid arthritis specific clinical decision tools for diagnosing osteoporosis in a postmenopausal population with rheumatoid arthritis who attend ambulatory specialist rheumatology clinics. A cross-sectional study of 127 ambulatory post-menopausal women with rheumatoid arthritis was performed. Patients currently receiving or who had previously received bone active therapy were excluded. Eligible women underwent clinical assessment and dual-energy-xray absorptiometry (DXA) bone mineral density assessment. Clinical decision tools, including those specific for rheumatoid arthritis, were compared to seven generic post-menopausal tools to predict osteoporosis (defined as T score < -2.5). Sensitivity, specificity, positive predictive and negative predictive values and area under the curve were assessed. The diagnostic attributes of the clinical decision tools were compared by examination of the area under the receiver-operator-curve. One hundred and twenty seven women participated. The median age was 62 (IQR 56-71) years. Median disease duration was 108 (60-168) months. Seventy two (57%) women had no record of a previous DXA examination. Eighty (63%) women had T scores at femoral neck or lumbar spine less than -1. The area under the ROC curve for clinical decision tool prediction of T score <-2.5 varied between 0.63 and 0.76. The rheumatoid arthritis specific decision tools did not perform better than generic tools, however, the National Osteoporosis Foundation score could potentially reduce the number of unnecessary DXA tests by approximately 45% in

  19. Energy Signal Tool for Decision Support in Building Energy Systems

    SciTech Connect

    Henze, G. P.; Pavlak, G. S.; Florita, A. R.; Dodier, R. H.; Hirsch, A. I.

    2014-12-01

    A prototype energy signal tool is demonstrated for operational whole-building and system-level energy use evaluation. The purpose of the tool is to give a summary of building energy use which allows a building operator to quickly distinguish normal and abnormal energy use. Toward that end, energy use status is displayed as a traffic light, which is a visual metaphor for energy use that is either substantially different from expected (red and yellow lights) or approximately the same as expected (green light). Which light to display for a given energy end use is determined by comparing expected to actual energy use. As expected, energy use is necessarily uncertain; we cannot choose the appropriate light with certainty. Instead, the energy signal tool chooses the light by minimizing the expected cost of displaying the wrong light. The expected energy use is represented by a probability distribution. Energy use is modeled by a low-order lumped parameter model. Uncertainty in energy use is quantified by a Monte Carlo exploration of the influence of model parameters on energy use. Distributions over model parameters are updated over time via Bayes' theorem. The simulation study was devised to assess whole-building energy signal accuracy in the presence of uncertainty and faults at the submetered level, which may lead to tradeoffs at the whole-building level that are not detectable without submetering.

  20. Risk-based Spacecraft Fire Safety Experiments

    NASA Technical Reports Server (NTRS)

    Apostolakis, G.; Catton, I.; Issacci, F.; Paulos, T.; Jones, S.; Paxton, K.; Paul, M.

    1992-01-01

    Viewgraphs on risk-based spacecraft fire safety experiments are presented. Spacecraft fire risk can never be reduced to a zero probability. Probabilistic risk assessment is a tool to reduce risk to an acceptable level.

  1. Developing a Decision Support Tool for Waste to Energy Calculations Using Energy Return on Investment

    DTIC Science & Technology

    2016-12-01

    DECISION SUPPORT TOOL FOR WASTE-TO- ENERGY CALCULATIONS USING ENERGY RETURN ON INVESTMENT by Adam C. Haag December 2016 Thesis Advisor...SUPPORT TOOL FOR WASTE-TO- ENERGY CALCULATIONS USING ENERGY RETURN ON INVESTMENT 5. FUNDING NUMBERS 6. AUTHOR(S) Adam C. Haag 7. PERFORMING...economic viability of sites for waste-to- energy technologies, mirroring the current tool’s capabilities and expanding its use. This tool returns

  2. Enhancement of LEEDS Decision Tools for E-Craft

    DTIC Science & Technology

    2012-03-13

    Manager (ONR 33X) ONR Office ofNaval Research 875 North Randolph Street 11. SPONSOR/MONITOR’S REPORT Arlington, VA 22203-1995 NUMBERIS) Ref: N00014-07-M...13, 2012 Prepared for: Office of Naval Research Award No. N00014-07-M-0127 March 13, 2012 Systems Modernization and Sustainment...Architecture of a Context‐based Diagnostic Tool  Due to lack of support and interest from the E-Craft team, research efforts were redirected toward the

  3. Sea Level Rise Decision Support Tools for Adaptation Planning in Vulnerable Coastal Communities

    NASA Astrophysics Data System (ADS)

    Rozum, J. S.; Marcy, D.

    2015-12-01

    NOAA is involved in a myriad of climate related research and projects that help decision makers and the public understand climate science as well as climate change impacts. The NOAA Office for Coastal Management (OCM) provides data, tools, trainings and technical assistance to coastal resource managers. Beginning in 2011, NOAA OCM began developing a sea level rise and coastal flooding impacts viewer which provides nationally consistent data sets and analyses to help communities with coastal management goals such as: understanding and communicating coastal flood hazards, performing vulnerability assessments and increasing coastal resilience, and prioritizing actions for different inundation/flooding scenarios. The Viewer is available on NOAA's Digital Coast platform: (coast.noaa.gov/ditgitalcoast/tools/slr). In this presentation we will share the lessons learned from our work with coastal decision-makers on the role of coastal flood risk data and tools in helping to shape future land use decisions and policies. We will also focus on a recent effort in California to help users understand the similarities and differences of a growing array of sea level rise decision support tools. NOAA staff and other partners convened a workshop entitled, "Lifting the Fog: Bringing Clarity to Sea Level Rise and Shoreline Change Models and Tools," which was attended by tool develops, science translators and coastal managers with the goal to create a collaborative communication framework to help California coastal decision-makers navigate the range of available sea level rise planning tools, and to inform tool developers of future planning needs. A sea level rise tools comparison matrix will be demonstrated. This matrix was developed as part of this effort and has been expanded to many other states via a partnership with NOAA, Climate Central, and The Nature Conservancy.

  4. Augmented cognition tool for rapid military decision making.

    SciTech Connect

    Taylor, Shawn Ellis; Bernard, Michael Lewis; Verzi, Stephen J.; Dubicka, Irene; Vineyard, Craig Michael

    2011-10-01

    This report describes the laboratory directed research and development work to model relevant areas of the brain that associate multi-modal information for long-term storage for the purpose of creating a more effective, and more automated, association mechanism to support rapid decision making. Using the biology and functionality of the hippocampus as an analogy or inspiration, we have developed an artificial neural network architecture to associate k-tuples (paired associates) of multimodal input records. The architecture is composed of coupled unimodal self-organizing neural modules that learn generalizations of unimodal components of the input record. Cross modal associations, stored as a higher-order tensor, are learned incrementally as these generalizations form. Graph algorithms are then applied to the tensor to extract multi-modal association networks formed during learning. Doing so yields a novel approach to data mining for knowledge discovery. This report describes the neurobiological inspiration, architecture, and operational characteristics of our model, and also provides a real world terrorist network example to illustrate the model's functionality.

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

    PubMed

    Cabrera, V E

    2017-07-18

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

  6. DECIDE: a Decision Support Tool to Facilitate Parents' Choices Regarding Genome-Wide Sequencing.

    PubMed

    Birch, Patricia; Adam, S; Bansback, N; Coe, R R; Hicklin, J; Lehman, A; Li, K C; Friedman, J M

    2016-12-01

    We describe the rationale, development, and usability testing for an integrated e-learning tool and decision aid for parents facing decisions about genome-wide sequencing (GWS) for their children with a suspected genetic condition. The online tool, DECIDE, is designed to provide decision-support and to promote high quality decisions about undergoing GWS with or without return of optional incidental finding results. DECIDE works by integrating educational material with decision aids. Users may tailor their learning by controlling both the amount of information and its format - text and diagrams and/or short videos. The decision aid guides users to weigh the importance of various relevant factors in their own lives and circumstances. After considering the pros and cons of GWS and return of incidental findings, DECIDE summarizes the user's responses and apparent preferred choices. In a usability study of 16 parents who had already chosen GWS after conventional genetic counselling, all participants found DECIDE to be helpful. Many would have been satisfied to use it alone to guide their GWS decisions, but most would prefer to have the option of consulting a health care professional as well to aid their decision. Further testing is necessary to establish the effectiveness of using DECIDE as an adjunct to or instead of conventional pre-test genetic counselling for clinical genome-wide sequencing.

  7. Decision-support tools for the assessment process

    SciTech Connect

    Whelan, Gene; Pelton, Mitch A.; Dorow, Kevin E.

    2004-06-14

    A new software system is under development that provides a framework to link disparate assessment software and databases for site-specific, regional, or national analyses. This system represents the merger of the Framework for Risk Analysis in Multimedia Environmental Systems (FRAMES), which performs site-specific assessments, and Multi-media, Multi-pathway, Multi-receptor Risk Assessment (3MRA) methodology, which performs regional and national assessments. This Merged System is an icon-driven, site-layout platform, which represents an interactive means by which the user graphically constructs a conceptualization of the problem by visually expressing the assessment, indicating sources of contamination, contaminant travel pathways through the environment, linkages between contamination and people or wildlife, and impacts associated with the contamination. It processes data as part of a systems-based assessment and is an open-architecture, object-oriented framework, which contains ''sockets'' for a collection of databases and computer codes that will transparently simulate elements of transport, exposure, and risk assessment, including contaminant source and release to and through overland soils, vadose and saturated zones, air, surface water, food supply, intake human health impacts, sensitivity/uncertainty, ecological impacts, with the ability to expand into areas including Geographical Information System (GIS), remediation technology, cost analysis, Data Quality Objectives, life-cycle management, and conceptual site design. A user can choose from a list of models, and the assessment path forward can be visually presented, which describes the models and their linkages from source through receptor to the decision-making endpoint.

  8. Designing a Graphical Decision Support Tool to Improve System Acquisition Decisions

    DTIC Science & Technology

    2009-06-01

    acquisition decision through the Internet . It also allows organizations to search for buyers or sellers of systems. It has been identified that the...following things : ♦ Be equipped with an adjustable head-mounted eye tracker. The eye tracker will be explained and calibrated. ♦ Complete a baseline...p. 47-62. 7. Mukhopadhyay, T. and S. Kekre, Strategic and Operational Benefits of Electronic Integration in B2B Procurement Processes. Management

  9. Data access and decision tools for coastal water resources ...

    EPA Pesticide Factsheets

    US EPA has supported the development of numerous models and tools to support implementation of environmental regulations. However, transfer of knowledge and methods from detailed technical models to support practical problem solving by local communities and watershed or coastal management organizations remains a challenge. We have developed the Estuary Data Mapper (EDM) to facilitate data discovery, visualization and access to support environmental problem solving for coastal watersheds and estuaries. EDM is a stand-alone application based on open-source software which requires only internet access for operation. Initially, development of EDM focused on delivery of raw data streams from distributed web services, ranging from atmospheric deposition to hydrologic, tidal, and water quality time series, estuarine habitat characteristics, and remote sensing products. We have transitioned to include access to value-added products which provide end-users with results of future scenario analysis, facilitate extension of models across geographic regions, and/or promote model interoperability. Here we present three examples: 1) the delivery of input data for the development of seagrass models across estuaries, 2) scenarios illustrating the implications of riparian buffer management (loss or restoration) for stream thermal regimes and fish communities, and 3) access to hydrology model outputs to foster connections across models at different scales, ultimately feeding

  10. Operational level decision aids with LG-based tools

    NASA Astrophysics Data System (ADS)

    Stilman, Boris; Yakhnis, Vladimir; Umanskiy, Oleg; Hearing, John

    2002-07-01

    The LG approach permits a game representation of the Engagement Theater in two modes, called the planning mode and the execution mode. The planning mode assumes that the computations are to be performed well before the actual engagement and thus a sophisticated (but slower) planning component of the LG hypergame is to be activated. On the planning stage, the emphasis is on the following. 1) distributing the battlefield resources to optimize some battlefield related criteria. Important optimization criteria are battlefield related, ones such as probabilities to achieve desired ends and survivability of the friendly forces; 2) developing of preliminary strategies for the commander to achieve certain desired end; 3) playing several what if situations to develop alternative strategies. Whereas the COA options for the resource distribution game could influence the COA options for selection of the preliminary and alternative strategies, the strategies are used to validate the effectiveness of the resource distribution, thus creating a feedback loop tying together the resources and battlefield actions. On the execution stage, the emphasis is on protecting the commander from possible errors caused by the information blizzard. The commander could have so many things on his/her mind that some negative consequences of a COA being decided upon may be overlooked. A faster execution version of the LG-based tool is intended to catch the undesired consequence and warn the commander.

  11. A knowledge authoring tool for clinical decision support.

    PubMed

    Dunsmuir, Dustin; Daniels, Jeremy; Brouse, Christopher; Ford, Simon; Ansermino, J Mark

    2008-06-01

    Anesthesiologists in the operating room are unable to constantly monitor all data generated by physiological monitors. They are further distracted by clinical and educational tasks. An expert system would ideally provide assistance to the anesthesiologist in this data-rich environment. Clinical monitoring expert systems have not been widely adopted, as traditional methods of knowledge encoding require both expert medical and programming skills, making knowledge acquisition difficult. A software application was developed for use as a knowledge authoring tool for physiological monitoring. This application enables clinicians to create knowledge rules without the need of a knowledge engineer or programmer. These rules are designed to provide clinical diagnosis, explanations and treatment advice for optimal patient care to the clinician in real time. By intelligently combining data from physiological monitors and demographical data sources the expert system can use these rules to assist in monitoring the patient. The knowledge authoring process is simplified by limiting connective relationships between rules. The application is designed to allow open collaboration between communities of clinicians to build a library of rules for clinical use. This design provides clinicians with a system for parameter surveillance and expert advice with a transparent pathway of reasoning. A usability evaluation demonstrated that anesthesiologists can rapidly develop useful rules for use in a predefined clinical scenario.

  12. Data access and decision tools for coastal water resources ...

    EPA Pesticide Factsheets

    US EPA has supported the development of numerous models and tools to support implementation of environmental regulations. However, transfer of knowledge and methods from detailed technical models to support practical problem solving by local communities and watershed or coastal management organizations remains a challenge. We have developed the Estuary Data Mapper (EDM) to facilitate data discovery, visualization and access to support environmental problem solving for coastal watersheds and estuaries. EDM is a stand-alone application based on open-source software which requires only internet access for operation. Initially, development of EDM focused on delivery of raw data streams from distributed web services, ranging from atmospheric deposition to hydrologic, tidal, and water quality time series, estuarine habitat characteristics, and remote sensing products. We have transitioned to include access to value-added products which provide end-users with results of future scenario analysis, facilitate extension of models across geographic regions, and/or promote model interoperability. Here we present three examples: 1) the delivery of input data for the development of seagrass models across estuaries, 2) scenarios illustrating the implications of riparian buffer management (loss or restoration) for stream thermal regimes and fish communities, and 3) access to hydrology model outputs to foster connections across models at different scales, ultimately feeding

  13. DeTMan: A Decision Tree Management Tool for the Web and PDA Environments

    PubMed Central

    Lindquist, Michael; Afrin, Lawrence B.; Norcross, E. Douglas

    2003-01-01

    Illness management protocols, often represented as decision trees, are used in many areas of medicine. Some clinical departments maintain numerous, often quite complex protocols. Protocol access in acute care situations can be challenging, especially when available only in hardcopy format. Access via the web and especially via personal digital assistants would be more helpful. In the absence of the prior availability of a general purpose web/PDA decision tree editor/ navigator, we are developing such a tool. PMID:14728421

  14. Testing an Irrigation Decision Support Tool for California Specialty Crops

    NASA Astrophysics Data System (ADS)

    Johnson, L.; Cahn, M.; Benzen, S.; Zaragoza, I.; Murphy, L.; Melton, F. S.; Martin, F.; Quackenbush, A.; Lockhart, T.

    2015-12-01

    Estimation of crop evapotranspiration supports efficiency of irrigation water management, which in turn can mitigate nitrate leaching, groundwater depletion, and provide energy savings. Past research in California and elsewhere has revealed strong relationships between photosynthetically active vegetation fraction (Fc) and crop evapotranspiration (ETc). Additional research has shown the potential of monitoring Fc by satellite remote sensing. The U.C. Cooperative Extension developed and operates CropManage (CM) as on-line database irrigation (and nitrogen) scheduling tool. CM accounts for the rapid growth and typically brief cycle of cool-season vegetables, where Fc and fraction of reference ET can change daily during canopy development. The model automates crop water requirement calculations based on reference ET data collected by California Dept. Water Resources. Empirically-derived equations are used to estimate daily Fc time-series for a given crop type primarily as a function of planting date and expected harvest date. An application programming interface (API) is under development to provide a check on modeled Fc of current crops and facilitate CM expansion to new crops. The API will enable CM to extract field scale Fc observations from NASA's Satellite Irrigation Management Support (SIMS). SIMS is mainly Landsat based and currently monitors Fc over about 8 million irrigation acres statewide, with potential for adding data from ESA/Sentinel for improved temporal resolution. In the current study, a replicated irrigation trial was performed on romaine lettuce at the USDA Agricultural Research Station in Salinas, CA. CropManage recommendations were used to guide water treatments by drip irrigation at 50%, 75%, 100% ETc replacement levels, with an added treatment at 150% ET representing grower standard practice. Experimental results indicate that yields from the 100% and 150% treatments were not significantly different and were in-line with industry average, while

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    2016-01-01

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

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

    PubMed

    Mathew, Joseph L

    2011-04-01

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

  18. Studying lineage decision-making in vitro: emerging concepts and novel tools.

    PubMed

    Semrau, Stefan; van Oudenaarden, Alexander

    2015-01-01

    Correct and timely lineage decisions are critical for normal embryonic development and homeostasis of adult tissues. Therefore, the search for fundamental principles that underlie lineage decision-making lies at the heart of developmental biology. Here, we review attempts to understand lineage decision-making as the interplay of single-cell heterogeneity and gene regulation. Fluctuations at the single-cell level are an important driving force behind cell-state transitions and the creation of cell-type diversity. Gene regulatory networks amplify such fluctuations and define stable cell types. They also mediate the influence of signaling inputs on the lineage decision. In this review, we focus on insights gleaned from in vitro differentiation of embryonic stem cells. We discuss emerging concepts, with an emphasis on transcriptional regulation, dynamical aspects of differentiation, and functional single-cell heterogeneity. We also highlight some novel tools to study lineage decision-making in vitro.

  19. An analytic decision support tool for resident allocation.

    PubMed

    Talay-Değirmenci, Işılay; Holmes, Casey J; Kuo, Paul C; Jennings, Otis B

    2013-01-01

    Moving residents through an academic residency program is complicated by a number of factors. Across all residency programs the percentage of residents that leave for any reason is between 3.4% and 3.8%.(1) There are a number of residents that participate in research. To avoid discrepancies in the number of residents at the all levels, programs must either limit the number of residents that go into the lab, the number that return to clinical duties, or the number of interns to hire. Traditionally this process consists of random selection and trial and error with names on magnetic strips moved around a board. With the matrix that we have developed this process is optimized and aided by a Microsoft Excel macro (Microsoft Corp, Redmond, Washington). We suggest that a residency program would have the same number of residents at each residency stage of clinical practice, as well as a steady number of residents at each research stage. The program consists of 2 phases, in the first phase, an Excel sheet called the "Brain Sheet," there are simple formulas that we have prepared to determine the number of interns to recruit, residents in the research phase, and residents that advance to the next stage of training. The second phase of the program, the macro, then takes the list of current resident names along with the residency level they are in, and according to the formulas allocates them to the relevant stages for future years, creating a resident matrix. Our macro for resident allocation would maximize the time of residency program administrators by simplifying the movement of residents through the program. It would also provide a tool for planning the number of new interns to recruit and program expansion. The application of our macro illustrates that analytical techniques can be used to minimize the time spent and avoid the trial and error while planning resident movement in a program. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier

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

    PubMed

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

    2016-08-26

    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. Descriptive analysis of all Choosing Wisely Canada patient materials. In May 2015, we selected all Choosing Wisely Canada patient materials from its official website. 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. 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  1. 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

  2. User Acceptance of a Software Tool for Decision Making in IT Outsourcing: A Qualitative Study in Large Companies from Sweden

    NASA Astrophysics Data System (ADS)

    Andresen, Christoffer; Hodosi, Georg; Saprykina, Irina; Rusu, Lazar

    Decisions for IT outsourcing are very complex and needs to be supported by considerations based on many (multiple) criteria. In order to facilitate the use of a specific tool by a decision-maker in IT outsourcing, we need to find out whether such a tool for this purpose will be accepted or rejected or what improvements must be added to this tool to be accepted by some IT decision makers in large companies from Sweden.

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

    PubMed

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

    2012-01-01

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

  4. The utility of clinical decision tools for diagnosing osteoporosis in postmenopausal women with rheumatoid arthritis

    PubMed Central

    Brand, Caroline; Lowe, Adrian; Hall, Stephen

    2008-01-01

    Background Patients with rheumatoid arthritis have a higher risk of low bone mineral density than normal age matched populations. There is limited evidence to support cost effectiveness of population screening in rheumatoid arthritis and case finding strategies have been proposed as a means to increase cost effectiveness of diagnostic screening for osteoporosis. This study aimed to assess the performance attributes of generic and rheumatoid arthritis specific clinical decision tools for diagnosing osteoporosis in a postmenopausal population with rheumatoid arthritis who attend ambulatory specialist rheumatology clinics. Methods A cross-sectional study of 127 ambulatory post-menopausal women with rheumatoid arthritis was performed. Patients currently receiving or who had previously received bone active therapy were excluded. Eligible women underwent clinical assessment and dual-energy-xray absorptiometry (DXA) bone mineral density assessment. Clinical decision tools, including those specific for rheumatoid arthritis, were compared to seven generic post-menopausal tools to predict osteoporosis (defined as T score < -2.5). Sensitivity, specificity, positive predictive and negative predictive values and area under the curve were assessed. The diagnostic attributes of the clinical decision tools were compared by examination of the area under the receiver-operator-curve. Results One hundred and twenty seven women participated. The median age was 62 (IQR 56–71) years. Median disease duration was 108 (60–168) months. Seventy two (57%) women had no record of a previous DXA examination. Eighty (63%) women had T scores at femoral neck or lumbar spine less than -1. The area under the ROC curve for clinical decision tool prediction of T score <-2.5 varied between 0.63 and 0.76. The rheumatoid arthritis specific decision tools did not perform better than generic tools, however, the National Osteoporosis Foundation score could potentially reduce the number of unnecessary DXA

  5. CorRECTreatment: A Web-based Decision Support Tool for Rectal Cancer Treatment that Uses the Analytic Hierarchy Process and Decision Tree

    PubMed Central

    Karakülah, G.; Dicle, O.; Sökmen, S.; Çelikoğlu, C.C.

    2015-01-01

    Summary Background The selection of appropriate rectal cancer treatment is a complex multi-criteria decision making process, in which clinical decision support systems might be used to assist and enrich physicians’ decision making. Objective The objective of the study was to develop a web-based clinical decision support tool for physicians in the selection of potentially beneficial treatment options for patients with rectal cancer. Methods The updated decision model contained 8 and 10 criteria in the first and second steps respectively. The decision support model, developed in our previous study by combining the Analytic Hierarchy Process (AHP) method which determines the priority of criteria and decision tree that formed using these priorities, was updated and applied to 388 patients data collected retrospectively. Later, a web-based decision support tool named corRECTreatment was developed. The compatibility of the treatment recommendations by the expert opinion and the decision support tool was examined for its consistency. Two surgeons were requested to recommend a treatment and an overall survival value for the treatment among 20 different cases that we selected and turned into a scenario among the most common and rare treatment options in the patient data set. Results In the AHP analyses of the criteria, it was found that the matrices, generated for both decision steps, were consistent (consistency ratio<0.1). Depending on the decisions of experts, the consistency value for the most frequent cases was found to be 80% for the first decision step and 100% for the second decision step. Similarly, for rare cases consistency was 50% for the first decision step and 80% for the second decision step. Conclusions The decision model and corRECTreatment, developed by applying these on real patient data, are expected to provide potential users with decision support in rectal cancer treatment processes and facilitate them in making projections about treatment options

  6. End of Asset Life Reinvestment Decision Support Tool (INFR2R11AT)

    EPA Science Inventory

    This “End of Asset Life” Reinvestment Decision-Support Tool is intended as a step by step guide for the asset management practitioner who faces the challenge of developing an investment strategy that represents the best integration of maintenance, operations, and capital investme...

  7. DEVELOPMENT OF PROTOCOLS AND DECISION SUPPORT TOOLS FOR ASSESSING WATERSHED SYSTEM ASSIMILATIVE

    EPA Science Inventory

    Investigations are underway on Lake Texoma, a Corps of Engineers lake on the Oklahoma/Texas border, to develop decision support tools and information to evaluate the transport and attenuation of contaminants and stressors in a lake ecosystem, and link them to observable ecologica...

  8. An Engineering Educator's Decision Support Tool for Improving Innovation in Student Design Projects

    ERIC Educational Resources Information Center

    Ozaltin, Nur Ozge; Besterfield-Sacre, Mary; Clark, Renee M.

    2015-01-01

    Learning how to design innovatively is a critical process skill for undergraduate engineers in the 21st century. To this end, our paper discusses the development and validation of a Bayesian network decision support tool that can be used by engineering educators to make recommendations that positively impact the innovativeness of product designs.…

  9. Integrating forest stand projections with wildlife occupancy models to develop a decision support tool

    Treesearch

    Michelle F. Tacconelli; Edward F. Loewenstein

    2012-01-01

    Natural resource managers must often balance multiple objectives on a single property. When these objectives are seemingly conflicting, the manager’s job can be extremely difficult and complex. This paper presents a decision support tool, designed to aid land managers in optimizing wildlife habitat needs while accomplishing additional objectives such as ecosystem...

  10. "Budget impact analyses": a practical policy making tool for drug reimbursement decisions.

    PubMed

    Jamshidi, Hamid Reza; Foroutan, Naghmeh; Salamzadeh, Jamshid

    2014-01-01

    In the present article, Budget Impact Analysis as an effective, practical financial tool has been introduced to the policy makers for improving drug formulary and reimbursement decision making. In Iran, Ministry of Health (MOH), health insurance organizations, and health care providers such as hospitals could take the most advantage of the BIAs reports.

  11. Decision Support Tool For Optimizing Best Management Practices In The US Corn Belt

    USDA-ARS?s Scientific Manuscript database

    Direct measurements combined with system modeling are used to estimate the impacts of management practices on crop yields and soil organic carbon (SOC). We developed a decision support tool that integrates the Environmental Policy Integrated Climate (EPIC) model with soil, climate, land use, and man...

  12. Decision-Support Tools and Databases to Inform Regional Stormwater Utility Development in New England

    EPA Science Inventory

    Development of stormwater utilities requires information on existing stormwater infrastructure and impervious cover as well as costs and benefits of stormwater management options. US EPA has developed a suite of databases and tools that can inform decision-making by regional sto...

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

    EPA Science Inventory

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

  14. End of Asset Life Reinvestment Decision Support Tool (INFR2R11AT)

    EPA Science Inventory

    This “End of Asset Life” Reinvestment Decision-Support Tool is intended as a step by step guide for the asset management practitioner who faces the challenge of developing an investment strategy that represents the best integration of maintenance, operations, and capital investme...

  15. DEVELOPMENT OF PROTOCOLS AND DECISION SUPPORT TOOLS FOR ASSESSING WATERSHED SYSTEM ASSIMILATIVE

    EPA Science Inventory

    Investigations are underway on Lake Texoma, a Corps of Engineers lake on the Oklahoma/Texas border, to develop decision support tools and information to evaluate the transport and attenuation of contaminants and stressors in a lake ecosystem, and link them to observable ecologica...

  16. Decision-Support Tools and Databases to Inform Regional Stormwater Utility Development in New England

    EPA Science Inventory

    Development of stormwater utilities requires information on existing stormwater infrastructure and impervious cover as well as costs and benefits of stormwater management options. US EPA has developed a suite of databases and tools that can inform decision-making by regional sto...

  17. Tools to aid post-wildfire assessment and erosion-mitigation treatment decisions

    Treesearch

    Peter R. Robichaud; Louise E. Ashmun

    2013-01-01

    A considerable investment in post-fire research over the past decade has improved our understanding of wildfire effects on soil, hydrology, erosion and erosion-mitigation treatment effectiveness. Using this new knowledge, we have developed several tools to assist land managers with post-wildfire assessment and treatment decisions, such as prediction models, research...

  18. The Integrated Medical Model - A Risk Assessment and Decision Support Tool for Human Space Flight Missions

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Minard, Charles G.; Saile, Lynn; FreiredeCarvalho, Mary; Myers, Jerry; Walton, Marlei; Butler, Douglas; Lopez, Vilma

    2010-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to space flight mission planners and medical system designers in assessing risks and optimizing medical systems. The IMM employs an evidence-based, probabilistic risk assessment (PRA) approach within the operational constraints of space flight.

  19. A Decision Support Prototype Tool for Predicting Student Performance in an ODL Environment

    ERIC Educational Resources Information Center

    Kotsiantis, S. B.; Pintelas, P. E.

    2004-01-01

    Machine Learning algorithms fed with data sets which include information such as attendance data, test scores and other student information can provide tutors with powerful tools for decision-making. Until now, much of the research has been limited to the relation between single variables and student performance. Combining multiple variables as…

  20. A Cross-National CAI Tool To Support Learning Operations Decision-Making and Market Analysis.

    ERIC Educational Resources Information Center

    Mockler, Robert J.; Afanasiev, Mikhail Y.; Dologite, Dorothy G.

    1999-01-01

    Describes bicultural (United States and Russia) development of a computer-aided instruction (CAI) tool to learn management decision-making using information systems technologies. The program has been used with undergraduate and graduate students in both countries; it integrates free and controlled market concepts and combines traditional computer…

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

    EPA Science Inventory

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

  2. Development of a forecasting tool to guide field management decisions related to fertilizer and manure

    USDA-ARS?s Scientific Manuscript database

    Managing the timing of fertilizer and manure application is critical to protecting water quality in the Chesapeake Bay watershed. While modern nutrient management tools are designed to help farmers with their long-term field management planning, they do not support daily decisions on when and where...

  3. A Decision Support Prototype Tool for Predicting Student Performance in an ODL Environment

    ERIC Educational Resources Information Center

    Kotsiantis, S. B.; Pintelas, P. E.

    2004-01-01

    Machine Learning algorithms fed with data sets which include information such as attendance data, test scores and other student information can provide tutors with powerful tools for decision-making. Until now, much of the research has been limited to the relation between single variables and student performance. Combining multiple variables as…

  4. Developing and testing a discharge planning decision support tool for hospitalized pediatric patients.

    PubMed

    Holland, Diane E; Conlon, Patricia M; Rohlik, Gina M; Gillard, Kris L; Tomlinson, Angie L; Raadt, Dawn M; Finseth, Onalee R; Rhudy, Lori M

    2014-04-01

    To develop and test a decision support tool that identifies patients who would benefit from early consult with discharge planners. A predictive, correlational design was used with parents/guardians of children (1 month to 18 years; N = 197). Data were collected by interviews and record reviews. Expert consensus determined referral to discharge planning. Mean age was 8.7 years; mean length of stay was 7.5 days. Forty percent (n = 79) were identified for early referral. The variable "substantial post-acute care needs" had the strongest association with expert consensus (internally validated AUC = 0.79). Findings from this study provide preliminary evidence for a decision support tool to improve the discharge planning process by reducing individual decision-making variability through systematic matching of patient needs to service delivery. © 2014, Wiley Periodicals, Inc.

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

    USGS Publications Warehouse

    Sohl, Terry L.; Claggett, Peter R.

    2013-01-01

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

  6. A software tool to assist business-process decision-making in the biopharmaceutical industry.

    PubMed

    Mustafa, Mustafa A; Washbrook, John; Lim, Ai Chye; Zhou, Yuhong; Titchener-Hooker, Nigel J; Morton, Philip; Berezenko, Steve; Farid, Suzanne S

    2004-01-01

    Conventionally, software tools for the design of bioprocesses have provided only limited business-related information for decision-making. There is an industrial need to investigate manufacturing options and to gauge the impact of various decisions from economic as well as process perspectives. This paper describes the development and use of a tool to provide an assessment of whole flowsheets by capturing both process and business aspects. The tool is demonstrated by considering the issues concerned when making decisions between two potential flowsheets for a common product. A case study approach is used to compare the process and business benefits of a conventional process route employing packed chromatography beds and an alternative that uses expanded bed adsorption (EBA). The tool allows direct evaluation of the benefits of capital cost reduction and increased yield offered by EBA against penalties of using potentially more expensive EBA matrix with lower lifetimes. Furthermore, the tool provides the ability to gauge the process robustness of each flowsheet option.

  7. Informed public choices for low-carbon electricity portfolios using a computer decision tool.

    PubMed

    Mayer, Lauren A Fleishman; Bruine de Bruin, Wändi; Morgan, M Granger

    2014-04-01

    Reducing CO2 emissions from the electricity sector will likely require policies that encourage the widespread deployment of a diverse mix of low-carbon electricity generation technologies. Public discourse informs such policies. To make informed decisions and to productively engage in public discourse, citizens need to understand the trade-offs between electricity technologies proposed for widespread deployment. Building on previous paper-and-pencil studies, we developed a computer tool that aimed to help nonexperts make informed decisions about the challenges faced in achieving a low-carbon energy future. We report on an initial usability study of this interactive computer tool. After providing participants with comparative and balanced information about 10 electricity technologies, we asked them to design a low-carbon electricity portfolio. Participants used the interactive computer tool, which constrained portfolio designs to be realistic and yield low CO2 emissions. As they changed their portfolios, the tool updated information about projected CO2 emissions, electricity costs, and specific environmental impacts. As in the previous paper-and-pencil studies, most participants designed diverse portfolios that included energy efficiency, nuclear, coal with carbon capture and sequestration, natural gas, and wind. Our results suggest that participants understood the tool and used it consistently. The tool may be downloaded from http://cedmcenter.org/tools-for-cedm/informing-the-public-about-low-carbon-technologies/ .

  8. Tool for decision-making regarding general evacuation during a rapid river flood.

    PubMed

    Radosavljevic, V; Belojevic, G; Pavlovic, N

    2017-05-01

    To propose a simple and effective tool for decision-making regarding general evacuation during a rapid river flood. Virtual testing of a tool in a real event. A four-component tool was applied to build an alternative scenario of the catastrophic river flood in Obrenovac, Serbia, on May 2014. The components of this tool are: (1) the amount of precipitation above the 95th percentile of all previous measurements; (2) upstream river discharge above the 95th percentile of all previous measurements; (3) upstream river level above the 95th percentile of all previous measurements; and (4) worsening of the hydrometeorological situation in the following 48 h. In the early morning of 16 May 2014, a rapid river wave flooded 80% of the Obrenovac territory. There were 13 deaths due to drowning. Application of the study tool shows that these lives could have been saved, as the score to recommend general evacuation was reached 1 day before the flooding. The application of this tool to two previous great floods in Serbia shows that the score to recommend general evacuation was reached either 1 day before or on the onset of flash flooding. Due to its simplicity, this tool is universally applicable to facilitate decision-making regarding general evacuation during a rapid river flood, and it should be further tested in future similar catastrophes. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  9. Risk profiling of cattle farms as a potential tool in risk-based surveillance for Mycobacterium bovis infection among cattle in tuberculosis-free areas.

    PubMed

    Ribeiro-Lima, Joao; Schwabenlander, Stacey; Oakes, Michael; Thompson, Beth; Wells, Scott J

    2016-06-15

    OBJECTIVE To develop a cattle herd risk-profiling system that could potentially inform risk-based surveillance strategies for Mycobacterium bovis infection in cattle and provide information that could be used to help direct resource allocation by a state agency for this purpose. DESIGN Cross-sectional study. SAMPLE Records for any size movement (importation) of cattle into Minnesota from other US states during 2009 (n = 7,185) and 2011 (8,107). PROCEDURES Data from certificates of veterinary inspection were entered into a spreadsheet. Movement data were summarized at premises and county levels, and for each level, the distribution of cattle moved and number of movements were evaluated. Risk profiling (assessment and categorization of risk for disease introduction) for each import movement was performed on the basis of known risk factors. Latent class analysis was used to assign movements to risk classifications with adjustment on the basis of expert opinions from personnel knowledgeable about bovine tuberculosis; these data were used to classify premises as very high, high, medium, or low risk for disease introduction. RESULTS In each year, approximately 1,500 premises imported cattle, typically beef and feeder types, with the peak of import movements during the fall season. The risk model identified 4 risk classes for cattle movements. Approximately 500 of the estimated 27,406 (2%) cattle premises in Minnesota were in the very high or high risk groups for either year; greatest density of these premises was in the southeast and southwest regions of the state. CONCLUSIONS AND CLINICAL RELEVANCE A risk-profiling approach was developed that can be applied in targeted surveillance efforts for bovine tuberculosis, particularly in disease-free areas.

  10. Developing and validating a practical decision support tool (DST) for biomass selection on marginal land.

    PubMed

    Andersson-Sköld, Y; Bardos, P; Chalot, M; Bert, V; Crutu, G; Phanthavongsa, P; Delplanque, M; Track, T; Cundy, A B

    2014-12-01

    Marginal, often contaminated, sites exist in large areas across the world as a result of historic activities such as industry, transportation and mineral extraction. Remediation, or other improvements, of these sites is typically only considered for sites with high exploitation pressure and those posing the highest risks to human health or the environment. At the same time there is increasing competition for land resources for different needs such as biofuel production. Potentially some of this land requirement could be met by production of biomass on brownfield or other marginal land, thereby improving the land while applying the crop cultivation as part of an integrated management strategy. The design and decision making for such a strategy will be site specific. A decision support framework, the Rejuvenate DST (decision support tool) has been developed with the aim of supporting such site specific decision making. This tool is presented here, and has been tested by applying it to a number of case study sites. The consequent SWOT (strength, weakness, opportunities and threats) analysis is discussed and evaluated. The DST was found to be systematic, transparent, and applicable for diverse sites in France, Romania and Sweden, in addition to the sites to which it was applied through its development. The DST is regarded as especially useful if applied as a checklist in an iterative way throughout the decision process, from identifying potential crops to identifying knowledge gaps, working/non-working management strategies and potential risks. The DST also provides a structure promoting effective stakeholder engagement.

  11. Cost effectiveness of pediatric pneumococcal conjugate vaccines: a comparative assessment of decision-making tools

    PubMed Central

    2011-01-01

    Background Several decision support tools have been developed to aid policymaking regarding the adoption of pneumococcal conjugate vaccine (PCV) into national pediatric immunization programs. The lack of critical appraisal of these tools makes it difficult for decision makers to understand and choose between them. With the aim to guide policymakers on their optimal use, we compared publicly available decision-making tools in relation to their methods, influential parameters and results. Methods The World Health Organization (WHO) requested access to several publicly available cost-effectiveness (CE) tools for PCV from both public and private provenance. All tools were critically assessed according to the WHO's guide for economic evaluations of immunization programs. Key attributes and characteristics were compared and a series of sensitivity analyses was performed to determine the main drivers of the results. The results were compared based on a standardized set of input parameters and assumptions. Results Three cost-effectiveness modeling tools were provided, including two cohort-based (Pan-American Health Organization (PAHO) ProVac Initiative TriVac, and PneumoADIP) and one population-based model (GlaxoSmithKline's SUPREMES). They all compared the introduction of PCV into national pediatric immunization program with no PCV use. The models were different in terms of model attributes, structure, and data requirement, but captured a similar range of diseases. Herd effects were estimated using different approaches in each model. The main driving parameters were vaccine efficacy against pneumococcal pneumonia, vaccine price, vaccine coverage, serotype coverage and disease burden. With a standardized set of input parameters developed for cohort modeling, TriVac and PneumoADIP produced similar incremental costs and health outcomes, and incremental cost-effectiveness ratios. Conclusions Vaccine cost (dose price and number of doses), vaccine efficacy and epidemiology of

  12. Early Engagement of Safety and Mission Assurance Expertise Using Systems Engineering Tools: A Risk-Based Approach to Early Identification of Safety and Assurance Requirements

    NASA Technical Reports Server (NTRS)

    Darpel, Scott; Beckman, Sean

    2016-01-01

    Decades of systems engineering practice have demonstrated that the earlier the identification of requirements occurs, the lower the chance that costly redesigns will needed later in the project life cycle. A better understanding of all requirements can also improve the likelihood of a design's success. Significant effort has been put into developing tools and practices that facilitate requirements determination, including those that are part of the model-based systems engineering (MBSE) paradigm. These efforts have yielded improvements in requirements definition, but have thus far focused on a design's performance needs. The identification of safety & mission assurance (S&MA) related requirements, in comparison, can occur after preliminary designs are already established, yielding forced redesigns. Engaging S&MA expertise at an earlier stage, facilitated by the use of MBSE tools, and focused on actual project risk, can yield the same type of design life cycle improvements that have been realized in technical and performance requirements.

  13. Flexible decision-making relative to reward quality and tool functionality in Goffin cockatoos (Cacatua goffiniana)

    PubMed Central

    Laumer, I. B.; Bugnyar, T.; Auersperg, A. M. I.

    2016-01-01

    Decisions involving the use of tools may require an agent to consider more levels of relational complexity than merely deciding between an immediate and a delayed option. Using a new experimental approach featuring two different types of tools, two apparatuses as well as two different types of reward, we investigated the Goffin cockatoos’ ability to make flexible and profitable decisions within five different setups. Paralleling previous results in primates, most birds overcame immediate drives in favor of future gains; some did so even if tool use involved additional work effort. Furthermore, at the group level subjects maximized their profit by simultaneously considering both the quality of an immediate versus a delayed food reward (accessible with a tool) and the functionality of the available tool. As their performance levels remained stable across trials in all testing setups, this was unlikely the result of a learning effect. The Goffin cockatoos’ ability to focus on relevant information was constrained when all task components (both food qualities, both apparatuses and both tools) were presented at the same time. PMID:27334699

  14. A spatial multicriteria decision making tool to define the best agricultural areas for sewage sludge amendment.

    PubMed

    Passuello, Ana; Cadiach, Oda; Perez, Yolanda; Schuhmacher, Marta

    2012-01-01

    Sewage sludge amendment on agricultural soils has recently become a practice of heightened interest, as a consequence of sewage sludge production increase. This practice has benefits to soil and crops, however it may also lead to environmental contamination, depending on the characteristics of the fields. In order to define the suitability of the different agricultural fields to receive sewage sludge, a spatial tool is proposed. This tool, elaborated in GIS platform, aggregates different criteria regarding human exposure and environmental contamination. The spatial tool was applied to a case study in the region of Catalonia (NE of Spain). Within the case study, each step of the tool development is detailed. The results show that the studied region has different suitability degrees, being the appropriate areas sufficient for receiving the total amount of sewage sludge produced. The sensitivity analysis showed that "groundwater contamination", "distance to urban areas", "metals concentration in soil" and "crop type" are the most important criteria of the evaluation. The developed tool successfully tackled the problem, providing a comprehensive procedure to evaluate agricultural land suitability to receive sewage sludge as an organic fertilizer. Also, the tool implementation gives insights to decision makers, guiding them to more confident decisions, based on an extensive group of criteria.

  15. Electromechanical mapping of the left ventricle: possible tool for online decision making in the catheterization laboratory.

    PubMed

    Tan, Eng S; Jessurun, Gillian Aj; Anthonio, Rutger L; Slart, Riemer Hja; Zijlstra, Felix; Tio, René A

    2009-05-01

    Clinical decision making in intervention cardiology often depends on information about the presence of myocardial viability and the extent of ischemia. Especially in the case of an occluded collaterally filled coronary branch, online decision making in selected patients may accelerate and improve patient care. The electromechanical NOGA mapping system offers the opportunity for online viability assessment. We describe two cases in which this diagnostic tool was used during daily practice. In our opinion, NOGA mapping can be helpful for 'online' viability evaluation in patients with an occluded collaterally filled coronary artery. In these patients, noninvasive viability evaluation may cause unnecessary delay in the overall treatment approach.

  16. Challenging the Academically Adrift: A New Decision-Making Tool to Help Improve Student Commitment to Academic Preparation

    ERIC Educational Resources Information Center

    Davis, Carolyn D.

    2013-01-01

    This paper describes research in progress concerning the development and use of a newly created tool, the Decision-Making Grid, which was designed to teach undergraduate management students to develop and use metacognitive regulation skills to improve decision-making by requiring students to construct improved decision-making models in a boundedly…

  17. Increasing systematicity leads to better selection decisions: Evidence from a computer paradigm for evaluating selection tools

    PubMed Central

    Björklund, Fredrik

    2017-01-01

    A computerized paradigm was created to allow for testing in the laboratory whether increasing systematicity helps the recruiter make better selection decisions. Participants were introduced to the job and the applicants on the computer screen and asked to select who they thought should be considered for the job and who should not. Level of systematicity, i.e. the extent to which the recruitment is methodical and uses prepared tools, was manipulated between subjects. Depending on experimental condition participants were helped by means of a tool for extracting judgment criteria (job analysis) and a tool for making judgments related to selected criteria (including calculation of a final score). The general prediction that increased systematicity leads to the selection of more qualified candidates was supported by the results, particularly when the motivation to put time and effort into the task was higher. The results support the claim from Industrial/Organizational psychologists that systematicity is a desirable characteristic in selection processes. The fact that increasing systematicity led to better selection decisions in a controlled laboratory experiment, along with process-related measures, suggests that this kind of paradigm could be useful when evaluating new tools for improving selection decisions, before they are tested in large (and costly) field studies of actual personnel selection. PMID:28542456

  18. Using an Electronic Decision Support Tool to Reduce Inappropriate Polypharmacy and Optimize Medicines: Rationale and Methods

    PubMed Central

    Tordoff, June; Dovey, Susan; Reith, David; Lloyd, Hywel; Tilyard, Murray; Smith, Alesha

    2016-01-01

    Background Polypharmacy and inappropriate continuation of medicines can lead to a significant risk of adverse drug events and drug interactions with patient harm and escalating health care costs as a result. Thorough review of patients’ medications focusing on the need for each drug can reduce the potential for harm. Limitations in performing effective medicine reviews in practice include consultation time constraints and funding for pharmacy services. We will aim to overcome these problems by designing an automatic electronic decision support tool (the medicines optimization/review and evaluation (MORE) module) that is embedded in general practice electronic records systems. The tool will focus on medicines optimization and reducing polypharmacy to aid prescribers in reviewing medicines and improve patient outcomes. Objective The objectives of this study are: (1) to develop an electronic decision support tool to assist prescribers in performing clinical medication reviews with a particular focus on patients experiencing multimorbidity and polypharmacy, and (2) evaluate and assess the use of the electronic decision support tool, providing pilot data on its usefulness in supporting prescribers during consultations with patients. Methods The first three study phases involve development of clinical rules outlining clinical interventions and the creation and validation of the MORE decision support tool. Phase four is a community-based, single-blind, prospective, 6-month controlled trial involving two interventions and two control general practices, matched for practice demographics. We will be measuring the number of times prescribers engage with the tool, total number of interventions suggested by the tool, and total number of times prescribers change medicines in response to recommendations. There will also be prospective follow-up of patients in the intervention group to examine whether changes to medications are upheld, and to determine the number of

  19. The contribution of science to risk-based decision-making: lessons from the development of full-scale treatment measures for acidic mine waters at Wheal Jane, UK.

    PubMed

    Younger, Paul L; Coulton, Richard H; Froggatt, Eric C

    2005-02-01

    The use of risk-based decision-making in environmental management is often assumed to rely primarily on the availability of robust scientific data and insights, while in practice socio-economic criteria are often of considerable importance. However, the relative contributions to decision-making made by scientific and socio-economic inputs are rarely assessed, and even less commonly reported. Such an assessment has been made for a major remediation project in southwest England, in which some 300 l/s of highly acidic, metalliferous mine waters are now being treated using oxidation and chemical neutralisation. In the process of reaching the decision to commission the treatment plant, a wide range of scientific studies were undertaken, including: biological impact assessments, hydrogeological investigations of the effect of pumping on the flooded mine system, and hydrological and geochemical characterisation, together with integrated catchment modelling, of pollutant sources and pathways. These investigations revealed that, despite the spectacular nature of the original mine water outburst in 1992, the ecology of the Fal estuary remains remarkably robust. No scientific evidence emerged of any grounds for concern over the estuarine ecology, even if mine water were left to flow untreated. However, a rare ecological resource known as "maerl" (a form of calcified seaweed) is harvested annually in the estuary, providing significant revenue to the local economy and underpinning the 'clean' image of local sea water. Social and environmental benefit surveys revealed strong public perceptions that any visible discoloration in the estuary must indicate a diminution in quality of the maerl, to the detriment of both the public image and economy of the area. This factor proved sufficient to justify the continued pump-and-treat operations at the mine site. Although the decisive factor in the end was socio-economic in nature, robust assessment of this factor could not have been made

  20. Design and Implementation of a Cloud Computing Adoption Decision Tool: Generating a Cloud Road

    PubMed Central

    Bildosola, Iñaki; Río-Belver, Rosa; Cilleruelo, Ernesto; Garechana, Gaizka

    2015-01-01

    Migrating to cloud computing is one of the current enterprise challenges. This technology provides a new paradigm based on “on-demand payment” for information and communication technologies. In this sense, the small and medium enterprise is supposed to be the most interested, since initial investments are avoided and the technology allows gradual implementation. However, even if the characteristics and capacities have been widely discussed, entry into the cloud is still lacking in terms of practical, real frameworks. This paper aims at filling this gap, presenting a real tool already implemented and tested, which can be used as a cloud computing adoption decision tool. This tool uses diagnosis based on specific questions to gather the required information and subsequently provide the user with valuable information to deploy the business within the cloud, specifically in the form of Software as a Service (SaaS) solutions. This information allows the decision makers to generate their particular Cloud Road. A pilot study has been carried out with enterprises at a local level with a two-fold objective: to ascertain the degree of knowledge on cloud computing and to identify the most interesting business areas and their related tools for this technology. As expected, the results show high interest and low knowledge on this subject and the tool presented aims to readdress this mismatch, insofar as possible. PMID:26230400

  1. Design and Implementation of a Cloud Computing Adoption Decision Tool: Generating a Cloud Road.

    PubMed

    Bildosola, Iñaki; Río-Belver, Rosa; Cilleruelo, Ernesto; Garechana, Gaizka

    2015-01-01

    Migrating to cloud computing is one of the current enterprise challenges. This technology provides a new paradigm based on "on-demand payment" for information and communication technologies. In this sense, the small and medium enterprise is supposed to be the most interested, since initial investments are avoided and the technology allows gradual implementation. However, even if the characteristics and capacities have been widely discussed, entry into the cloud is still lacking in terms of practical, real frameworks. This paper aims at filling this gap, presenting a real tool already implemented and tested, which can be used as a cloud computing adoption decision tool. This tool uses diagnosis based on specific questions to gather the required information and subsequently provide the user with valuable information to deploy the business within the cloud, specifically in the form of Software as a Service (SaaS) solutions. This information allows the decision makers to generate their particular Cloud Road. A pilot study has been carried out with enterprises at a local level with a two-fold objective: to ascertain the degree of knowledge on cloud computing and to identify the most interesting business areas and their related tools for this technology. As expected, the results show high interest and low knowledge on this subject and the tool presented aims to readdress this mismatch, insofar as possible.

  2. LCA-IWM: a decision support tool for sustainability assessment of waste management systems.

    PubMed

    den Boer, J; den Boer, E; Jager, J

    2007-01-01

    The paper outlines the most significant result of the project 'The use of life cycle assessment tools for the development of integrated waste management strategies for cities and regions with rapid growing economies', which was the development of two decision-support tools: a municipal waste prognostic tool and a waste management system assessment tool. The article focuses on the assessment tool, which supports the adequate decision making in the planning of urban waste management systems by allowing the creation and comparison of different scenarios, considering three basic subsystems: (i) temporary storage; (ii) collection and transport and (iii) treatment, disposal and recycling. The design and analysis options, as well as the assumptions made for each subsystem, are shortly introduced, providing an overview of the applied methodologies and technologies. The sustainability assessment methodology used in the project to support the selection of the most adequate scenario is presented with a brief explanation of the procedures, criteria and indicators applied on the evaluation of each of the three sustainability pillars.

  3. LCA-IWM: A decision support tool for sustainability assessment of waste management systems

    SciTech Connect

    Boer, J. den Boer, E. den; Jager, J.

    2007-07-01

    The paper outlines the most significant result of the project 'The use of life cycle assessment tools for the development of integrated waste management strategies for cities and regions with rapid growing economies', which was the development of two decision-support tools: a municipal waste prognostic tool and a waste management system assessment tool. The article focuses on the assessment tool, which supports the adequate decision making in the planning of urban waste management systems by allowing the creation and comparison of different scenarios, considering three basic subsystems: (i) temporary storage; (ii) collection and transport and (iii) treatment, disposal and recycling. The design and analysis options, as well as the assumptions made for each subsystem, are shortly introduced, providing an overview of the applied methodologies and technologies. The sustainability assessment methodology used in the project to support the selection of the most adequate scenario is presented with a brief explanation of the procedures, criteria and indicators applied on the evaluation of each of the three sustainability pillars.

  4. Project I-COP - architecture of software tool for decision support in oncology.

    PubMed

    Blaha, Milan; Janča, Dalibor; Klika, Petr; Mužík, Jan; Dušek, Ladislav

    2013-01-01

    This article briefly describes the development of the I-COP tool, which is designed to promote education and decision making of clinical oncologists. It is based on real data from medical facilities, which are processed, stored in database, analyzed and finally displayed in an interactive software application. Used data sources are shortly described in individual sections together with the functionality of developed tools. The final goal of this project is to provide support for work and education within each involved partner center. Clinical oncologists are therefore supposed to be the authors and users at the same time.

  5. Description of an on-line decision-aid tool for generation-load balance control

    SciTech Connect

    Jourdin, P.; Vintache, P.; Heilbronn, B.; Lagrange, V. . Direction des Etudes et Recherches); Cartignies, E.; Millot, P. . Lab. d'Automatique Industrielle et Humaine)

    1994-02-01

    This paper presents the preliminary results of a design study, carried out at the Research Center of Electricite de France, of an on-line decision aid tool for real-time operation. This tool attempts to provide operators with an aid for an on-line generation rescheduling, when disturbances occur in the generation-load balance. Using Artificial Intelligence techniques, a method has been developed (based on a design-aid mock-up) which combines a knowledge base, heuristic rules, and classical algorithms. The first results, issued from simulations on cases derived from actual operation, are very promising.

  6. Verification and Validation of NASA-Supported Enhancements to Decision Support Tools of PECAD

    NASA Technical Reports Server (NTRS)

    Ross, Kenton W.; McKellip, Rodney; Moore, Roxzana F.; Fendley, Debbie

    2005-01-01

    This section of the evaluation report summarizes the verification and validation (V&V) of recently implemented, NASA-supported enhancements to the decision support tools of the Production Estimates and Crop Assessment Division (PECAD). The implemented enhancements include operationally tailored Moderate Resolution Imaging Spectroradiometer (MODIS) products and products of the Global Reservoir and Lake Monitor (GRLM). The MODIS products are currently made available through two separate decision support tools: the MODIS Image Gallery and the U.S. Department of Agriculture (USDA) Foreign Agricultural Service (FAS) MODIS Normalized Difference Vegetation Index (NDVI) Database. Both the Global Reservoir and Lake Monitor and MODIS Image Gallery provide near-real-time products through PECAD's CropExplorer. This discussion addresses two areas: 1. Assessments of the standard NASA products on which these enhancements are based. 2. Characterizations of the performance of the new operational products.

  7. Tools for decision-making in older cancer patients. Role of the comprehensive geriatric assessment.

    PubMed

    Molina-Garrido, M J; Guillen-Ponce, C; Castellano, C Sanchez; Errasquin, B Montero; Mora-Rufete, A; Cruz-Jentoft, A J

    2014-06-01

    Approximately 60% of cancer incidence and 70% of cancer mortality occurs in individuals older than 65 years. The optimal approach to cancer therapy in older adults is often unclear. Historically, advanced age has been an exclusion criterion in clinical cancer trials, and older adults have been consistently underrepresented. As a result, there is a lack of information about treatment efficacy and tolerability in this population. Comprehensive Geriatric Assessment (CGA) is one of the most useful tools for the oncologist to make decisions related to older patients diagnosed with cancer. This tool has proved to be very useful to detect many deficits, tolerance to chemotherapy and survival in such patients. In this review, we analyze the role of CGA in decision making in geriatric oncology.

  8. Developing an Atrial Fibrillation Guideline Support Tool (AFGuST) for Shared Decision Making

    PubMed Central

    Eckman, Mark H.; Wise, Ruth E.; Naylor, Katherine; Arduser, Lora; Lip, Gregory Y.H.; Kissela, Brett; Flaherty, Matthew; Kleindorfer, Dawn; Khan, Faisal; Schauer, Daniel P.; Kues, John; Costea, Alexandru

    2015-01-01

    Objective Patient values and preferences are an important component to decision making when tradeoffs exist that impact quality of life, such as tradeoffs between stroke prevention and hemorrhage in patients with atrial fibrillation (AF) contemplating anticoagulant therapy. Our objective is to describe the development of an Atrial Fibrillation Guideline Support Tool (AFGuST) to assist the process of integrating patients’ preferences into this decision. Materials and Methods CHA2DS2VASc and HAS-BLED were used to calculate risks for stroke and hemorrhage. We developed a Markov decision analytic model as a computational “engine” to integrate patient-specific risk for stroke and hemorrhage and individual patient values for relevant outcomes in decisions about anticoagulant therapy. Results Individual patient preferences for health-related outcomes may have greater or lesser impact on the choice of optimal antithrombotic therapy, depending upon the balance of patient-specific risks for ischemic stroke and major bleeding. These factors have been incorporated into patient-tailored booklets which, along with an informational video were developed through an iterative process with clinicians and patient focus groups. Key Limitations Current risk prediction models for hemorrhage, such as the HAS-BLED, used in the AFGuST, do not incorporate all potentially significant risk factors. Novel oral anticoagulant agents recently approved for use in the United States, Canada, and Europe have not been included in the AFGuST. Rather, warfarin has been used as a conservative proxy for all oral anticoagulant therapy. Conclusions We present a proof of concept that a patient-tailored decision-support tool could bridge the gap between guidelines and practice by incorporating individual patient’s stroke and bleeding risks and their values for major bleeding events and stroke to facilitate a shared decision making process. If effective, the AFGuST could be used as an adjunct to

  9. A Coastal Flood Decision Support Tool for Forecast Operations in Alaska

    NASA Astrophysics Data System (ADS)

    van Breukelen, C. M.; Moore, A.; Plumb, E. W.

    2015-12-01

    ABSTRACT Coastal flooding and erosion poses a serious threat to infrastructure, livelihood, and property for communities along Alaska's northern and western coastline. While the National Weather Service Alaska Region (NWS-AR) forecasts conditions favorable for coastal flooding, an improvement can be made in communicating event impacts between NWS-AR and local residents. Scientific jargon used by NWS-AR to indicate the severity of flooding potential is often misconstrued by residents. Additionally, the coastal flood forecasting process is cumbersome and time consuming due to scattered sources of flood guidance. To alleviate these problems, a single coastal flooding decision support tool was created for the Fairbanks Weather Forecast Office to help bridge the communication gap, streamline the forecast and warning process, and take into account both the meteorological and socioeconomic systems at work during a flood event. This tool builds on previous research and data collected by the Alaska Division of Geological and Geophysical Surveys (DGGS) and the NWS-AR, using high resolution elevation data to model the impacts of storm tide rise above the mean lower low water level on five of the most at-risk communities along the Alaskan coast. Important local buildings and infrastructure are highlighted, allowing forecasters to relate the severity of the storm tide in terms of local landmarks that are familiar to residents. In this way, this decision support tool allows for a conversion from model output storm tide levels into real world impacts that are easily understood by forecasters, emergency managers, and other stakeholders, helping to build a Weather-Ready Nation. An overview of the new coastal flood decision support tool in NWS-AR forecast operations will be discussed. KEYWORDS Forecasting; coastal flooding; coastal hazards; decision support

  10. Evaluation of Algorithms for a Miles-in-Trail Decision Support Tool

    NASA Technical Reports Server (NTRS)

    Bloem, Michael; Hattaway, David; Bambos, Nicholas

    2012-01-01

    Four machine learning algorithms were prototyped and evaluated for use in a proposed decision support tool that would assist air traffic managers as they set Miles-in-Trail restrictions. The tool would display probabilities that each possible Miles-in-Trail value should be used in a given situation. The algorithms were evaluated with an expected Miles-in-Trail cost that assumes traffic managers set restrictions based on the tool-suggested probabilities. Basic Support Vector Machine, random forest, and decision tree algorithms were evaluated, as was a softmax regression algorithm that was modified to explicitly reduce the expected Miles-in-Trail cost. The algorithms were evaluated with data from the summer of 2011 for air traffic flows bound to the Newark Liberty International Airport (EWR) over the ARD, PENNS, and SHAFF fixes. The algorithms were provided with 18 input features that describe the weather at EWR, the runway configuration at EWR, the scheduled traffic demand at EWR and the fixes, and other traffic management initiatives in place at EWR. Features describing other traffic management initiatives at EWR and the weather at EWR achieved relatively high information gain scores, indicating that they are the most useful for estimating Miles-in-Trail. In spite of a high variance or over-fitting problem, the decision tree algorithm achieved the lowest expected Miles-in-Trail costs when the algorithms were evaluated using 10-fold cross validation with the summer 2011 data for these air traffic flows.

  11. Decision support tool for soil sampling of heterogeneous pesticide (chlordecone) pollution.

    PubMed

    Clostre, Florence; Lesueur-Jannoyer, Magalie; Achard, Raphaël; Letourmy, Philippe; Cabidoche, Yves-Marie; Cattan, Philippe

    2014-02-01

    When field pollution is heterogeneous due to localized pesticide application, as is the case of chlordecone (CLD), the mean level of pollution is difficult to assess. Our objective was to design a decision support tool to optimize soil sampling. We analyzed the CLD heterogeneity of soil content at 0-30- and 30-60-cm depth. This was done within and between nine plots (0.4 to 1.8 ha) on andosol and ferralsol. We determined that 20 pooled subsamples per plot were a satisfactory compromise with respect to both cost and accuracy. Globally, CLD content was greater for andosols and the upper soil horizon (0-30 cm). Soil organic carbon cannot account for CLD intra-field variability. Cropping systems and tillage practices influence the CLD content and distribution; that is CLD pollution was higher under intensive banana cropping systems and, while upper soil horizon was more polluted than the lower one with shallow tillage (<40 cm), deeper tillage led to a homogenization and a dilution of the pollution in the soil profile. The decision tool we proposed compiles and organizes these results to better assess CLD soil pollution in terms of sampling depth, distance, and unit at field scale. It accounts for sampling objectives, farming practices (cropping system, tillage), type of soil, and topographical characteristics (slope) to design a relevant sampling plan. This decision support tool is also adaptable to other types of heterogeneous agricultural pollution at field level.

  12. Collaborating with Youth to Inform and Develop Tools for Psychotropic Decision Making

    PubMed Central

    Murphy, Andrea; Gardner, David; Kutcher, Stan; Davidson, Simon; Manion, Ian

    2010-01-01

    Introduction: Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. Methods: A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. Results: Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. Conclusion: An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders. PMID:21037916

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

    PubMed

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

    2016-02-01

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

  14. Usability Testing and Adaptation of the Pediatric Cardiovascular Risk Reduction Clinical Decision Support Tool.

    PubMed

    Williams, Pamela A; Furberg, Robert D; Bagwell, Jacqueline E; LaBresh, Kenneth A

    2016-06-21

    Cardiovascular disease (CVD) is 1 of the leading causes of death, years of life lost, and disability-adjusted years of life lost worldwide. CVD prevention for children and teens is needed, as CVD risk factors and behaviors beginning in youth contribute to CVD development. In 2012, the National Heart, Lung, and Blood Institute released their "Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents" for clinicians, describing CVD risk factors they should address with patients at primary care preventative visits. However, uptake of new guidelines is slow. Clinical decision support (CDS) tools can improve guideline uptake. In this paper, we describe our process of testing and adapting a CDS tool to help clinicians evaluate patient risk, recommend behaviors to prevent development of risk, and complete complex calculations to determine appropriate interventions as recommended by the guidelines, using a user-centered design approach. The objective of the study was to assess the usability of a pediatric CVD risk factor tool by clinicians. The tool was tested using one-on-one in-person testing and a "think aloud" approach with 5 clinicians and by using the tool in clinical practice along with formal usability metrics with 14 pediatricians. Thematic analysis of the data from the in-person testing and clinical practice testing identified suggestions for change in 3 major areas: user experience, content refinement, and technical deployment. Descriptive statistical techniques were employed to summarize users' overall experience with the tool. Data from testers showed that general reactions toward the CDS tool were positive. Clinical practice testers suggested revisions to make the application more user-friendly, especially for clinicians using the application on the iPhone, and called for refining recommendations to be more succinct and better tailored to the patient. Tester feedback was incorporated into the design when feasible

  15. Usability Testing and Adaptation of the Pediatric Cardiovascular Risk Reduction Clinical Decision Support Tool

    PubMed Central

    Furberg, Robert D; Bagwell, Jacqueline E; LaBresh, Kenneth A

    2016-01-01

    Background Cardiovascular disease (CVD) is 1 of the leading causes of death, years of life lost, and disability-adjusted years of life lost worldwide. CVD prevention for children and teens is needed, as CVD risk factors and behaviors beginning in youth contribute to CVD development. In 2012, the National Heart, Lung, and Blood Institute released their “Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents” for clinicians, describing CVD risk factors they should address with patients at primary care preventative visits. However, uptake of new guidelines is slow. Clinical decision support (CDS) tools can improve guideline uptake. In this paper, we describe our process of testing and adapting a CDS tool to help clinicians evaluate patient risk, recommend behaviors to prevent development of risk, and complete complex calculations to determine appropriate interventions as recommended by the guidelines, using a user-centered design approach. Objective The objective of the study was to assess the usability of a pediatric CVD risk factor tool by clinicians. Methods The tool was tested using one-on-one in-person testing and a “think aloud” approach with 5 clinicians and by using the tool in clinical practice along with formal usability metrics with 14 pediatricians. Thematic analysis of the data from the in-person testing and clinical practice testing identified suggestions for change in 3 major areas: user experience, content refinement, and technical deployment. Descriptive statistical techniques were employed to summarize users’ overall experience with the tool. Results Data from testers showed that general reactions toward the CDS tool were positive. Clinical practice testers suggested revisions to make the application more user-friendly, especially for clinicians using the application on the iPhone, and called for refining recommendations to be more succinct and better tailored to the patient. Tester feedback was

  16. Usability Testing of a Complex Clinical Decision Support Tool in the Emergency Department: Lessons Learned.

    PubMed

    Press, Anne; McCullagh, Lauren; Khan, Sundas; Schachter, Andy; Pardo, Salvatore; McGinn, Thomas

    2015-09-10

    As the electronic health record (EHR) becomes the preferred documentation tool across medical practices, health care organizations are pushing for clinical decision support systems (CDSS) to help bring clinical decision support (CDS) tools to the forefront of patient-physician interactions. A CDSS is integrated into the EHR and allows physicians to easily utilize CDS tools. However, often CDSS are integrated into the EHR without an initial phase of usability testing, resulting in poor adoption rates. Usability testing is important because it evaluates a CDSS by testing it on actual users. This paper outlines the usability phase of a study, which will test the impact of integration of the Wells CDSS for pulmonary embolism (PE) diagnosis into a large urban emergency department, where workflow is often chaotic and high stakes decisions are frequently made. We hypothesize that conducting usability testing prior to integration of the Wells score into an emergency room EHR will result in increased adoption rates by physicians. The objective of the study was to conduct usability testing for the integration of the Wells clinical prediction rule into a tertiary care center's emergency department EHR. We conducted usability testing of a CDS tool in the emergency department EHR. The CDS tool consisted of the Wells rule for PE in the form of a calculator and was triggered off computed tomography (CT) orders or patients' chief complaint. The study was conducted at a tertiary hospital in Queens, New York. There were seven residents that were recruited and participated in two phases of usability testing. The usability testing employed a "think aloud" method and "near-live" clinical simulation, where care providers interacted with standardized patients enacting a clinical scenario. Both phases were audiotaped, video-taped, and had screen-capture software activated for onscreen recordings. Phase I: Data from the "think-aloud" phase of the study showed an overall positive outlook on

  17. The development of an online decision support tool for organizational readiness for change

    PubMed Central

    2014-01-01

    Background Much importance has been placed on assessing readiness for change as one of the earliest steps of implementation, but measuring it can be a complex and daunting task. Organizations and individuals struggle with how to reliably and accurately measure readiness for change. Several measures have been developed to help organizations assess readiness, but these are often underused due to the difficulty of selecting the right measure. In response to this challenge, we will develop and test a prototype of a decision support tool that is designed to guide individuals interested in implementation in the selection of an appropriate readiness assessment measure for their setting. Methods A multi-phase approach will be used to develop the decision support tool. First, we will identify key measures for assessing organizational readiness for change from a recently completed systematic review. Included measures will be those developed for healthcare settings (e.g., acute care, public health, mental health) and that have been deemed valid and reliable. Second, study investigators and field experts will engage in a mapping exercise to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a stakeholder panel will be recruited and consulted to determine the feasibility and relevance of the selected measures using a modified Delphi process. Fourth, findings from the mapping exercise and stakeholder consultation will inform the development of a decision support tool that will guide users in appropriately selecting change readiness measures. Fifth, the tool will undergo usability testing. Discussion Our proposed decision support tool will address current challenges in the field of organizational change readiness by aiding individuals in selecting a valid and reliable assessment measure that is relevant to user needs and practice settings. We anticipate that implementers and researchers who use our tool will

  18. The development of an online decision support tool for organizational readiness for change.

    PubMed

    Khan, Sobia; Timmings, Caitlyn; Moore, Julia E; Marquez, Christine; Pyka, Kasha; Gheihman, Galina; Straus, Sharon E

    2014-05-10

    Much importance has been placed on assessing readiness for change as one of the earliest steps of implementation, but measuring it can be a complex and daunting task. Organizations and individuals struggle with how to reliably and accurately measure readiness for change. Several measures have been developed to help organizations assess readiness, but these are often underused due to the difficulty of selecting the right measure. In response to this challenge, we will develop and test a prototype of a decision support tool that is designed to guide individuals interested in implementation in the selection of an appropriate readiness assessment measure for their setting. A multi-phase approach will be used to develop the decision support tool. First, we will identify key measures for assessing organizational readiness for change from a recently completed systematic review. Included measures will be those developed for healthcare settings (e.g., acute care, public health, mental health) and that have been deemed valid and reliable. Second, study investigators and field experts will engage in a mapping exercise to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a stakeholder panel will be recruited and consulted to determine the feasibility and relevance of the selected measures using a modified Delphi process. Fourth, findings from the mapping exercise and stakeholder consultation will inform the development of a decision support tool that will guide users in appropriately selecting change readiness measures. Fifth, the tool will undergo usability testing. Our proposed decision support tool will address current challenges in the field of organizational change readiness by aiding individuals in selecting a valid and reliable assessment measure that is relevant to user needs and practice settings. We anticipate that implementers and researchers who use our tool will be more likely to conduct

  19. Inclusion of social indicators in decision support tools for the selection of sustainable site remediation options.

    PubMed

    Cappuyns, Valérie

    2016-12-15

    Sustainable remediation requires a balanced decision-making process in which environmental, economic and social aspects of different remediation options are all considered together and the optimum remediation solution is selected. More attention has been paid to the evaluation of environmental and economic aspects, in particular to reduce the human and environmental risks and the remediation costs, to the exclusion of social aspects of remediation. This paper investigates how social aspects are currently considered in sustainability assessments of remediation projects. A selection of decision support tools (DSTs), used for the sustainability assessment of a remediation project, is analyzed to define how social aspects are considered in those tools. The social indicator categories of the Sustainable Remediation Forum - United Kingdom (SuRF-UK), are used as a basis for this evaluation. The consideration of social aspects in the investigated decision support tools is limited, but a clear increase is noticed in more recently developed tools. Among the five social indicator categories defined by SuRF-UK to facilitate a holistic consideration of social aspects of a remediation project only "Human health and safety" is systematically taken into account. "Neighbourhood and locality" is also often addressed, mostly emphasizing the potential disturbance caused by the remediation activities. However, the evaluation of 'Ethics and Equality', Communities and community involvement', and 'Uncertainty and evidence' is often neglected. Nevertheless, concrete examples can be found in some of the investigated tools. Specific legislation, standard procedures, and guidelines that have to be followed in a region or country are mainly been set up in the context of protecting human and ecosystem health, safety and prevention of nuisance. However, they sometimes already include some of the aspects addressed by the social indicators. In this perspective the use of DST to evaluate the

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

    PubMed

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

    2012-12-19

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

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

    PubMed Central

    2012-01-01

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

  2. Discrete event simulation for healthcare organizations: a tool for decision making.

    PubMed

    Hamrock, Eric; Paige, Kerrie; Parks, Jennifer; Scheulen, James; Levin, Scott

    2013-01-01

    Healthcare organizations face challenges in efficiently accommodating increased patient demand with limited resources and capacity. The modern reimbursement environment prioritizes the maximization of operational efficiency and the reduction of unnecessary costs (i.e., waste) while maintaining or improving quality. As healthcare organizations adapt, significant pressures are placed on leaders to make difficult operational and budgetary decisions. In lieu of hard data, decision makers often base these decisions on subjective information. Discrete event simulation (DES), a computerized method of imitating the operation of a real-world system (e.g., healthcare delivery facility) over time, can provide decision makers with an evidence-based tool to develop and objectively vet operational solutions prior to implementation. DES in healthcare commonly focuses on (1) improving patient flow, (2) managing bed capacity, (3) scheduling staff, (4) managing patient admission and scheduling procedures, and (5) using ancillary resources (e.g., labs, pharmacies). This article describes applicable scenarios, outlines DES concepts, and describes the steps required for development. An original DES model developed to examine crowding and patient flow for staffing decision making at an urban academic emergency department serves as a practical example.

  3. Examination of the effectiveness of DVD decision support tools for patients with unruptured cerebral aneurysms.

    PubMed

    Nozaki, Kazuhiko; Okubo, Chie; Yokoyama, Yoko; Morita, Akio; Akamatsu, Rie; Nakayama, Takeo; Fukuhara, Shun-ichi; Hashimoto, Nobuo

    2007-12-01

    Preventative treatments for unruptured cerebral aneurysms include craniotomy, endovascular treatment, and follow up. Since there is no agreement as to the best procedure, it is important to provide adequate information so that the patient and physician can share in the decision-making process. A multi-media DVD was created to inform patients of the facts. This study examined how effectively this DVD changes patients' recognition including knowledge of unruptured cerebral aneurysms. Forty-seven patients with unruptured cerebral aneurysms who sought neurosurgery consultation between December 2005 and February 2006 completed a questionnaire before and after watching the DVD, as well as at 3 months follow up. Before watching the DVD, the average knowledge score was 8.72 out of 15 total points. The average score increased to 12.4 after watching the DVD (p < 0.001). At 3 months follow up, the average score was 10.34, which was still higher than before watching the DVD (p < 0.01). Participants' knowledge about treatment methods also increased after watching the DVD (p < 0.001). Compared to 63.2% who were satisfied with their treatment decision before watching the DVD, 69.6% were satisfied with their decision after watching the DVD. All participants responded that the use of multi-media images was helpful in better understanding treatment options and in making informed decisions. The DVD was favorably accepted as a decision support tool by patients with unruptured cerebral aneurysm and effectively increased patients' knowledge.

  4. A decision support tool to prioritize risk management options for contaminated sites.

    PubMed

    Sorvari, Jaana; Seppälä, Jyri

    2010-03-15

    The decisions on risk management (RM) of contaminated sites in Finland have typically been driven by practical factors such as time and money. However, RM is a multifaceted task that generally involves several additional determinants, e.g. performance and environmental effects of remediation methods, psychological and social factors. Therefore, we adopted a multi-criteria decision analysis approach and developed a decision support tool (DST) that is viable in decision-making in such a complex situation. The basic components of the DST are based on the Dutch REC system. However, our DST is more case-specific and allows the consideration of the type, magnitude and scale of contamination, land use, environmental conditions and socio-cultural aspects (e.g. loss of cultural heritage, image aspects). The construction of the DST was started by structuring the decision problem using a value tree. Based on this work we adopted the Multi-Attribute Value Theory (MAVT) for data aggregation. The final DST was demonstrated by two model sites for which the RM alternatives and site-specific data were created on the basis of factual remediation projects and by interviewing experts. The demonstration of the DST was carried out in a workshop where representatives of different stakeholders were requested to rank and weight the decision criteria involved. To get information on the consistency of the ranking of the RM alternatives, we used different weighting techniques (ratio estimation and pair-wise weighting) and alternative ways to treat individual respondents' weights in calculating the preference scores for each RM alternative. These dissimilar approaches resulted in some differences in the preference order of the RM alternatives. The demonstration showed that attention has to be paid to the proper description of the site, the principles of the procedure and the decision criteria. Nevertheless, the procedure proved to enable efficient communication between different stakeholders

  5. Assessing students' learning and decision-making skills using high performance web-based computational tools

    NASA Astrophysics Data System (ADS)

    Martin, Akilah

    Using web-based computational tool in classrooms in conjunction with advanced computing models provide the opportunity for students to learn large scale processes, such as state, regional, and global environmental issues that are difficult to incorporate into student learning exercises with present basic models. These tools aided in bridging the gap between multi-field scale models and enhanced student learning. The expectations were that students would improve their decision-making skills by solving realistic and large scale (multi-field conditions) environmental issues that were made possible through faster computation time, larger datasets, larger scale (multi-field), and predictions over longer time periods using the Century soil organic carbon model. The Century Model was linked to a web-based series of functional pages through which students could run the model through. In this project, 239 undergraduate students' learning and decision-making skills using high performance classroom computing tools were assessed. Among the many Century Model parameters, the students were able to alter four variables (climate, crop, tillage, and soil texture). Students were able to simulate several scenarios simultaneously. The results of the study revealed that pretest for the four courses combined was found significant (P < 0.05), meaning that the pretest was a major contributor to their increased posttest score. Although, the scenario scale (multi-field conditions vs. single field conditions) factor was not statistically significant, the students completing the multi-field scenario assignment scored higher on the posttest and also had a higher increase in points from pretest to posttest. Overall, these results revealed that the tool provided had a positive impact on the students' learning which was evident in their enhanced pretest to posttest score and also their perceptions from the written evaluation they provided. Most students felt that the project was a good learning

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

    NASA Astrophysics Data System (ADS)

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

    2006-05-01

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

  7. For Third Enrollment Period, Marketplaces Expand Decision Support Tools To Assist Consumers.

    PubMed

    Wong, Charlene A; Polsky, Daniel E; Jones, Arthur T; Weiner, Janet; Town, Robert J; Baker, Tom

    2016-04-01

    The design of the Affordable Care Act's online health insurance Marketplaces can improve how consumers make complex health plan choices. We examined the choice environment on the state-based Marketplaces and HealthCare.gov in the third open enrollment period. Compared to previous enrollment periods, we found greater adoption of some decision support tools, such as total cost estimators and integrated provider lookups. Total cost estimators differed in how they generated estimates: In some Marketplaces, consumers categorized their own utilization, while in others, consumers answered detailed questions and were assigned a utilization profile. The tools available before creating an account (in the window-shopping period) and afterward (in the real-shopping period) differed in several Marketplaces. For example, five Marketplaces provided total cost estimators to window shoppers, but only two provided them to real shoppers. Further research is needed on the impact of different choice environments and on which tools are most effective in helping consumers pick optimal plans.

  8. Modeling Tool for Decision Support during Early Days of an Anthrax Event

    PubMed Central

    Meltzer, Martin I.; Shadomy, Sean; Bower, William A.; Hupert, Nathaniel

    2017-01-01

    Health officials lack field-implementable tools for forecasting the effects that a large-scale release of Bacillus anthracis spores would have on public health and hospitals. We created a modeling tool (combining inhalational anthrax caseload projections based on initial case reports, effects of variable postexposure prophylaxis campaigns, and healthcare facility surge capacity requirements) to project hospitalizations and casualties from a newly detected inhalation anthrax event, and we examined the consequences of intervention choices. With only 3 days of case counts, the model can predict final attack sizes for simulated Sverdlovsk-like events (1979 USSR) with sufficient accuracy for decision making and confirms the value of early postexposure prophylaxis initiation. According to a baseline scenario, hospital treatment volume peaks 15 days after exposure, deaths peak earlier (day 5), and recovery peaks later (day 23). This tool gives public health, hospital, and emergency planners scenario-specific information for developing quantitative response plans for this threat. PMID:27983505

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

    PubMed

    Huysegoms, Lies; Cappuyns, Valérie

    2017-03-10

    In Europe alone, there are more than 2,5 million potentially contaminated sites of which 14% are expected to require remediation. Contaminated soil and groundwater can cause damage to human health as well as to valuable ecosystems. Globally more attention has been paid to this problem of soil contamination in the past decades. For example, more than 58 000 sites have been remediated in Europe between 2006 and 2011. Together with this increase in remediation projects there has been a surge in the development of new remediation technologies and decision support tools to be able to match every site and its specific characteristics to the best possible remediation alternative. In the past years the development of decision support tools (DST) has evolved in a more sustainable direction. Several DSTs added the claim not only to denote effective or technologically and economically feasible remediation alternatives but also to point out the more or most sustainable remediation alternatives. These trends in the evaluation of site remediation options left users with a confusing clew of possibly applicable tools to assist them in decision making for contaminated site remediation. This review provides a structured overview on the extent decision support tools for contaminated site remediation, that claim to assist in choosing the most sustainable remediation alternative, actually include the different elements of sustainability proposed in our assessment framework. The review contains an in-depth analysis of thirteen tools specifically developed to assess the sustainability of site remediation alternatives. This analysis is based on six criteria derived from the definition of sustainable development of the Brundtland report. The six criteria were concretized by using the three pillars of sustainability, applied to site remediation according to the SuRF-UK framework, two criteria derived from Life Cycle Assessment and Cost-Benefit Analysis, and an 'User friendly' criterion

  10. Effective dialogue: Enhanced public engagement as a legitimising tool for municipal waste management decision-making

    SciTech Connect

    Garnett, Kenisha; Cooper, Tim

    2014-12-15

    Highlights: • A review of public engagement in waste management decision-making is undertaken. • Enhanced public engagement is explored as a means to legitimise waste decisions. • Analytical–deliberative processes are explored as a tool for effective dialogue. • Considerations for integrating public values with technical analysis are outlined. • Insights into the design of appropriate public engagement processes are provided. - Abstract: The complexity of municipal waste management decision-making has increased in recent years, accompanied by growing scrutiny from stakeholders, including local communities. This complexity reflects a socio-technical framing of the risks and social impacts associated with selecting technologies and sites for waste treatment and disposal facilities. Consequently there is growing pressure on local authorities for stakeholders (including communities) to be given an early opportunity to shape local waste policy in order to encourage swift planning, development and acceptance of the technologies needed to meet statutory targets to divert waste from landfill. This paper presents findings from a research project that explored the use of analytical–deliberative processes as a legitimising tool for waste management decision-making. Adopting a mixed methods approach, the study revealed that communicating the practical benefits of more inclusive forms of engagement is proving difficult even though planning and policy delays are hindering development and implementation of waste management infrastructure. Adopting analytical–deliberative processes at a more strategic level will require local authorities and practitioners to demonstrate how expert-citizen deliberations may foster progress in resolving controversial issues, through change in individuals, communities and institutions. The findings suggest that a significant shift in culture will be necessary for local authorities to realise the potential of more inclusive decision

  11. Formative assessment and design of a complex clinical decision support tool for pulmonary embolism.

    PubMed

    Khan, Sundas; McCullagh, Lauren; Press, Anne; Kharche, Manish; Schachter, Andy; Pardo, Salvatore; McGinn, Thomas

    2016-02-01

    Electronic health record (EHR)-based clinical decision support (CDS) tools are rolled out with the urgency to meet federal requirements without time for usability testing and refinement of the user interface. As part of a larger project to design, develop and integrate a pulmonary embolism CDS tool for emergency physicians, we conducted a formative assessment to determine providers' level of interest and input on designs and content. This was a study to conduct a formative assessment of emergency medicine (EM) physicians that included focus groups and key informant interviews. The focus of this study was twofold, to determine the general attitude towards CDS tool integration and the ideal integration point into the clinical workflow. To accomplish this, we first approached EM physicians in a focus group, then, during key informant interviews, we presented workflow designs and gave a scenario to help the providers visualise how the CDS tool works. Participants were asked questions regarding the trigger location, trigger words, integration into their workflow, perceived utility and heuristic of the tool. Results from the participants' survey responses to trigger location, perceived utility and efficiency, indicated that the providers felt the tool would be more of a hindrance than an aid. However, some providers commented that they had not had exposure to CDS tools but had used online calculators, and thought the tools would be helpful at the point-of-care if integrated into the EHR. Furthermore, there was a preference for an order entry wireframe. This study highlights several factors to consider when designing CDS tools: (1) formative assessment of EHR functionality and clinical environment workflow, (2) focus groups and key informative interviews to incorporate providers' perceptions of CDS and workflow integration and/or (3) the demonstration of proposed workflows through wireframes to help providers visualise design concepts.

  12. Decision-support tools for Extreme Weather and Climate Events in the Northeast United States

    NASA Astrophysics Data System (ADS)

    Kumar, S.; Lowery, M.; Whelchel, A.

    2013-12-01

    Decision-support tools were assessed for the 2013 National Climate Assessment technical input document, "Climate Change in the Northeast, A Sourcebook". The assessment included tools designed to generate and deliver actionable information to assist states and highly populated urban and other communities in assessment of climate change vulnerability and risk, quantification of effects, and identification of adaptive strategies in the context of adaptation planning across inter-annual, seasonal and multi-decadal time scales. State-level adaptation planning in the Northeast has generally relied on qualitative vulnerability assessments by expert panels and stakeholders, although some states have undertaken initiatives to develop statewide databases to support vulnerability assessments by urban and local governments, and state agencies. The devastation caused by Superstorm Sandy in October 2012 has raised awareness of the potential for extreme weather events to unprecedented levels and created urgency for action, especially in coastal urban and suburban communities that experienced pronounced impacts - especially in New Jersey, New York and Connecticut. Planning approaches vary, but any adaptation and resiliency planning process must include the following: - Knowledge of the probable change in a climate variable (e.g., precipitation, temperature, sea-level rise) over time or that the climate variable will attain a certain threshold deemed to be significant; - Knowledge of intensity and frequency of climate hazards (past, current or future events or conditions with potential to cause harm) and their relationship with climate variables; - Assessment of climate vulnerabilities (sensitive resources, infrastructure or populations exposed to climate-related hazards); - Assessment of relative risks to vulnerable resources; - Identification and prioritization of adaptive strategies to address risks. Many organizations are developing decision-support tools to assist in the urban

  13. Data Driven Farming: Delivering the Benefits of Remotely Sensed Data and Decision Support Tools to Farmers

    NASA Astrophysics Data System (ADS)

    Shriver, J.; Soloff, J. A.; Molen, N.

    2014-12-01

    Web-based agricultural management software allows for the delivery of previously hard to access soil, weather and remotely sensed data to growers. While access to these data sources is beneficial, growers can realize large gains by leveraging field level data and integrating decision support tools that have been presented in the literature. Using a previously developed model for estimating the growth stage of maize (Sakamoto et al. 2010), we examine how remotely sensed data can be integrated into a web-based agricultural management tool, informing grower management decisions by providing near real-time estimates of crop growth stage and sub-field level variability in growing conditions. When combined with field-level soil and weather data, growers can use remote sensing based models to tailor management activities, taking variable (climate related) and invariant (site characteristic) yield determining factors into account.Time series of Wide Dynamic Range Vegetation Index (WDRVI) derived from Landsat observations were linked to 97 fields growing maize across the Mid-western region of the United States in 2013. Crop growth stage day of year (DOY) estimates (V2.5, R1, R5, and R6) were predicted for each field based on the WDRVI profile and compared to a growing degree day based estimate. These estimates aid in scheduling growth stage specific management activities and allow farmers to more efficiently monitor geographically remote fields. Within-field variation in growing conditions is presented on an ordinal scale (below average, average, above average) based on the field-level distribution of WDRVI values at each observation. Monitoring of sub-field level conditions allows growers to calibrate field-level yield estimates, prioritize field scouting activities and plan targeted interventions. Integration of these tools into existing web-based agricultural management tools allows growers to easily incorporate remotely sensed data into their decision making process

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

    NASA Technical Reports Server (NTRS)

    Otterstatter, Matthew R.

    2005-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Otterstatter, Matthew R.

    2005-01-01

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

  16. Integrated Decision-Making Tool to Develop Spent Fuel Strategies for Research Reactors

    SciTech Connect

    Beatty, Randy L; Harrison, Thomas J

    2016-01-01

    IAEA Member States operating or having previously operated a Research Reactor are responsible for the safe and sustainable management and disposal of associated radioactive waste, including research reactor spent nuclear fuel (RRSNF). This includes the safe disposal of RRSNF or the corresponding equivalent waste returned after spent fuel reprocessing. One key challenge to developing general recommendations lies in the diversity of spent fuel types, locations and national/regional circumstances rather than mass or volume alone. This is especially true given that RRSNF inventories are relatively small, and research reactors are rarely operated at a high power level or duration typical of commercial power plants. Presently, many countries lack an effective long-term policy for managing RRSNF. This paper presents results of the International Atomic Energy Agency (IAEA) Coordinated Research Project (CRP) #T33001 on Options and Technologies for Managing the Back End of the Research Reactor Nuclear Fuel Cycle which includes an Integrated Decision Making Tool called BRIDE (Back-end Research reactor Integrated Decision Evaluation). This is a multi-attribute decision-making tool that combines the Total Estimated Cost of each life-cycle scenario with Non-economic factors such as public acceptance, technical maturity etc and ranks optional back-end scenarios specific to member states situations in order to develop a specific member state strategic plan with a preferred or recommended option for managing spent fuel from Research Reactors.

  17. A visualization tool to support decision making in environmental and biological planning

    USGS Publications Warehouse

    Romañach, Stephanie S.; McKelvy, James M.; Conzelmann, Craig; Suir, Kevin J.

    2014-01-01

    Large-scale ecosystem management involves consideration of many factors for informed decision making. The EverVIEW Data Viewer is a cross-platform desktop decision support tool to help decision makers compare simulation model outputs from competing plans for restoring Florida's Greater Everglades. The integration of NetCDF metadata conventions into EverVIEW allows end-users from multiple institutions within and beyond the Everglades restoration community to share information and tools. Our development process incorporates continuous interaction with targeted end-users for increased likelihood of adoption. One of EverVIEW's signature features is side-by-side map panels, which can be used to simultaneously compare species or habitat impacts from alternative restoration plans. Other features include examination of potential restoration plan impacts across multiple geographic or tabular displays, and animation through time. As a result of an iterative, standards-driven approach, EverVIEW is relevant to large-scale planning beyond Florida, and is used in multiple biological planning efforts in the United States.

  18. Stakeholder views of management and decision support tools to integrate climate change into Great Lakes Lake Whitefish management

    USGS Publications Warehouse

    Lynch, Abigail J.; Taylor, William W.; McCright, Aaron M.

    2016-01-01

    Decision support tools can aid decision making by systematically incorporating information, accounting for uncertainties, and facilitating evaluation between alternatives. Without user buy-in, however, decision support tools can fail to influence decision-making processes. We surveyed fishery researchers, managers, and fishers affiliated with the Lake Whitefish Coregonus clupeaformis fishery in the 1836 Treaty Waters of Lakes Huron, Michigan, and Superior to assess opinions of current and future management needs to identify barriers to, and opportunities for, developing a decision support tool based on Lake Whitefish recruitment projections with climate change. Approximately 64% of 39 respondents were satisfied with current management, and nearly 85% agreed that science was well integrated into management programs. Though decision support tools can facilitate science integration into management, respondents suggest that they face significant implementation barriers, including lack of political will to change management and perceived uncertainty in decision support outputs. Recommendations from this survey can inform development of decision support tools for fishery management in the Great Lakes and other regions.

  19. Randomized Controlled Trial of a Video Decision Support Tool for Cardiopulmonary Resuscitation Decision Making in Advanced Cancer

    PubMed Central

    Volandes, Angelo E.; Paasche-Orlow, Michael K.; Mitchell, Susan L.; El-Jawahri, Areej; Davis, Aretha Delight; Barry, Michael J.; Hartshorn, Kevan L.; Jackson, Vicki Ann; Gillick, Muriel R.; Walker-Corkery, Elizabeth S.; Chang, Yuchiao; López, Lenny; Kemeny, Margaret; Bulone, Linda; Mann, Eileen; Misra, Sumi; Peachey, Matt; Abbo, Elmer D.; Eichler, April F.; Epstein, Andrew S.; Noy, Ariela; Levin, Tomer T.; Temel, Jennifer S.

    2013-01-01

    Purpose Decision making regarding cardiopulmonary resuscitation (CPR) is challenging. This study examined the effect of a video decision support tool on CPR preferences among patients with advanced cancer. Patients and Methods We performed a randomized controlled trial of 150 patients with advanced cancer from four oncology centers. Participants in the control arm (n = 80) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation. Participants in the intervention arm (n = 70) listened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient. The primary outcome was participants' preference for or against CPR measured immediately after exposure to either modality. Secondary outcomes were participants' knowledge of CPR (score range of 0 to 4, with higher score indicating more knowledge) and comfort with video. Results The mean age of participants was 62 years (standard deviation, 11 years); 49% were women, 44% were African American or Latino, and 47% had lung or colon cancer. After the verbal narrative, in the control arm, 38 participants (48%) wanted CPR, 41 (51%) wanted no CPR, and one (1%) was uncertain. In contrast, in the intervention arm, 14 participants (20%) wanted CPR, 55 (79%) wanted no CPR, and 1 (1%) was uncertain (unadjusted odds ratio, 3.5; 95% CI, 1.7 to 7.2; P < .001). Mean knowledge scores were higher in the intervention arm than in the control arm (3.3 ± 1.0 v 2.6 ± 1.3, respectively; P < .001), and 65 participants (93%) in the intervention arm were comfortable watching the video. Conclusion Participants with advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative. PMID:23233708

  20. Decision Support Tools Evaluation Report for FAS/PECAD, Version 2.0

    NASA Technical Reports Server (NTRS)

    Ross, Kenton; McKellip, Rodney; Mason, Ted; Zanoni, Vicki; Morris, Keith

    2004-01-01

    Global agricultral intelligence is a key element of decision support eithin the U.S. Department of Agriculture (USDA). Estimeates of production and yield issued by the USDA for both foreign and domestic agriculture are primary sources of information for policy and management decision making. The USDA monitors the major global agricultural commodities through the Production Estimates and Crop Assessment Division (PECAD) of its Foreign Agricultural Service (FAS). Specifically, PECAD iintelligence focuses on global agricultural production and on conditions that affect food security. In conjunction with the USDA, NASA is evaluating the potential for products from NASA's Earth Science Enterprise (ESE) missions to add value to PECAD's decision support tools. NASA is usig a systems engineering approach to evaluate the potential enhancement of PECAD's decision support system (DSS)-first by understanding the components of the system and its input requirements, then by recommending NASA products that may be integrated as system inputs to improve the accuracy, quality, or efficiency of the DSS output. This report documents the evaluation phase of the systems engineering process and includes an examination of the system architecture, operations, and input requirements, as well as an initial assessment of specific ESE measurement systems and products that should be considered for their potential to enhance the PECAD DSS.

  1. Developing a Tool for Measuring the Decision-Making Competence of Older Adults

    PubMed Central

    Finucane, Melissa L.; Gullion, Christina M.

    2010-01-01

    The authors evaluated the reliability and validity of a tool for measuring older adults’ decision-making competence (DMC). Two-hundred-five younger adults (25-45 years), 208 young-older adults (65-74 years), and 198 old-older adults (75-97 years) made judgments and decisions related to health, finance, and nutrition. Reliable indices of comprehension, dimension weighting, and cognitive reflection were developed. Unlike previous research, the authors were able to compare old-older with young-older adults’ performance. As hypothesized, old-older adults performed more poorly than young-older adults; both groups of older adults performed more poorly than younger adults. Hierarchical regression analyses showed that a large amount of variance in decision performance across age groups (including mean trends) could be accounted for by social variables, health measures, basic cognitive skills, attitudinal measures, and numeracy. Structural equation modeling revealed significant pathways from three exogenous latent factors (crystallized intelligence, other cognitive abilities, and age) to the endogenous DMC latent factor. Further research is needed to validate the meaning of performance on these tasks for real-life decision making. PMID:20545413

  2. Benefits and limitations of using decision analytic tools to assess uncertainty and prioritize Landscape Conservation Cooperative information needs

    USGS Publications Warehouse

    Post van der Burg, Max; Cullinane Thomas, Catherine; Holcombe, Tracy R.; Nelson, Richard D.

    2016-01-01

    The Landscape Conservation Cooperatives (LCCs) are a network of partnerships throughout North America that are tasked with integrating science and management to support more effective delivery of conservation at a landscape scale. In order to achieve this integration, some LCCs have adopted the approach of providing their partners with better scientific information in an effort to facilitate more effective and coordinated conservation decisions. Taking this approach has led many LCCs to begin funding research to provide the information for improved decision making. To ensure that funding goes to research projects with the highest likelihood of leading to more integrated broad scale conservation, some LCCs have also developed approaches for prioritizing which information needs will be of most benefit to their partnerships. We describe two case studies in which decision analytic tools were used to quantitatively assess the relative importance of information for decisions made by partners in the Plains and Prairie Potholes LCC. The results of the case studies point toward a few valuable lessons in terms of using these tools with LCCs. Decision analytic tools tend to help shift focus away from research oriented discussions and toward discussions about how information is used in making better decisions. However, many technical experts do not have enough knowledge about decision making contexts to fully inform the latter type of discussion. When assessed in the right decision context, however, decision analyses can point out where uncertainties actually affect optimal decisions and where they do not. This helps technical experts understand that not all research is valuable in improving decision making. But perhaps most importantly, our results suggest that decision analytic tools may be more useful for LCCs as way of developing integrated objectives for coordinating partner decisions across the landscape, rather than simply ranking research priorities.

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

    SciTech Connect

    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 approach - 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.

  4. A decision support tool for landfill methane generation and gas collection.

    PubMed

    Emkes, Harriet; Coulon, Frédéric; Wagland, Stuart

    2015-09-01

    This study presents a decision support tool (DST) to enhance methane generation at individual landfill sites. To date there is no such tool available to provide landfill decision makers with clear and simplified information to evaluate biochemical processes within a landfill site, to assess performance of gas production and to identify potential remedies to any issues. The current lack in understanding stems from the complexity of the landfill waste degradation process. Two scoring sets for landfill gas production performance are calculated with the tool: (1) methane output score which measures the deviation of the actual methane output rate at each site which the prediction generated by the first order decay model LandGEM; and (2) landfill gas indicators' score, which measures the deviation of the landfill gas indicators from their ideal ranges for optimal methane generation conditions. Landfill gas indicators include moisture content, temperature, alkalinity, pH, BOD, COD, BOD/COD ratio, ammonia, chloride, iron and zinc. A total landfill gas indicator score is provided using multi-criteria analysis to calculate the sum of weighted scores for each indicator. The weights for each indicator are calculated using an analytical hierarchical process. The tool is tested against five real scenarios for landfill sites in UK with a range of good, average and poor landfill methane generation over a one year period (2012). An interpretation of the results is given for each scenario and recommendations are highlighted for methane output rate enhancement. Results demonstrate how the tool can help landfill managers and operators to enhance their understanding of methane generation at a site-specific level, track landfill methane generation over time, compare and rank sites, and identify problems areas within a landfill site.

  5. An ArcGIS decision support tool for artificial reefs site selection (ArcGIS ARSS)

    NASA Astrophysics Data System (ADS)

    Stylianou, Stavros; Zodiatis, George

    2017-04-01

    Although the use and benefits of artificial reefs, both socio-economic and environmental, have been recognized with research and national development programmes worldwide their development is rarely subjected to a rigorous site selection process and the majority of the projects use the traditional (non-GIS) approach, based on trial and error mode. Recent studies have shown that the use of Geographic Information Systems, unlike to traditional methods, for the identification of suitable areas for artificial reefs siting seems to offer a number of distinct advantages minimizing possible errors, time and cost. A decision support tool (DSS) has been developed based on the existing knowledge, the multi-criteria decision analysis techniques and the GIS approach used in previous studies in order to help the stakeholders to identify the optimal locations for artificial reefs deployment on the basis of the physical, biological, oceanographic and socio-economic features of the sites. The tool provides to the users the ability to produce a final report with the results and suitability maps. The ArcGIS ARSS support tool runs within the existing ArcMap 10.2.x environment and for the development the VB .NET high level programming language has been used along with ArcObjects 10.2.x. Two local-scale case studies were conducted in order to test the application of the tool focusing on artificial reef siting. The results obtained from the case studies have shown that the tool can be successfully integrated within the site selection process in order to select objectively the optimal site for artificial reefs deployment.

  6. Decision tools for bacterial blight resistance gene deployment in rice-based agricultural ecosystems

    PubMed Central

    Dossa, Gerbert S.; Sparks, Adam; Cruz, Casiana Vera; Oliva, Ricardo

    2015-01-01

    Attempting to achieve long-lasting and stable resistance using uniformly deployed rice varieties is not a sustainable approach. The real situation appears to be much more complex and dynamic, one in which pathogens quickly adapt to resistant varieties. To prevent disease epidemics, deployment should be customized and this decision will require interdisciplinary actions. This perspective article aims to highlight the current progress on disease resistance deployment to control bacterial blight in rice. Although the model system rice-Xanthomonas oryzae pv. oryzae has distinctive features that underpin the need for a case-by-case analysis, strategies to integrate those elements into a unique decision tool could be easily extended to other crops. PMID:25999970

  7. Decision tools for bacterial blight resistance gene deployment in rice-based agricultural ecosystems.

    PubMed

    Dossa, Gerbert S; Sparks, Adam; Cruz, Casiana Vera; Oliva, Ricardo

    2015-01-01

    Attempting to achieve long-lasting and stable resistance using uniformly deployed rice varieties is not a sustainable approach. The real situation appears to be much more complex and dynamic, one in which pathogens quickly adapt to resistant varieties. To prevent disease epidemics, deployment should be customized and this decision will require interdisciplinary actions. This perspective article aims to highlight the current progress on disease resistance deployment to control bacterial blight in rice. Although the model system rice-Xanthomonas oryzae pv. oryzae has distinctive features that underpin the need for a case-by-case analysis, strategies to integrate those elements into a unique decision tool could be easily extended to other crops.

  8. Decision models in the evaluation of psychotropic drugs : useful tool or useless toy?

    PubMed

    Barbui, Corrado; Lintas, Camilla

    2006-09-01

    A current contribution in the European Journal of Health Economics employs a decision model to compare health care costs of olanzapine and risperidone treatment for schizophrenia. The model suggests that a treatment strategy of first-line olanzapine is cost-saving over a 1-year period, with additional clinical benefits in the form of avoided relapses in the long-term. From a clinical perspective this finding is indubitably relevant, but can physicians and policy makers believe it? The study is presented in a balanced way, assumptions are based on data extracted from clinical trials published in major psychiatric journals, and the theoretical underpinnings of the model are reasonable. Despite these positive aspects, we believe that the methodology used in this study-the decision model approach-is an unsuitable and potentially misleading tool for evaluating psychotropic drugs. In this commentary, taking the olanzapine vs. risperidone model as an example, arguments are provided to support this statement.

  9. [AntibioticScout.ch: A decision supporting tool for antimicrobial stewardship: application to companion animal medicine].

    PubMed

    Peter, R; Demuth, D; Müntener, C; Lampart, M; Heim, D; Mevissen, M; Schüpbach-Regula, G; Schuller, S; Stucki, F; Willi, B; Burkhardt, W; Francey, T; Nett, C; Tschuor, F; Naegeli, H

    2017-10-01

    Bacterial resistances to antimicrobial drugs pose serious public health challenges. The observed increase of resistances is attributed to the uncontrolled, massive and often unnecessary administration of antibiotics both in human and veterinary medicine. To support the responsible use of antimicrobials in animals and help veterinarians selecting the most suitable antimicrobial drugs, we developed the AntibioticScout.ch as a comprehensive decision supporting tool providing online access to the current knowledge of rational antibiotic prescription practices. User-friendly search functions allow for the fast and efficient retrieval of information that is structured in this database by animal species, organ systems and therapeutic indications. In addition, an online form allows to report treatment failures in order to identify problematic cases as well as ensuing risks and take appropriate mitigation measures. The present report describes the workflow of this decision support system applied to the prudent use of antimicrobials in companion animal medicine.

  10. Participatory design of probability-based decision support tools for in-hospital nurses.

    PubMed

    Jeffery, Alvin D; Novak, Laurie L; Kennedy, Betsy; Dietrich, Mary S; Mion, Lorraine C

    2017-06-19

    To describe nurses' preferences for the design of a probability-based clinical decision support (PB-CDS) tool for in-hospital clinical deterioration. A convenience sample of bedside nurses, charge nurses, and rapid response nurses ( n  = 20) from adult and pediatric hospitals completed participatory design sessions with researchers in a simulation laboratory to elicit preferred design considerations for a PB-CDS tool. Following theme-based content analysis, we shared findings with user interface designers and created a low-fidelity prototype. Three major themes and several considerations for design elements of a PB-CDS tool surfaced from end users. Themes focused on "painting a picture" of the patient condition over time, promoting empowerment, and aligning probability information with what a nurse already believes about the patient. The most notable design element consideration included visualizing a temporal trend of the predicted probability of the outcome along with user-selected overlapping depictions of vital signs, laboratory values, and outcome-related treatments and interventions. Participants expressed that the prototype adequately operationalized requests from the design sessions. Participatory design served as a valuable method in taking the first step toward developing PB-CDS tools for nurses. This information about preferred design elements of tools that support, rather than interrupt, nurses' cognitive workflows can benefit future studies in this field as well as nurses' practice.

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

    PubMed

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

    2016-01-01

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

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

    EPA Science Inventory

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

  18. A Set of Web-based Tools for Integrating Scientific Research and Decision-Making through Systems Thinking

    EPA Science Inventory

    Currently, many policy and management decisions are made without considering the goods and services humans derive from ecosystems and the costs associated with protecting them. This approach is unlikely to be sustainable. Conceptual frameworks provide a tool for capturing, visual...

  19. A Set of Web-based Tools for Integrating Scientific Research and Decision-Making through Systems Thinking

    EPA Science Inventory

    Currently, many policy and management decisions are made without considering the goods and services humans derive from ecosystems and the costs associated with protecting them. This approach is unlikely to be sustainable. Conceptual frameworks provide a tool for capturing, visual...

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

    PubMed Central

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

    2015-01-01

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

  1. Clinical decision support tools for osteoporosis disease management: a systematic review of randomized controlled trials.

    PubMed

    Kastner, Monika; Straus, Sharon E

    2008-12-01

    Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management.

  2. Clinical Decision Support Tools for Osteoporosis Disease Management: A Systematic Review of Randomized Controlled Trials

    PubMed Central

    Straus, Sharon E.

    2008-01-01

    BACKGROUND Studies indicate a gap between evidence and clinical practice in osteoporosis management. Tools that facilitate clinical decision making at the point of care are promising strategies for closing these practice gaps. OBJECTIVE To systematically review the literature to identify and describe the effectiveness of tools that support clinical decision making in osteoporosis disease management. DATA SOURCES Medline, EMBASE, CINAHL, and EBM Reviews (CDSR, DARE, CCTR, and ACP J Club), and contact with experts in the field. REVIEW METHODS Randomized controlled trials (RCTs) in any language from 1966 to July 2006 investigating disease management interventions in patients at risk for osteoporosis. Outcomes included fractures and bone mineral density (BMD) testing. Two investigators independently assessed articles for relevance and study quality, and extracted data using standardized forms. RESULTS Of 1,246 citations that were screened for relevance, 13 RCTs met the inclusion criteria. Reported study quality was generally poor. Meta-analysis was not done because of methodological and clinical heterogeneity; 77% of studies included a reminder or education as a component of their intervention. Three studies of reminders plus education targeted to physicians and patients showed increased BMD testing (RR range 1.43 to 8.67) and osteoporosis medication use (RR range 1.60 to 8.67). A physician reminder plus a patient risk assessment strategy found reduced fractures [RR 0.58, 95% confidence interval (CI) 0.37 to 0.90] and increased osteoporosis therapy (RR 2.44, CI 1.43 to 4.17). CONCLUSION Multi-component tools that are targeted to physicians and patients may be effective for supporting clinical decision making in osteoporosis disease management. Electronic supplementary material The online version of this article (doi:10.1007/s11606-008-0812-9) contains supplementary material, which is available to authorized users. PMID:18836782

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

    NASA Astrophysics Data System (ADS)

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

    2010-03-01

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

  4. Addendum to Air Quality: Decision Support Tools, Partner Plans, Working Groups, Committees

    NASA Technical Reports Server (NTRS)

    Holekamp, Kara; Frisbie, Troy; Estep, Lee

    2005-01-01

    In the original report dated February 11, 2005, the utility of the NASA Earth science data in the air quality activities of other agencies and organizations was assessed by reviewing strategic and mission plans and by conducting personal interviews with agency experts to identify and investigate agencies with the potential for partnership with NASA. The overarching agency strategic plans were reviewed and commonalities such as the desire for partnerships and technology development were noted. The addendum to the original report contains such information about the Tennessee Valley Authority and will be inserted in Section 2.6 of "Air Quality Decision Support Tools, Partner Plans, Working Groups, Committees".

  5. Addendum to Air Quality: Decision Support Tools, Partner Plans, Working Groups, Committees

    NASA Technical Reports Server (NTRS)

    Holekamp, Kara; Frisbie, Troy; Estep, Lee

    2005-01-01

    In the original report dated February 11, 2005, the utility of NASA Earth science data in the air quality activities of other agencies and organizations was assessed by reviewing strategic and mission plans and by conducting personal interviews with agency experts to identify and investigate agencies with the potential for partnership with NASA. The overarching agency strategic plans were reviewed and commonalities such as the desire for partnerships and technology development were noted. This addendum to the original report contains such information about the Tennessee Valley Authority and will be inserted as Section 2.6 of "Air Quality: Decision Support Tools, Partner Plans, Working Groups, Committees."

  6. Remote Sensing: A valuable tool in the Forest Service decision making process. [in Utah

    NASA Technical Reports Server (NTRS)

    Stanton, F. L.

    1975-01-01

    Forest Service studies for integrating remotely sensed data into existing information systems highlight a need to: (1) re-examine present methods of collecting and organizing data, (2) develop an integrated information system for rapidly processing and interpreting data, (3) apply existing technological tools in new ways, and (4) provide accurate and timely information for making right management decisions. The Forest Service developed an integrated information system using remote sensors, microdensitometers, computer hardware and software, and interactive accessories. Their efforts substantially reduce the time it takes for collecting and processing data.

  7. Predicting Human Error in Air Traffic Control Decision Support Tools and Free Flight Concepts

    NASA Technical Reports Server (NTRS)

    Mogford, Richard; Kopardekar, Parimal

    2001-01-01

    The document is a set of briefing slides summarizing the work the Advanced Air Transportation Technologies (AATT) Project is doing on predicting air traffic controller and airline pilot human error when using new decision support software tools and when involved in testing new air traffic control concepts. Previous work in this area is reviewed as well as research being done jointly with the FAA. Plans for error prediction work in the AATT Project are discussed. The audience is human factors researchers and aviation psychologists from government and industry.

  8. Remote Sensing: A valuable tool in the Forest Service decision making process. [in Utah

    NASA Technical Reports Server (NTRS)

    Stanton, F. L.

    1975-01-01

    Forest Service studies for integrating remotely sensed data into existing information systems highlight a need to: (1) re-examine present methods of collecting and organizing data, (2) develop an integrated information system for rapidly processing and interpreting data, (3) apply existing technological tools in new ways, and (4) provide accurate and timely information for making right management decisions. The Forest Service developed an integrated information system using remote sensors, microdensitometers, computer hardware and software, and interactive accessories. Their efforts substantially reduce the time it takes for collecting and processing data.

  9. Performance of online drug information databases as clinical decision support tools in infectious disease medication management.

    PubMed

    Polen, Hyla H; Zapantis, Antonia; Clauson, Kevin A; Clauson, Kevin Alan; Jebrock, Jennifer; Paris, Mark

    2008-11-06

    Infectious disease (ID) medication management is complex and clinical decision support tools (CDSTs) can provide valuable assistance. This study evaluated scope and completeness of ID drug information found in online databases by evaluating their ability to answer 147 question/answer pairs. Scope scores produced highest rankings (%) for: Micromedex (82.3), Lexi-Comp/American Hospital Formulary Service (81.0), and Medscape Drug Reference (81.0); lowest includes: Epocrates Online Premium (47.0), Johns Hopkins ABX Guide (45.6), and PEPID PDC (40.8).

  10. Predicting Human Error in Air Traffic Control Decision Support Tools and Free Flight Concepts

    NASA Technical Reports Server (NTRS)

    Mogford, Richard; Kopardekar, Parimal

    2001-01-01

    The document is a set of briefing slides summarizing the work the Advanced Air Transportation Technologies (AATT) Project is doing on predicting air traffic controller and airline pilot human error when using new decision support software tools and when involved in testing new air traffic control concepts. Previous work in this area is reviewed as well as research being done jointly with the FAA. Plans for error prediction work in the AATT Project are discussed. The audience is human factors researchers and aviation psychologists from government and industry.

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

    Treesearch

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

    2013-01-01

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

  12. Developing and Validating a Tool to Assess Ethical Decision-Making Ability of Nursing Students, Using Rubrics

    ERIC Educational Resources Information Center

    Indhraratana, Apinya; Kaemkate, Wannee

    2012-01-01

    The aim of this paper is to develop a reliable and valid tool to assess ethical decision-making ability of nursing students using rubrics. A proposed ethical decision making process, from reviewing related literature was used as a framework for developing the rubrics. Participants included purposive sample of 86 nursing students from the Royal…

  13. Developing and Validating a Tool to Assess Ethical Decision-Making Ability of Nursing Students, Using Rubrics

    ERIC Educational Resources Information Center

    Indhraratana, Apinya; Kaemkate, Wannee

    2012-01-01

    The aim of this paper is to develop a reliable and valid tool to assess ethical decision-making ability of nursing students using rubrics. A proposed ethical decision making process, from reviewing related literature was used as a framework for developing the rubrics. Participants included purposive sample of 86 nursing students from the Royal…

  14. Decision support tools for urban water and wastewater systems--focussing on hazardous flows assessment.

    PubMed

    Malmqvist, P A; Palmquist, H

    2005-01-01

    The Swedish research programme Urban Water has developed a concept of a multi-criteria basis intended to support decision-making for urban water and wastewater systems. Five criteria groups were established for sustainability assessment of urban water systems: Health and Hygiene, Environment, Economy, Socio-culture, and Technology. Each criterion requires a set of indicators corresponding to quantifiable facts and figures, or qualitative data to comparatively assess the different alternatives in the decision process. The decision support process starts as a baseline study where the existing conditions are addressed. Alternative strategies of the future urban water system are developed and analysed by different tools and methodologies in assessing the five criteria groups. Eventually, the results and conclusions are integrated and synthesised into a basis for decision-making. As an example of a decision support basis for chemical safety, a barrier perspective was introduced to find out if and to what extent hazardous substances can be stopped, diverged, or transformed at various points in the wastewater system. A set of barriers was suggested, i.e. behaviour, systems design, process design, optional recipients, and organisational. The barrier approach was applied to two alternative municipal wastewater system designs--a combined wastewater system vs. a source separated system--analysing the fate of phosphorus, cadmium, and triclosan. The study showed that the combined system caused a higher substance flow to the receiving waterbody than the separated system. The combined system also brought more phosphorus and cadmium to the farmland than the separated system, but only half the amount of triclosan.

  15. Tools for Risk-Based UXO Remediation

    DTIC Science & Technology

    2014-01-01

    we (i) performed a probabilistic risk assessment using polarizabilities and ground truth information from Camp San Luis Obispo , Camp Butner, and...actual depth distribution of the UXO recovered at San Luis Obispo and results of the synthetic seed study, we conclude that all of the UXO, at least...same detection scheme, for burial depths of up to 0.77m. Thus, the detection process applied to ESTCP’s Classification Study at San Luis Obispo , CA

  16. Methods Linking Predictive Weather and Fine-scale Soil Moisture to Crop and Irrigation Decision Tools

    NASA Astrophysics Data System (ADS)

    Jones, A. S.; Andales, A.; Niemann, J. D.; Cammarere, M.; Fletcher, S. J.; Corbett, J.

    2016-12-01

    More than 30% of all irrigated US agricultural output comes from the lands sustained by the Ogallala Aquifer in the western Great Plains. The agricultural production practices in six states (CO, KS, NE, NM, OK, and TX) affect water usage and the interactive multi-scale phytobiome processes of the individual crop types. Tested methods to optimize water use and crop production at the field-scale are needed as the Ogallala water resources undergo change. This work presents methods used to link predictive weather and downscaled soil moisture at 10-30 m scales for use in crop and irrigation applications, and other decision tools. Our focus is on the CSU Water Irrigation Scheduler for Efficient (WISE) Application tool, crop yield models, and remote soil moisture characterization as a demonstration of how complex fine-scale phytobiome processes and methods can be linked to weather and environmental remote sensing data sets in near real-time using scalable technologies.

  17. Sharing clinical decisions for multimorbidity case management using social network and open-source tools.

    PubMed

    Martínez-García, Alicia; Moreno-Conde, Alberto; Jódar-Sánchez, Francisco; Leal, Sandra; Parra, Carlos

    2013-12-01

    Social networks applied through Web 2.0 tools have gained importance in health domain, because they produce improvements on the communication and coordination capabilities among health professionals. This is highly relevant for multimorbidity patients care because there is a large number of health professionals in charge of patient care, and this requires to obtain clinical consensus in their decisions. Our objective is to develop a tool for collaborative work among health professionals for multimorbidity patient care. We describe the architecture to incorporate decision support functionalities in a social network tool to enable the adoption of shared decisions among health professionals from different care levels. As part of the first stage of the project, this paper describes the results obtained in a pilot study about acceptance and use of the social network component in our healthcare setting. At Virgen del Rocío University Hospital we have designed and developed the Shared Care Platform (SCP) to provide support in the continuity of care for multimorbidity patients. The SCP has two consecutively developed components: social network component, called Clinical Wall, and Clinical Decision Support (CDS) system. The Clinical Wall contains a record where health professionals are able to debate and define shared decisions. We conducted a pilot study to assess the use and acceptance of the SCP by healthcare professionals through questionnaire based on the theory of the Technology Acceptance Model. In March 2012 we released and deployed the SCP, but only with the social network component. The pilot project lasted 6 months in the hospital and 2 primary care centers. From March to September 2012 we created 16 records in the Clinical Wall, all with a high priority. A total of 10 professionals took part in the exchange of messages: 3 internists and 7 general practitioners generated 33 messages. 12 of the 16 record (75%) were answered by the destination health professionals

  18. DEVELOPMENT OF PROTOCOLS AND DECISION SUPPORT TOOLS FOR ASSESSING WATERSHED SYSTEM ASSIMILATIVE CAPACITY (SAC), IN SUPPORT OF RISK-BASED ECOSYSTEM MANAGEMENT/RESTORATION PRACTICES

    EPA Science Inventory

    The National Risk Management Research Laboratory (NRMRL) has instituted a program for Risk Management Research for Ecosystem Restoration in Watersheds. This program is one component of the Office of Research and Development Ecosystem Protection Research Program. As part of this...

  19. A decision support tool for identifying abuse of controlled substances by ForwardHealth Medicaid members.

    PubMed

    Mailloux, Allan T; Cummings, Stephen W; Mugdh, Mrinal

    2010-01-01

    Our objective was to use Wisconsin's Medicaid Evaluation and Decision Support (MEDS) data warehouse to develop and validate a decision support tool (DST) that (1) identifies Wisconsin Medicaid fee-for-service recipients who are abusing controlled substances, (2) effectively replicates clinical pharmacist recommendations for interventions intended to curb abuse of physician and pharmacy services, and (3) automates data extraction, profile generation and tracking of recommendations and interventions. From pharmacist manual reviews of medication profiles, seven measures of overutilization of controlled substances were developed, including (1-2) 6-month and 2-month "shopping" scores, (3-4) 6-month and 2-month forgery scores, (5) duplicate/same day prescriptions, (6) count of controlled substance claims, and the (7) shopping 6-month score for the individual therapeutic class with the highest score. The pattern analysis logic for the measures was encoded into SQL and applied to the medication profiles of 190 recipients who had already undergone manual review. The scores for each measure and numbers of providers were analyzed by exhaustive chi-squared automatic interaction detection (CHAID) to determine significant thresholds and combinations of predictors of pharmacist recommendations, resulting in a decision tree to classify recipients by pharmacist recommendations. The overall correct classification rate of the decision tree was 95.3%, with a 2.4% false positive rate and 4.0% false negative rate for lock-in versus prescriber-alert letter recommendations. Measures used by the decision tree include the 2-month and 6-month shopping scores, and the number of pharmacies and prescribers. The number of pharmacies was the best predictor of abuse of controlled substances. When a Medicaid recipient receives prescriptions for controlled substances at 8 or more pharmacies, the likelihood of a lock-in recommendation is 90%. The availability of the Wisconsin MEDS data warehouse has

  20. Identifying Decision Support Tools to Bridge Climate and Agricultural Needs in the Midwest

    NASA Astrophysics Data System (ADS)

    Hall, B. L.; Kluck, D. R.; Hatfield, J.; Black, C.; Kellner, O.; Woloszyn, M.; Timlin, M. S.

    2015-12-01

    Climate monitoring tools designed to help stakeholders reduce climate impacts have been developed for the primary Midwest field crops of corn and soybean. However, the region also produces vital livestock and specialty crops that currently lack similar climate monitoring and projection tools. In autumn 2015, the National Oceanic and Atmospheric Administration's (NOAA's) National Integrated Drought Information System (NIDIS) and Midwestern Regional Climate Center (MRCC) partnered with the US Department of Agriculture's Midwest Climate Hub to convene agriculture stakeholders, climate scientists, and climate service specialists to discuss climate impacts and needs for these two, often under-represented, sectors. The goals of this workshop were to (1) identify climate impacts that specialty crops and livestock producers face within the Midwest, (2) develop an understanding of the types of climate and weather information and tools currently available in the Midwest that could be applied to decision making, and (3) discover the types of climate and weather information and tools needed to address concerns of specialty crop and livestock commodities across the Midwest. This presentation will discuss the workshop and provide highlights of the outcomes that developed into strategic plans for the future to better serve these sectors of agriculture in the Midwest.

  1. 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

  2. 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

  3. Learning environment simulator: a tool for local decision makers and first responders

    SciTech Connect

    Leclaire, Rene J; Hirsch, Gary B

    2009-01-01

    The National Infrastructure Simulation and Analysis Center (NISAC) has developed a prototype learning environment simulator (LES) based on the Critical Infrastructure Protection Decision Support System (CIPDSS) infrastructure and scenario models. The LES is designed to engage decision makers at the grass-roots level (local/city/state) to deepen their understanding of an evolving crisis, enhance their intuition and allow them to test their own strategies for events before they occur. An initial version is being developed, centered on a pandemic influenza outbreak and has been successfully tested with a group of hospital administrators and first responders. LES is not a predictive tool but rather a simulated environment allowing the user to experience the complexities of a crisis before it happens. Users can contrast various approaches to the crisis, competing with alternative strategies of their own or other participants. LES is designed to assist decision makers in making informed choices by functionally representing relevant scenarios before they occur, including impacts to critical infrastructures with their interdependencies, and estimating human health & safety and economic impacts. In this paper a brief overview of the underlying models are given followed by a description of the LES, its interface and usage and an overview of the experience testing LES with a group of hospital administrators and first responders. The paper concludes with a brief discussion of the work remaining to make LES operational.

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

    NASA Technical Reports Server (NTRS)

    McKellipo, Rodney; Ross, Kenton W.

    2006-01-01

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

  5. Effective dialogue: enhanced public engagement as a legitimising tool for municipal waste management decision-making.

    PubMed

    Garnett, Kenisha; Cooper, Tim

    2014-12-01

    The complexity of municipal waste management decision-making has increased in recent years, accompanied by growing scrutiny from stakeholders, including local communities. This complexity reflects a socio-technical framing of the risks and social impacts associated with selecting technologies and sites for waste treatment and disposal facilities. Consequently there is growing pressure on local authorities for stakeholders (including communities) to be given an early opportunity to shape local waste policy in order to encourage swift planning, development and acceptance of the technologies needed to meet statutory targets to divert waste from landfill. This paper presents findings from a research project that explored the use of analytical-deliberative processes as a legitimising tool for waste management decision-making. Adopting a mixed methods approach, the study revealed that communicating the practical benefits of more inclusive forms of engagement is proving difficult even though planning and policy delays are hindering development and implementation of waste management infrastructure. Adopting analytical-deliberative processes at a more strategic level will require local authorities and practitioners to demonstrate how expert-citizen deliberations may foster progress in resolving controversial issues, through change in individuals, communities and institutions. The findings suggest that a significant shift in culture will be necessary for local authorities to realise the potential of more inclusive decision processes. This calls for political actors and civic society to collaborate in institutionalising public involvement in both strategic and local planning structures.

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

    PubMed

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

    2017-01-01

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

  7. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Minard, Charles; Saile, Lynn; deCarvalho, Mary Freire; Myers, Jerry; Walton, Marlei; Butler, Douglas; Iyengar, Sriram; Johnson-Throop, Kathy; Baumann, David

    2009-01-01

    The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

  8. The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Human Space Flight Missions

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric L.; Minard, Charles; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

    2011-01-01

    This slide presentation reviews the Integrated Medical Model (IMM) and its use as a risk assessment and decision support tool for human space flight missions. The IMM is an integrated, quantified, evidence-based decision support tool useful to NASA crew health and mission planners. It is intended to assist in optimizing crew health, safety and mission success within the constraints of the space flight environment for in-flight operations. It uses ISS data to assist in planning for the Exploration Program and it is not intended to assist in post flight research. The IMM was used to update Probability Risk Assessment (PRA) for the purpose of updating forecasts for the conditions requiring evacuation (EVAC) or Loss of Crew Life (LOC) for the ISS. The IMM validation approach includes comparison with actual events and involves both qualitative and quantitaive approaches. The results of these comparisons are reviewed. Another use of the IMM is to optimize the medical kits taking into consideration the specific mission and the crew profile. An example of the use of the IMM to optimize the medical kits is reviewed.

  9. Evaluation of Pushback Decision-Support Tool Concept for Charlotte Douglas International Airport Ramp Operations

    NASA Technical Reports Server (NTRS)

    Hayashi, Miwa; Hoang, Ty; Jung, Yoon C.; Malik, Waqar; Lee, Hanbong; Dulchinos, Victoria L.

    2015-01-01

    This paper proposes a new departure pushback decision-support tool (DST) for airport ramp-tower controllers. It is based on NASA's Spot and Runway Departure Advisor (SARDA) collaborative decision-making concept, except with the modification that the gate releases now are controlled by tactical pushback (or gate-hold) advisories instead of strategic pre-assignments of target pushback times to individual departure flights. The proposed ramp DST relies on data exchange with the airport traffic control tower (ATCT) to coordinate pushbacks with the ATCT's flow-management intentions under current operational constraints, such as Traffic Management Initiative constraints. Airlines would benefit in reduced taxi delay and fuel burn. The concept was evaluated in a human-in-the-loop simulation experiment with current ramp-tower controllers at the Charlotte Douglas International Airport as participants. The results showed that the tool helped reduce taxi time by one minute per flight and overall departure flight fuel consumption by 10-12% without reducing runway throughput. Expect Departure Clearance Time (EDCT) conformance also was improved when advisories were provided. These benefits were attained without increasing the ramp-tower controllers' workload. Additionally, the advisories reduced the ATCT controllers' workload.

  10. A review of decision support, risk communication and patient information tools for thrombolytic treatment in acute stroke: lessons for tool developers

    PubMed Central

    2013-01-01

    Background Tools to support clinical or patient decision-making in the treatment/management of a health condition are used in a range of clinical settings for numerous preference-sensitive healthcare decisions. Their impact in clinical practice is largely dependent on their quality across a range of domains. We critically analysed currently available tools to support decision making or patient understanding in the treatment of acute ischaemic stroke with intravenous thrombolysis, as an exemplar to provide clinicians/researchers with practical guidance on development, evaluation and implementation of such tools for other preference-sensitive treatment options/decisions in different clinical contexts. Methods Tools were identified from bibliographic databases, Internet searches and a survey of UK and North American stroke networks. Two reviewers critically analysed tools to establish: information on benefits/risks of thrombolysis included in tools, and the methods used to convey probabilistic information (verbal descriptors, numerical and graphical); adherence to guidance on presenting outcome probabilities (IPDASi probabilities items) and information content (Picker Institute Checklist); readability (Fog Index); and the extent that tools had comprehensive development processes. Results Nine tools of 26 identified included information on a full range of benefits/risks of thrombolysis. Verbal descriptors, frequencies and percentages were used to convey probabilistic information in 20, 19 and 18 tools respectively, whilst nine used graphical methods. Shortcomings in presentation of outcome probabilities (e.g. omitting outcomes without treatment) were identified. Patient information tools had an aggregate median Fog index score of 10. None of the tools had comprehensive development processes. Conclusions Tools to support decision making or patient understanding in the treatment of acute stroke with thrombolysis have been sub-optimally developed. Development of tools

  11. Values based decision making: a tool for achieving the goals of healthcare.

    PubMed

    Mills, Anne E; Spencer, Edward M

    2005-03-01

    The recognition that the success of the healthcare organization depends on its achievement of two interrelated goals is a relatively recent phenomenon. In its mid-history the healthcare organization was largely able to ignore cost issues. In its latter history, many would argue that it ignored its quality goals as it pursued its cost goals (15). Either approach, given declining revenues and a competitive landscape, is incompatible with continued responsible operation. If this is true, then tools that were appropriate when the healthcare organization was focused on the achievement of one or another of these goals are not adequate as the healthcare organization seeks to achieve both goals together. Thus, new perspectives and new tools must be found that help the organization address two intimately related but sometimes conflicting goals. Values based decision-making can be the perspective needed, and organization ethics is one tool that can be of use in supporting it within the institution. But there are caveats. In order for values based decision-making to be effective, leadership must take an active role in promoting its use. It must relinquish a degree of control and it must begin to trust its stakeholders to make decisions within the context of the organization's values and goals. This can be extremely difficult, as control by senior management is often seen as the only effective means of ensuring that correct decisions are made. There are additional difficulties in the healthcare organization. Control rests within two groups and the healthcare organization is operating in an environment in which variance elimination is emphasized as a means of controlling costs. This may be an appealing notion for revenue strapped healthcare organization leaders, but it implies greater control exerted by managers, not less. Relinquishing any degree of control is a frightening prospect, but it has been done successfully. An excellent example of leadership encouraging decisions

  12. Life cycle costing as a decision making tool for technology acquisition in radio-diagnosis

    PubMed Central

    Chakravarty, Abhijit; Debnath, Jyotindu

    2014-01-01

    Background Life cycle costing analysis is an emerging conceptual tool to validate capital investment in healthcare. Methods A preliminary study was done to analyze the long-term cost impact of acquiring a new 3 T MRI system when compared to technological upgradation of the existing 1.5 T MRI system with a view to evolve a decision matrix for correct investment planning and technology management. Operating costing method was utilized to estimate cost per unit MRI scan, costing inputs were considered for the existing 1.5 T and the proposed 3 T machine. Cost for each expected year in the life span of both 1.5 T and 3 T MRI scan options were then discounted to its Net Present Value. Net Present Value thus calculated for both the alternative options of 1.5 T and 3 T MRI machine was charted along with various intangible but critical Figures of Merit (FOM) to create a decision matrix for capital investment planning. Result Considering all fixed and variable costs contributing towards assumed operation, unit cost per MRI procedure was found to be Rs. 4244.58 for the 1.5 T upgrade and Rs. 6059.37 for the new 3 T MRI machine. Life Cycle Cost Analysis of the proposed 1.5 T upgrade and new 3 T machine showed a Net Present Value of Rs. 42,148,587.80 and Rs. 27,587,842.38 respectively. Conclusion The utility of life cycle costing as a strategic decision making tool towards evaluating alternative options for capital investment planning in health care environment is reiterated. PMID:25609862

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

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

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

  14. DE-CERTS: A Decision Support System for a Comparative Evaluation Method for Risk Management Methodologies and Tools

    DTIC Science & Technology

    1991-09-01

    Patton , Michael Quinn . Qualitative Evaluation Methods . Sage, 1980. Pfleeger, Charles P...the research and indicates directions for further research . 6 II. CERTS: A COMPARATIVE EVALUATION METHOD FOR RISK MANAGDENT METHODOLOGIES AND TOOLS A...A DECISION SUPPORT SYSTEM FOR A COMPARATIVE EVALUATION METHOD FOR RISK MANAGEMENT METHODOLOGIES AND TOOLS by Leonard A. Crump Jr. and James G.

  15. Facilitating adaptive management in the Chesapeake Bay Watershed through the use of online decision support tools

    USGS Publications Warehouse

    Mullinx, Cassandra; Phillips, Scott; Shenk, Kelly; Hearn, Paul; Devereux, Olivia

    2009-01-01

    The Chesapeake Bay Program (CBP) is attempting to more strategically implement management actions to improve the health of the Nation’s largest estuary. In 2007 the U.S. Geological Survey (USGS) and U.S. Environmental Protection Agency (USEPA) CBP office began a joint effort to develop a suite of Internetaccessible decision-support tools and to help meet the needs of CBP partners to improve water quality and habitat conditions in the Chesapeake Bay and its watersheds. An adaptive management framework is being used to provide a structured decision process for information and individual tools needed to implement and assess practices to improve the condition of the Chesapeake Bay ecosystem. The Chesapeake Online Adaptive Support Toolkit (COAST) is a collection of web-based analytical tools and information, organized in an adaptive management framework, intended to aid decisionmakers in protecting and restoring the integrity of the Bay ecosystem. The initial version of COAST is focused on water quality issues. During early and mid- 2008, initial ideas for COAST were shared and discussed with various CBP partners and other potential user groups. At these meetings, test cases were selected to help improve understanding of the types of information and analytical functionality that would be most useful for specific partners’ needs. These discussions added considerable knowledge about the nature of decisionmaking for Federal, State, local and nongovernmental partners. Version 1.0 of COAST, released in early winter of 2008, will be further reviewed to determine improvements needed to address implementation and assessment of water quality practices. Future versions of COAST may address other aspects of ecosystem restoration, including restoration of habitat and living resources and maintaining watershed health.

  16. Validating Performance of a Hospital Discharge Planning Decision Tool in Community Hospitals.

    PubMed

    Holland, Diane E; Brandt, Cheryl; Targonski, Paul V; Bowles, Kathryn H

    The Early Screen for Discharge Planning (ESDP) is a decision support tool developed in an urban academic medical center. High ESDP scores identify patients with nonroutine discharge plans who would benefit from early discharge planning intervention. We aimed to determine the predictive performance of the ESDP in a different practice setting. Rural regional community hospital. We designed a comparative, descriptive survey study and enrolled a convenience sample of 222 patients (identified at admission) who provided informed consent. Sample characteristics and ESDP scores were collected during enrollment. The Problems After Discharge Questionnaire, EuroQoL-5Dimensions quality-of-life measure, length of stay, and use of post-acute care services were recorded after discharge. We compared outcomes between patients with low and high ESDP scores. More than half of the sample (51.8%) had a high ESDP score. Patients with high ESDP scores reported more problems after discharge (p = .02), reported lower quality of life (p < .001), had longer length of stays (p = .04), and used post-acute care services (p = .006) more than patients with low ESDP scores. The difference in the average percentage of unmet needs was not statistically significant (p = .12), but patients with high ESDP scores reported more unmet needs than patients with low ESDP scores. The value of systematically proactive approaches to discharge planning is increasingly recognized, but establishing the performance capacity of support tools is critical for optimizing benefit. These study findings support use of the ESDP in regional community hospitals, making it a useful, open-source decision support tool for various health care delivery systems.

  17. Assigning Treatment to HCC Patients for Transplantation: Utility of a New Decision-Making Tool.

    PubMed

    Shah, Najmul Hassan; Dar, Faisal Saud; Bhatti, Abu Bakar Hafeez; Rana, Atif; Salih, Mohammad

    2016-10-28

    BACKGROUND The Barcelona clinic liver cancer (BCLC) staging system is considered the standard of care for hepatocellular carcinoma (HCC) management. It has various limitations, including lack of second-line treatment options and combination therapy. We prospectively collected data on our HCC patients based on a new decision-making tool (NDT). The objective of this study was to determine the applicability of this tool and compare it with BCLC for treatment allocation, in particular with respect to liver transplantation. MATERIAL AND METHODS We retrospectively reviewed HCC patients who were managed based on an NDT that was developed in 2012. All patients whose treatment decision was based on this tool between 2012 and 2015 were included. Comparison was made with BCLC. Survival was compared for patients who underwent liver transplantation. RESULTS Based on the NDT, 406 (40.6%) patients were eligible for curative treatment versus only 22 (2.2%) patients based on BCLC. A total of 58 (5.8%) patients underwent liver transplant based on the NDT, while only 2 (0.2%) were transplantable based on BCLC. Estimated 3-year survival for transplanted patients based on the NDT was 73%. There were 41 (4.1%) stage C and 15 (1.5%) stage D BCLC patients who received transplant based on the NDT. Estimated 3-year survival for stage A, C, and D BCLC patients who received transplantation was 100%,72%, and 67%, respectively (P=0.6). CONCLUSIONS The NDT correctly identified a group of HCC patients for liver transplantation who would otherwise have received palliative treatment based on the BCLC algorithm.

  18. Opportunities and Strategies to Incorporate Ecosystem Services Knowledge and Decision Support Tools into Planning and Decision Making in Hawai`i

    NASA Astrophysics Data System (ADS)

    Bremer, Leah L.; Delevaux, Jade M. S.; Leary, James J. K.; J. Cox, Linda; Oleson, Kirsten L. L.

    2015-04-01

    Incorporating ecosystem services into management decisions is a promising means to link conservation and human well-being. Nonetheless, planning and management in Hawai`i, a state with highly valued natural capital, has yet to broadly utilize an ecosystem service approach. We conducted a stakeholder assessment, based on semi-structured interviews, with terrestrial ( n = 26) and marine ( n = 27) natural resource managers across the State of Hawai`i to understand the current use of ecosystem services (ES) knowledge and decision support tools and whether, how, and under what contexts, further development would potentially be useful. We found that ES knowledge and tools customized to Hawai`i could be useful for communication and outreach, justifying management decisions, and spatial planning. Greater incorporation of this approach is clearly desired and has a strong potential to contribute to more sustainable decision making and planning in Hawai`i and other oceanic island systems. However, the unique biophysical, socio-economic, and cultural context of Hawai`i, and other island systems, will require substantial adaptation of existing ES tools. Based on our findings, we identified four key opportunities for the use of ES knowledge and tools in Hawai`i: (1) linking native forest protection to watershed health; (2) supporting sustainable agriculture; (3) facilitating ridge-to-reef management; and (4) supporting statewide terrestrial and marine spatial planning. Given the interest expressed by natural resource managers, we envision broad adoption of ES knowledge and decision support tools if knowledge and tools are tailored to the Hawaiian context and coupled with adequate outreach and training.

  19. Opportunities and strategies to incorporate ecosystem services knowledge and decision support tools into planning and decision making in Hawai'i.

    PubMed

    Bremer, Leah L; Delevaux, Jade M S; Leary, James J K; J Cox, Linda; Oleson, Kirsten L L

    2015-04-01

    Incorporating ecosystem services into management decisions is a promising means to link conservation and human well-being. Nonetheless, planning and management in Hawai'i, a state with highly valued natural capital, has yet to broadly utilize an ecosystem service approach. We conducted a stakeholder assessment, based on semi-structured interviews, with terrestrial (n = 26) and marine (n = 27) natural resource managers across the State of Hawai'i to understand the current use of ecosystem services (ES) knowledge and decision support tools and whether, how, and under what contexts, further development would potentially be useful. We found that ES knowledge and tools customized to Hawai'i could be useful for communication and outreach, justifying management decisions, and spatial planning. Greater incorporation of this approach is clearly desired and has a strong potential to contribute to more sustainable decision making and planning in Hawai'i and other oceanic island systems. However, the unique biophysical, socio-economic, and cultural context of Hawai'i, and other island systems, will require substantial adaptation of existing ES tools. Based on our findings, we identified four key opportunities for the use of ES knowledge and tools in Hawai'i: (1) linking native forest protection to watershed health; (2) supporting sustainable agriculture; (3) facilitating ridge-to-reef management; and (4) supporting statewide terrestrial and marine spatial planning. Given the interest expressed by natural resource managers, we envision broad adoption of ES knowledge and decision support tools if knowledge and tools are tailored to the Hawaiian context and coupled with adequate outreach and training.

  20. "Think aloud" and "Near live" usability testing of two complex clinical decision support tools.

    PubMed

    Richardson, Safiya; Mishuris, Rebecca; O'Connell, Alexander; Feldstein, David; Hess, Rachel; Smith, Paul; McCullagh, Lauren; McGinn, Thomas; Mann, Devin

    2017-10-01

    Low provider adoption continues to be a significant barrier to realizing the potential of clinical decision support. "Think Aloud" and "Near Live" usability testing were conducted on two clinical decision support tools. Each was composed of an alert, a clinical prediction rule which estimated risk of either group A Streptococcus pharyngitis or pneumonia and an automatic order set based on risk. The objective of this study was to further understanding of the facilitators of usability and to evaluate the types of additional information gained from proceeding to "Near Live" testing after completing "Think Aloud". This was a qualitative observational study conducted at a large academic health care system with 12 primary care providers. During "Think Aloud" testing, participants were provided with written clinical scenarios and asked to verbalize their thought process while interacting with the tool. During "Near Live" testing participants interacted with a mock patient. Morae usability software was used to record full screen capture and audio during every session. Participant comments were placed into coding categories and analyzed for generalizable themes. Themes were compared across usability methods. "Think Aloud" and "Near Live" usability testing generated similar themes under the coding categories visibility, workflow, content, understand-ability and navigation. However, they generated significantly different themes under the coding categories usability, practical usefulness and medical usefulness. During both types of testing participants found the tool easier to use when important text was distinct in its appearance, alerts were passive and appropriately timed, content was up to date, language was clear and simple, and each component of the tool included obvious indicators of next steps. Participant comments reflected higher expectations for usability and usefulness during "Near Live" testing. For example, visit aids, such as automatically generated order sets

  1. Data for decision making: strategic information tools for hospital management during a pandemic.

    PubMed

    Farias, Daniel R; Raffo, Lucrecia; Bacigalupo, Silvia; Cremaschi, Maria; Vence, Liliana; Ramos, Susana; Salguero, Ana; Claudio, Martin; Meites, Elissa; Cubito, Alejandro

    2010-10-01

    During the 2009 influenza A (H1N1) pandemic, Argentina's Hospital Nacional Profesor Alejandro Posadas, a referral center in the capital province of Buenos Aires, treated a large urban patient population. Beginning in April, after severe influenza had been reported in North America but before any suspected cases of H1N1 had been reported in Argentina, the authors formed a pandemic planning committee to direct our hospital's response. An important strategy of the management team was to create a single daily monitoring tool that could integrate multiple information sources. We describe our pandemic planning strategy so that it may serve as a template for other hospitals. We describe our integrated data management system and the indicators it measured. We also describe the iterative process used to develop these tools and the current versions we use in surveillance for possible new waves of pandemic influenza. We present 3 examples of strategic decision making applied to data from our integrated information system. Daily pandemic surveillance data motivated the planning committee to reallocate hospital resources to care for patients during the peak pandemic period. This report illustrates the importance of pandemic planning and advanced integrated information tools for management of a health care facility during a pandemic.

  2. Decision Tools: What To Consider When Partnering for Learnware = Outils de decision: Facteurs a considerer dans la mise en place de partenariats pour les technologies d'apprentissage.

    ERIC Educational Resources Information Center

    Stahmer, Anna; Green, Lyndsay

    This report provides a set of decision tools for learnware developers in private companies, public organizations, and education institutions to use in developing strategic alliances or partnerships for the development, delivery, and marketing of learnware products and services designed to meet Canadians' lifelong learning needs. The report…

  3. Risk based guideline values and the development of preliminary remediation goals

    SciTech Connect

    Brothers, R.A.; Cox, D.M.; Guty, J.L.; Miller, D.B.; Motheramgari, K.; Stinnette, S.E.

    1995-02-01

    Risk managers at federal facilities often need a risk-based tool to rapidly assess the possible human health risks of large numbers of sites before completing a baseline risk assessment. Risk-based concentrations, based on Preliminary Remediation Goal (PRG) development methodology, can be used as screening guideline values. We have developed a set of guideline values (GVs) for the Mound Facility at Miamisburg, Ohio, that are risk based, decision-making tools. The GVs are used (with regulatory approval) to rapidly assess the possibility that sites may be considered for {open_quotes}no action{close_quotes} decisions. The GVs are neither PRGs nor final remedial action levels. Development of the GVs on a facilitywide basis incorporated known contaminants of potential concern, physical and chemical characteristics of contaminated media, current and potential future land uses, and exposure pathway assumptions. Because no one site was used in the development process, the GVs can be applied (after consideration of the land use and exposure potential) to any site on the facility. The facilitywide approach will streamline the PRG development process by minimizing the efforts to develop site-specific PRGs for each operable unit at a considerable saving of time and effort.

  4. An Interface to Drought Mitigation: Decision Support Tools from the National Drought Mitigation Center

    NASA Astrophysics Data System (ADS)

    Svoboda, M.; Fuchs, B.; Hayes, M. J.

    2012-12-01

    The National Drought Mitigation Center (NDMC) (http://drought.unl.edu) has been working with the National Integrated Drought Information System (NIDIS) (http://drought.gov) and other partners with a goal of developing tools to enhance drought risk management activities around the world. The NDMC is a national center founded in 1995 and located at the University of Nebraska-Lincoln. The NDMC conducts basic and applied research, services and decision support applications, along with maintaining a number of operational drought-related tools and products including the U.S. Drought Monitor (USDM), Drought Impact Reporter (DIR) and Vegetation Drought Response Index (VegDRI). The NDMC's newly launched National Drought Atlas (NDA) will be the focus of this presentation. Building off the concept of the original National Electronic Drought Atlas (NEDA) developed by the United States Army Corps of Engineers (led by Hoskings, Wallis and Guttman in the early 1990s), the original NEDA consisted of approximately 1000 stations taken from the Historical Climate Network (HCN). The period of record was limited at that time with most stations only having digital data from the late 1940s to present. For the NDMC's NDA, more than 12,000 stations with precipitation and/or temperature records from the National Weather Service Cooperative data (COOP) network were analyzed through the Regional Climate Centers' (RCCs) Applied Climate Information System (ACIS). From the initial sample set of 12,000 sites considered, over 3000 stations had at least 40 years of data and over 1700 sites had over 60 years of data meeting our criteria. A unique period of record (POR) was established for each station based on the screening criteria, with each station having a unique starting date. From the final selection of 3059 stations, all have at least 40+ years of data and 827 sites contain over 80+ years of data. In essence, the new NDA tripled the size and doubled the period of record of those sites used in

  5. Information technology and decision support tools for stakeholder-driven river basin salinity management

    SciTech Connect

    Quinn, N.W.T; Cozad, D.B.; Lee, G.

    2010-01-01

    Innovative strategies for effective basin-scale salinity management have been developed in the Hunter River Basin of Australia and more recently in the San Joaquin River Basin of California. In both instances web-based stakeholder information dissemination has been a key to achieving a high level of stakeholder involvement and the formulation of effective decision support salinity management tools. A common element to implementation of salinity management strategies in both river basins has been the concept of river assimilative capacity for controlling export salt loading and the potential for trading of the right to discharge salt load to the river - the Hunter River in Australia and the San Joaquin River in California. Both rivers provide basin drainage and the means of exporting salt to the ocean. The paper compares and contrasts the use of monitoring, modeling and information dissemination in the two basins to achieve environmental compliance and sustain irrigated agriculture in an equitable and socially and politically acceptable manner.

  6. Biliary tract cancers: molecular profiling as a tool for treatment decisions. A literature review.

    PubMed

    Berardi, Rossana; Rossana, Berardi; Scartozzi, Mario; Mario, Scartozzi; Freddari, Federica; Federica, Freddari; Squadroni, Michela; Michela, Squadroni; Santinelli, Alfredo; Alfredo, Santinelli; Bearzi, Italo; Italo, Bearzi; Fabris, Guidalberto; Guidalberto, Fabris; Cascinu, Stefano; Stefano, Cascinu

    2006-08-01

    Biliary tract cancer is a quite rare disease; despite recent significant advances in imaging modalities, most of the patients have advanced disease at presentation thus making radical surgery not feasible. Many different chemotherapeutic regimens have been investigated in small uncontrolled studies, with generally disappointing results. We extensively reviewed the literature on this topic trying to give an explanation to chemoresistance in this setting of patients and considering the molecular profiling as a tool for treatment decision. This review is divided in two parts, in the first one we illustrated chemotherapy results and possible mechanisms of resistance. In the second part we analysed the new molecular targets developing an hypothesis about the future therapeutics perspectives.

  7. Using Dynamic Simulations and Automated Decision Tools to Design Lunar Habitats

    NASA Technical Reports Server (NTRS)

    Bell, Scott; Rodriguez, Luis; Kortenkamp, David

    2005-01-01

    This paper describes the role of transient simulations, heuristic techniques, and closed loop integrated control in designing and sizing habitat life support systems. The integration of these three elements allows for more accurate requirements to be derived in advance of hardware choices. As a test case, we used a typical lunar surface habitat. Large numbers of habitat configurations were rapidly tested and evaluated using automated decision support tools. Through this process, preliminary sizing for habitat life support systems were derived. Our preliminary results show that by using transient simulations and closed loop control , we substantially reduced the system mass required to meet mission goals. This has greater implications for general systems analyses and for life support systems. It is likely that transient models, realtime integrated control, and other analyses capable of capturing the uncertainties of systems can be useful for systems analyses much earlier in the system development life cycle than has previously been considered.

  8. A decision support tool for synchronizing technology advances with strategic mission objectives

    NASA Technical Reports Server (NTRS)

    Hornstein, Rhoda S.; Willoughby, John K.

    1992-01-01

    Successful accomplishment of the objectives of many long-range future missions in areas such as space systems, land-use planning, and natural resource management requires significant technology developments. This paper describes the development of a decision-support data-derived tool called MisTec for helping strategic planners to determine technology development alternatives and to synchronize the technology development schedules with the performance schedules of future long-term missions. Special attention is given to the operations, concept, design, and functional capabilities of the MisTec. The MisTec was initially designed for manned Mars mission, but can be adapted to support other high-technology long-range strategic planning situations, making it possible for a mission analyst, planner, or manager to describe a mission scenario, determine the technology alternatives for making the mission achievable, and to plan the R&D activity necessary to achieve the required technology advances.

  9. A decision support tool for synchronizing technology advances with strategic mission objectives

    NASA Technical Reports Server (NTRS)

    Hornstein, Rhoda S.; Willoughby, John K.

    1992-01-01

    Successful accomplishment of the objectives of many long-range future missions in areas such as space systems, land-use planning, and natural resource management requires significant technology developments. This paper describes the development of a decision-support data-derived tool called MisTec for helping strategic planners to determine technology development alternatives and to synchronize the technology development schedules with the performance schedules of future long-term missions. Special attention is given to the operations, concept, design, and functional capabilities of the MisTec. The MisTec was initially designed for manned Mars mission, but can be adapted to support other high-technology long-range strategic planning situations, making it possible for a mission analyst, planner, or manager to describe a mission scenario, determine the technology alternatives for making the mission achievable, and to plan the R&D activity necessary to achieve the required technology advances.

  10. A decision support tool to optimize IMRT QA workflow in a multi-vendor equipment environment

    NASA Astrophysics Data System (ADS)

    Arumugam, Sankar; Xing, Aitang; Vial, Philip; Holloway, Lois

    2014-03-01

    Development of a software tool to ease the Intensity Modulated Radiation Therapy (IMRT) pre-treatment Quality Assurance process is presented in this study. The delivery of IMRT involves equipment from multiple vendors. The limitations of the equipment involved in this chain will impact on the best choice of equipment. This often results in the user needing to use multiple pieces of equipment before determining the most appropriate choices to optimise the QA work flow. This is a time consuming process and potentially delays the start of patient treatment. Software was developed in-house to assist the decision making process, validating deliverability of beam delivery parameters and selecting appropriate detector systems and configuration for QA of IMRT plans. The software has been demonstrated to be accurate and improves efficiency of IMRT pre-treatment QA.

  11. Disaster Response Tools for Decision Support and Data Discovery - E-DECIDER and GeoGateway

    NASA Astrophysics Data System (ADS)

    Glasscoe, M. T.; Donnellan, A.; Parker, J. W.; Granat, R. A.; Lyzenga, G. A.; Pierce, M. E.; Wang, J.; Grant Ludwig, L.; Eguchi, R. T.; Huyck, C. K.; Hu, Z.; Chen, Z.; Yoder, M. R.; Rundle, J. B.; Rosinski, A.

    2015-12-01

    Providing actionable data for situational awareness following an earthquake or other disaster is critical to decision makers in order to improve their ability to anticipate requirements and provide appropriate resources for response. E-DECIDER (Emergency Data Enhanced Cyber-Infrastructure for Disaster Evaluation and Response) is a decision support system producing remote sensing and geophysical modeling products that are relevant to the emergency preparedness and response communities and serves as a gateway to enable the delivery of actionable information to these communities. GeoGateway is a data product search and analysis gateway for scientific discovery, field use, and disaster response focused on NASA UAVSAR and GPS data that integrates with fault data, seismicity and models. Key information on the nature, magnitude and scope of damage, or Essential Elements of Information (EEI), necessary to achieve situational awareness are often generated from a wide array of organizations and disciplines, using any number of geospatial and non-geospatial technologies. We have worked in partnership with the California Earthquake Clearinghouse to develop actionable data products for use in their response efforts, particularly in regularly scheduled, statewide exercises like the recent May 2015 Capstone/SoCal NLE/Ardent Sentry Exercises and in the August 2014 South Napa earthquake activation. We also provided a number of products, services, and consultation to the NASA agency-wide response to the April 2015 Gorkha, Nepal earthquake. We will present perspectives on developing tools for decision support and data discovery in partnership with the Clearinghouse and for the Nepal earthquake. Products delivered included map layers as part of the common operational data plan for the Clearinghouse, delivered through XchangeCore Web Service Data Orchestration, enabling users to create merged datasets from multiple providers. For the Nepal response effort, products included models

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

    NASA Astrophysics Data System (ADS)

    Spahr, K.; Hogue, T. S.

    2016-12-01

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

  13. The GMOseek matrix: a decision support tool for optimizing the detection of genetically modified plants

    PubMed Central

    2013-01-01

    Background Since their first commercialization, the diversity of taxa and the genetic composition of transgene sequences in genetically modified plants (GMOs) are constantly increasing. To date, the detection of GMOs and derived products is commonly performed by PCR-based methods targeting specific DNA sequences introduced into the host genome. Information available regarding the GMOs’ molecular characterization is dispersed and not appropriately organized. For this reason, GMO testing is very challenging and requires more complex screening strategies and decision making schemes, demanding in return the use of efficient bioinformatics tools relying on reliable information. Description The GMOseek matrix was built as a comprehensive, online open-access tabulated database which provides a reliable, comprehensive and user-friendly overview of 328 GMO events and 247 different genetic elements (status: 18/07/2013). The GMOseek matrix is aiming to facilitate GMO detection from plant origin at different phases of the analysis. It assists in selecting the targets for a screening analysis, interpreting the screening results, checking the occurrence of a screening element in a group of selected GMOs, identifying gaps in the available pool of GMO detection methods, and designing a decision tree. The GMOseek matrix is an independent database with effective functionalities in a format facilitating transferability to other platforms. Data were collected from all available sources and experimentally tested where detection methods and certified reference materials (CRMs) were available. Conclusions The GMOseek matrix is currently a unique and very valuable tool with reliable information on GMOs from plant origin and their present genetic elements that enables further development of appropriate strategies for GMO detection. It is flexible enough to be further updated with new information and integrated in different applications and platforms. PMID:23965170

  14. A flexible and national scale approach to coastal decision tools incorporating sea level rise

    NASA Astrophysics Data System (ADS)

    Strauss, B.; Kulp, S. A.; Tebaldi, C.

    2014-12-01

    Climate science and sea level models constantly evolve. In this context, maps and analyses of exposure to sea level rise - or coastal flooding aggravated by rise - quickly fall out of date when based upon a specific model projection or projection set. At the same time, policy makers and planners prefer simple and stable risk assessments for their future planning. Here, using Climate Central's Surging Seas Risk Finder, we describe and illustrate a decision tool framework that separates the spatial and temporal dimensions of coastal exposure in order to help alleviate this tension. The Risk Finder presents local maps and exposure analyses simply as functions of a discrete set of local water levels. In turn, each water level may be achieved at different times, with different probabilities, according to different combinations of sea level change, storm surge and tide. This temporal dimension is expressed in a separate module of the Risk Finder, so that users may explore the probabilities and time frames of different water levels, as a function of different sea level models and emissions scenarios. With such an approach, decision-makers can quickly get a sense of the range of risks for each water level given current understanding. At the same time, the models and scenarios can easily be updated over time as the science evolves, while avoiding the labor of regenerating maps and exposure analyses. In this talk, we will also use the tool to highlight key findings from a new U.S. national assessment of sea level and coastal flood risk. For example, more than 2.5 million people and $500 billion dollars of property value sit on land less than 2 meters above the high tide line in Florida alone.

  15. Applying an ethical decision-making tool to a nurse management dilemma.

    PubMed

    Toren, Orly; Wagner, Nurith

    2010-05-01

    This article considers ethical dilemmas that nurse managers may confront and suggests an ethical decision-making model that could be used as a tool for resolving such dilemmas. The focus of the article is on the question: Can nurse managers choose the ethically right solution in conflicting situations when nurses' rights collide with patients' rights to quality care in a world of cost-effective and economic constraint? Managers' responsibility is to ensure and facilitate a safe and ethical working environment in which nurses are able to give quality care to their patients. In nursing it is frequently declared that managers' main obligations are to patients' needs and their rights to receive quality care. However, managers' ethical responsibilities are not only to patients but also to the nurses working in their institution. This article describes a real (but disguised) situation from an Israeli health care context to illustrate the dilemmas that may arise. The question is posed of whether nurse managers can maintain patients' and nurses' rights and, at the same time, fulfill their obligation to the conflicting demands of the organization. The article also offers a way to solve conflict by using an ethical decision-making model.

  16. The POCER indicator: a decision tool for non-agricultural pesticide use.

    PubMed

    Claeys, Sara; Vagenende, Bénédicte; De Smet, Bart; Lelieur, Liesbeth; Steurbaut, Walter

    2005-08-01

    Pesticides are used not only in agriculture but also by public services and households. Much information is available on the influence of agricultural applications on human health by occupational exposure and on the environment. There is still a need for adequate information on the impact of non-agricultural applications of pesticides. The POCER indicator (Pesticide Occupational and Environmental Risk indicator) has been developed at Ghent University for agricultural situations, as a tool for applicators and decision-makers, by calculating the impact of pesticide treatments on the applicator, the worker, the bystander, groundwater, surface water, bees, earthworms, birds, useful arthropods and persistence in soil. A few adaptations in the POCER calculation method can make the indicator also very useful for non-agricultural conditions. The impact of plant protection products on human health and environment in public services and households can be calculated and the scores can be compared with each other, resulting in an improved pesticide programme. Decision makers might use the POCER indicator to evaluate the reduction programme of public services and communities and offer them measurements to reduce the impact of pesticides. For example, wearing protective clothing or taking into account the distance between application and surface water can greatly reduce the impact score. 2005 Society of Chemical Industry

  17. Recognition of Protozoa and Metazoa using image analysis tools, discriminant analysis, neural networks and decision trees.

    PubMed

    Ginoris, Y P; Amaral, A L; Nicolau, A; Coelho, M A Z; Ferreira, E C

    2007-07-09

    Protozoa and metazoa are considered good indicators of the treatment quality in activated sludge systems due to the fact that these organisms are fairly sensitive to physical, chemical and operational processes. Therefore, it is possible to establish close relationships between the predominance of certain species or groups of species and several operational parameters of the plant, such as the biotic indices, namely the Sludge Biotic Index (SBI). This procedure requires the identification, classification and enumeration of the different species, which is usually achieved manually implying both time and expertise availability. Digital image analysis combined with multivariate statistical techniques has proved to be a useful tool to classify and quantify organisms in an automatic and not subjective way. This work presents a semi-automatic image analysis procedure for protozoa and metazoa recognition developed in Matlab language. The obtained morphological descriptors were analyzed using discriminant analysis, neural network and decision trees multivariable statistical techniques to identify and classify each protozoan or metazoan. The obtained procedure was quite adequate for distinguishing between the non-sessile protozoa classes and also for the metazoa classes, with high values for the overall species recognition with the exception of sessile protozoa. In terms of the wastewater conditions assessment the obtained results were found to be suitable for the prediction of these conditions. Finally, the discriminant analysis and neural networks results were found to be quite similar whereas the decision trees technique was less appropriate.

  18. Comparing two tools for ecosystem service assessments regarding water resources decisions.

    PubMed

    Dennedy-Frank, P James; Muenich, Rebecca Logsdon; Chaubey, Indrajeet; Ziv, Guy

    2016-07-15

    We present a comparison of two ecohydrologic models commonly used for planning land management to assess the production of hydrologic ecosystem services: the Soil and Water Assessment Tool (SWAT) and the Integrated Valuation of Ecosystem Services and Tradeoffs (InVEST) annual water yield model. We compare these two models at two distinct sites in the US: the Wildcat Creek Watershed in Indiana and the Upper Upatoi Creek Watershed in Georgia. The InVEST and SWAT models provide similar estimates of the spatial distribution of water yield in Wildcat Creek, but very different estimates of the spatial distribution of water yield in Upper Upatoi Creek. The InVEST model may do a poor job estimating the spatial distribution of water yield in the Upper Upatoi Creek Watershed because baseflow provides a significant portion of the site's total water yield, which means that storage dynamics which are not modeled by InVEST may be important. We also compare the ability of these two models, as well as one newly developed set of ecosystem service indices, to deliver useful guidance for land management decisions focused on providing hydrologic ecosystem services in three particular decision contexts: environmental flow ecosystem services, ecosystem services for potable water supply, and ecosystem services for rainfed irrigation. We present a simple framework for selecting models or indices to evaluate hydrologic ecosystem services as a way to formalize where models deliver useful guidance. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

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

    2016-12-01

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

  20. A spatial decision support tool for estimating population catchments to aid rural and remote health service allocation planning.

    PubMed

    Schuurman, Nadine; Randall, Ellen; Berube, Myriam

    2011-12-01

    There is mounting pressure on healthcare planners to manage and contain costs. In rural regions, there is a particular need to rationalize health service allocation to ensure the best possible coverage for a dispersed population. Rural health administrators need to be able to quantify the population affected by their allocation decisions and, therefore, need the capacity to incorporate spatial analyses into their decision-making process. Spatial decision support systems (SDSS) can provide this capability. In this article, we combine geographical information systems (GIS) with a web-based graphical user interface (webGUI) in a SDSS tool that enables rural decision-makers charged with service allocation, to estimate population catchments around specific health services in rural and remote areas. Using this tool, health-care planners can model multiple scenarios to determine the optimal location for health services, as well as the number of people served in each instance.

  1. No perfect tools: trade-offs of sustainability principles and user requirements in designing support tools for land-use decisions between greenfields and brownfields.

    PubMed

    Bartke, Stephan; Schwarze, Reimund

    2015-04-15

    The EU Soil Thematic Strategy calls for the application of sustainability concepts and methods as part of an integrated policy to prevent soil degradation and to increase the re-use of brownfields. Although certain general principles have been proposed for the evaluation of sustainable development, the practical application of sustainability assessment tools (SATs) is contingent on the actual requirements of tool users, e.g. planners or investors, to pick up such instruments in actual decision making. We examine the normative sustainability principles that need to be taken into account in order to make sound land-use decisions between new development on greenfield sites and the regeneration of brownfields - and relate these principles to empirically observed user requirements and the properties of available SATs. In this way we provide an overview of approaches to sustainability assessment. Three stylized approaches, represented in each case by a typical tool selected from the literature, are presented and contrasted with (1) the norm-oriented Bellagio sustainability principles and (2) the requirements of three different stakeholder groups: decision makers, scientists/experts and representatives of the general public. The paper disentangles some of the inevitable trade-offs involved in seeking to implement sustainable land-use planning, i.e. between norm orientation and holism, broad participation and effective communication. It concludes with the controversial assessment that there are no perfect tools and that to be meaningful the user requirements of decision makers must take precedence over those of other interest groups in the design of SATs.

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

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

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

  3. Clinical decision-making tools for exam selection, reporting and dose tracking.

    PubMed

    Brink, James A

    2014-10-01

    Although many efforts have been made to reduce the radiation dose associated with individual medical imaging examinations to "as low as reasonably achievable," efforts to ensure such examinations are performed only when medically indicated and appropriate are equally if not more important. Variations in the use of ionizing radiation for medical imaging are concerning, regardless of whether they occur on a local, regional or national basis. Such variations among practices can be reduced with the use of decision support tools at the time of order entry. These tools help reduce radiation exposure among practices through the appropriate use of medical imaging. Similarly, adoption of best practices among imaging facilities can be promoted through tracking the radiation exposure among imaging patients. Practices can benchmark their aggregate radiation exposures for medical imaging through the use of dose index registries. However several variables must be considered when contemplating individual patient dose tracking. The specific dose measures and the variation among them introduced by variations in body habitus must be understood. Moreover the uncertainties in risk estimation from dose metrics related to age, gender and life expectancy must also be taken into account.

  4. Deriving the East Riding Elbow Rule (ER2): a maximally sensitive decision tool for elbow injury.

    PubMed

    Arundel, David; Williams, Paul; Townend, Will

    2014-05-01

    To derive a maximally sensitive decision rule for clinical practice to rule out the need for x-ray examination after elbow injury in adults and children. Emergency department patients with acute elbow injury were recruited. Practitioners used their usual judgement to assess whether x-ray examination was required. Radiographs were reported on by radiologists blind to clinical assessment. Patients not x-rayed were followed-up at 7 days by telephone interview, and those with ongoing pain were recalled for assessment. Recursive partitioning was used to derive a maximally sensitive decision tool. Inter-rater variability for significant discriminators was subsequently evaluated by a cohort of 20 emergency department clinicians. 492 patients were recruited (May 2006-November 2008): 50.4% were male; 26.8% were children; 444 (90.2%) had an x-ray; 167 (37.6%) showed abnormality. A follow-up telephone interview was conducted with 28; none were recalled. Thirteen could not be contacted, none of whom returned within 3 months. Sixteen patients with fractures were able to fully extend their elbow. The sensitivity of elbow extension alone was 84% (95% CI 77% to 88%), with specificity of 54% (95% CI 53% to 58%). A 100% sensitive (95% CI 97% to 100%) decision rule for adults (n=348) was derived based on (1) inability to fully extend the elbow, (2) tenderness over radial head, olecranon or medial epicondyle, and (3) presence of bruising (specificity 24% (95% CI 19% to 30%)). A similar rule for children could not be derived. A simple and highly sensitive clinical decision rule for adult elbow fracture was derived in our cohort. A validation study in a second population is now required. At present, we are unable to recommend a rule-out strategy for elbow injuries in children. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. External Validation of a Decision Tool To Guide Post-Operative Management of Patients with Secondary Peritonitis.

    PubMed

    Atema, Jasper J; Ram, Kim; Schultz, Marcus J; Boermeester, Marja A

    Timely identification of patients in need of an intervention for abdominal sepsis after initial surgical management of secondary peritonitis is vital but complex. The aim of this study was to validate a decision tool for this purpose and to evaluate its potential to guide post-operative management. A prospective cohort study was conducted on consecutive adult patients undergoing surgery for secondary peritonitis in a single hospital. Assessments using the decision tool, based on one intra-operative and five post-operative variables, were performed on the second and third post-operative days and when the patients' clinical status deteriorated. Scores were compared with the clinical reference standard of persistent sepsis based on the clinical course or findings at imaging or surgery. Additionally, the potential of the decision tool to guide management in terms of diagnostic imaging in three previously defined score categories (low, intermediate, and high) was evaluated. A total of 161 assessments were performed in 69 patients. The majority of cases of secondary peritonitis (68%) were caused by perforation of the gastrointestinal tract. Post-operative persistent sepsis occurred in 28 patients. The discriminative capacity of the decision tool score was fair (area under the curve of the receiver operating characteristic = 0.79). The incidence rate differed significantly between the three score categories (p < 0.001). The negative predictive value of a decision tool score categorized as low probability was 89% (95% confidence interval [CI] 82-94) and 65% (95% CI 47-79) for an intermediate score. Diagnostic imaging was performed more frequently when there was an intermediate score than when the score was categorized as low (46% vs. 24%; p < 0.001). In patients operated on for secondary peritonitis, the decision tool score predicts with fair accuracy whether persistent sepsis is present.

  6. Climate change, land slide risks and sustainable development, risk analysis and decision support process tool

    NASA Astrophysics Data System (ADS)

    Andersson-sköld, Y. B.; Tremblay, M.

    2011-12-01

    aspects in the decision making process on adaptation measures has been developed and is currently being tested in municipalities including central Gothenburg, and smaller municipalities in Sweden and Norway. The tool is a matrix based decision support tool (MDST) aiming for encoring discussion among experts and stakeholders. The first steps in the decision process include identification, inventory and assessment of the potential impacts of climate change such as landslides (or other events or actions). These steps are also included in general technical/physical risk and vulnerability analyses such as the risk analysis of the Göta älv valley. The MDST also includes further subsequent steps of the risk management process, and the full sequence of the MDST includes risk identification, risk specification, risk assessment, identification of measures, impact analysis of measures including an assessment of environmental, social and economical costs and benefits, a weight process and visualisation of the result. Here the MDST with some examples from the methodology for the Göta river valley analysis and the risk mitigation analysis from Sweden and Norway will be presented.

  7. Usability evaluation of a clinical decision support tool for osteoporosis disease management.

    PubMed

    Kastner, Monika; Lottridge, Danielle; Marquez, Christine; Newton, David; Straus, Sharon E

    2010-12-10

    Osteoporosis affects over 200 million people worldwide at a high cost to healthcare systems. Although guidelines are available, patients are not receiving appropriate diagnostic testing or treatment. Findings from a systematic review of osteoporosis interventions and a series of focus groups were used to develop a functional multifaceted tool that can support clinical decision-making in osteoporosis disease management at the point of care. The objective of our study was to assess how well the prototype met functional goals and usability needs. We conducted a usability study for each component of the tool--the Best Practice Recommendation Prompt (BestPROMPT), the Risk Assessment Questionnaire (RAQ), and the Customised Osteoporosis Education (COPE) sheet--using the framework described by Kushniruk and Patel. All studies consisted of one-on-one sessions with a moderator using a standardised worksheet. Sessions were audio- and video-taped and transcribed verbatim. Data analysis consisted of a combination of qualitative and quantitative analyses. In study 1, physicians liked that the BestPROMPT can provide customised recommendations based on risk factors identified from the RAQ. Barriers included lack of time to use the tool, the need to alter clinic workflow to enable point-of-care use, and that the tool may disrupt the real reason for the visit. In study 2, patients completed the RAQ in a mean of 6 minutes, 35 seconds. Of the 42 critical incidents, 60% were navigational and most occurred when the first nine participants were using the stylus pen; no critical incidents were observed with the last six participants that used the touch screen. Patients thought that the RAQ questions were easy to read and understand, but they found it difficult to initiate the questionnaire. Suggestions for improvement included improving aspects of the interface and navigation. The results of study 3 showed that most patients were able to understand and describe sections of the COPE sheet

  8. Usability evaluation of a clinical decision support tool for osteoporosis disease management

    PubMed Central

    2010-01-01

    Background Osteoporosis affects over 200 million people worldwide at a high cost to healthcare systems. Although guidelines are available, patients are not receiving appropriate diagnostic testing or treatment. Findings from a systematic review of osteoporosis interventions and a series of focus groups were used to develop a functional multifaceted tool that can support clinical decision-making in osteoporosis disease management at the point of care. The objective of our study was to assess how well the prototype met functional goals and usability needs. Methods We conducted a usability study for each component of the tool--the Best Practice Recommendation Prompt (BestPROMPT), the Risk Assessment Questionnaire (RAQ), and the Customised Osteoporosis Education (COPE) sheet--using the framework described by Kushniruk and Patel. All studies consisted of one-on-one sessions with a moderator using a standardised worksheet. Sessions were audio- and video-taped and transcribed verbatim. Data analysis consisted of a combination of qualitative and quantitative analyses. Results In study 1, physicians liked that the BestPROMPT can provide customised recommendations based on risk factors identified from the RAQ. Barriers included lack of time to use the tool, the need to alter clinic workflow to enable point-of-care use, and that the tool may disrupt the real reason for the visit. In study 2, patients completed the RAQ in a mean of 6 minutes, 35 seconds. Of the 42 critical incidents, 60% were navigational and most occurred when the first nine participants were using the stylus pen; no critical incidents were observed with the last six participants that used the touch screen. Patients thought that the RAQ questions were easy to read and understand, but they found it difficult to initiate the questionnaire. Suggestions for improvement included improving aspects of the interface and navigation. The results of study 3 showed that most patients were able to understand and describe

  9. Assessing capacity in the setting of self-neglect: development of a novel screening tool for decision-making capacity.

    PubMed

    Naik, Aanand D; Pickens, Sabrina; Burnett, Jason; Lai, James M; Dyer, Carmel Bitondo

    2006-01-01

    Compared with older adults with disabilities and those who autonomously choose to live in squalor, self-neglect syndrome arises from a predicate state of vulnerability in frail older adults. This state of vulnerability is characteristically associated with a decline in decision-making capacity regarding the ability to care for and protect oneself. We developed the COMP Screen to evaluate vulnerable older adults to identify potential gaps in decision-making capacity using a screening tool. A total of 182 older adults were evaluated and consistent declines in cognitive ability and decision-making processes were present in this population. However, there were no significant differences between elders referred for self-neglect and matched older adults. These findings suggest that declines in decision-making processes are not uncommon in vulnerable older adults but traditional conceptualizations of decision-making capacity may be inadequate for differentiating the capacity for self-care and protection in elders who self-neglect.

  10. Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers.

    PubMed

    Parker, Lisa

    2017-07-01

    Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. The Lichtenberg Financial Decision Screening Scale (LFDSS): A new tool for assessing financial decision making and preventing financial exploitation

    PubMed Central

    Lichtenberg, P.A.; Howard, H; Simaskp, P.; Mall, S.; Speir, J.; Farrell, C.; Tatro, R; Rahman-Filipiak, A.; Ficker, L.J.

    2016-01-01

    One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale’s implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS workers and 79 seen by other professionals. Case examples are included. PMID:27010780

  12. The Lichtenberg Financial Decision Screening Scale (LFDSS): A new tool for assessing financial decision making and preventing financial exploitation.

    PubMed

    Lichtenberg, Peter A; Ficker, Lisa; Rahman-Filipiak, Analise; Tatro, Ron; Farrell, Cynthia; Speir, James J; Mall, Sanford J; Simasko, Patrick; Collens, Howard H; Jackman, John Daniel

    2016-01-01

    One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale's implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.

  13. An Updated Decision Support Interface: A Tool for Remote Monitoring of Crop Growing Conditions

    NASA Astrophysics Data System (ADS)

    Husak, G. J.; Budde, M. E.; Rowland, J.; Verdin, J. P.; Funk, C. C.; Landsfeld, M. F.

    2014-12-01

    Remote sensing of agroclimatological variables to monitor food production conditions is a critical component of the Famine Early Warning Systems Network portfolio of tools for assessing food security in the developing world. The Decision Support Interface (DSI) seeks to integrate a number of remotely sensed and modeled variables to create a single, simplified portal for analysis of crop growing conditions. The DSI has been reformulated to incorporate more variables and give the user more freedom in exploring the available data. This refinement seeks to transition the DSI from a "first glance" agroclimatic indicator to one better suited for the differentiation of drought events. The DSI performs analysis of variables over primary agricultural zones at the first sub-national administrative level. It uses the spatially averaged rainfall, normalized difference vegetation index (NDVI), water requirement satisfaction index (WRSI), and actual evapotranspiration (ETa) to identify potential hazards to food security. Presenting this information in a web-based client gives food security analysts and decision makers a lightweight portal for information on crop growing conditions in the region. The crop zones used for the aggregation contain timing information which is critical to the DSI presentation. Rainfall and ETa are accumulated from different points in the crop phenology to identify season-long deficits in rainfall or transpiration that adversely affect the crop-growing conditions. Furthermore, the NDVI and WRSI serve as their own seasonal accumulated measures of growing conditions by capturing vegetation vigor or actual evapotranspiration deficits. The DSI is currently active for major growing regions of sub-Saharan Africa, with intention of expanding to other areas over the coming years.

  14. Visual aid tool to improve decision making in acute stroke care.

    PubMed

    Saposnik, Gustavo; Goyal, Mayank; Majoie, Charles; Dippel, Diederik; Roos, Yvo; Demchuk, Andrew; Menon, Bijoy; Mitchell, Peter; Campbell, Bruce; Dávalos, Antoni; Jovin, Tudor; Hill, Michael D

    2016-10-01

    Background Acute stroke care represents a challenge for decision makers. Recent randomized trials showed the benefits of endovascular therapy. Our goal was to provide a visual aid tool to guide clinicians in the decision process of endovascular intervention in patients with acute ischemic stroke. Methods We created visual plots (Cates' plots; www.nntonline.net ) representing benefits of standard of care vs. endovascular thrombectomy from the pooled analysis of five RCTs using stent retrievers. These plots represent the following clinically relevant outcomes (1) functionally independent state (modified Rankin scale (mRS) 0 to 2 at 90 days) (2) excellent recovery (mRS 0-1) at 90 days, (3) NIHSS 0-2 (4) early neurological recovery, and (5) revascularization at 24 h. Subgroups visually represented include time to treatment and baseline stroke severity strata. Results Overall, 1287 patients (634 assigned to endovascular thrombectomy, 653 assigned to control were included to create the visual plots. Cates' visual plots revealed that for every 100 patients with acute ischemic stroke and large vessel occlusion, 27 would achieve independence at 90 days (mRS 0-2) in the control group compared to 49 (95% CI 43-56) in the intervention group. Similarly, 21 patients would achieve early neurological recovery at 24 h compared to 54 (95% CI 45-63) out of 100 for the intervention group. Conclusion Cates' plots may assist clinicians and patients to visualize and compare potential outcomes after an acute ischemic stroke. Our results suggest that for every 100 treated individuals with an acute ischemic stroke and a large vessel occlusion, endovascular thrombectomy would provide 22 additional patients reaching independency at three months and 33 more patients achieving ENR compared to controls.

  15. Ecosystem Decision Support: A Living Database of Existing Tools, Approaches and Techniques for Supporting Decisions Related to Ecosystem Services

    EPA Science Inventory

    Planners and decision makers are challenged to consider not only direct market costs, but also ecological externalities. There is an increasing emphasis on ecosystem services in the context of human well-being, and therefore the valuation and accounting of ecosystem services is b...

  16. Ecosystem Decision Support: A Living Database of Existing Tools, Approaches and Techniques for Supporting Decisions Related to Ecosystem Services

    EPA Science Inventory

    Planners and decision makers are challenged to consider not only direct market costs, but also ecological externalities. There is an increasing emphasis on ecosystem services in the context of human well-being, and therefore the valuation and accounting of ecosystem services is b...

  17. A Windows-based tool for the study of clinical decision-making.

    PubMed

    Mackel, J V; Farris, H; Mittman, B S; Wilkes, M; Kanouse, D E

    1995-01-01

    Studies of health-provider decision-making, and of their practice patterns, play a central role in efforts to improve the quality and effectiveness of care and in decreasing costs of healthcare delivery systems. Researchers from a variety of disciplines have studied a broad range of clinical conditions, using a number of methodological approaches and measurement tools, including self-report, written clinical vignettes, simulated clinical encounters using actors as patients and analysis of medical records and administrative data. Although these provide information about the outcomes of clinical decisions, they provide little or no information about the process of the decision. Most clinicians agree that the decision process is as important as the outcome, and indeed it is not unusual to have an exemplary process but a poor outcome. Process information is therefore a crucial dimension of care evaluation. In this paper, we describe a new software product that was originally used to measure diagnostic reasoning in the basic medical science of immunology; subsequently adapted to measure key steps in the clinical decision-making process. This Windows-based software is user-friendly, inexpensive, and requires only commonly available hardware for its operation. It is very flexible, permitting the creation of unlimited numbers and types of clinical scenarios, with diagnostic and/or management approaches. Being clinically "real-world," the scenarios are familiar to the user, who is therefore likely to respond in a "real-world" fashion, with the consequent improved accuracy of data. In addition, a wide range of users may be accommodated. The clinical activities of physicians, nurses, pharmacists, and any other clinical providers may be measured and analyzed by the system. Non-clinical providers, such as managers and administrators, could also be assessed. The system has three major modes. In the Authoring Mode, the author creates a menu, which is common to a number of linked

  18. Rapid Prototyping of Hyperspectral Image Analysis Algorithms for Improved Invasive Species Decision Support Tools

    NASA Astrophysics Data System (ADS)

    Bruce, L. M.; Ball, J. E.; Evangilista, P.; Stohlgren, T. J.

    2006-12-01

    Nonnative invasive species adversely impact ecosystems, causing loss of native plant diversity, species extinction, and impairment of wildlife habitats. As a result, over the past decade federal and state agencies and nongovernmental organizations have begun to work more closely together to address the management of invasive species. In 2005, approximately 500M dollars was budgeted by U.S. Federal Agencies for the management of invasive species. Despite extensive expenditures, most of the methods used to detect and quantify the distribution of these invaders are ad hoc, at best. Likewise, decisions on the type of management techniques to be used or evaluation of the success of these methods are typically non-systematic. More efficient methods to detect or predict the occurrence of these species, as well as the incorporation of this knowledge into decision support systems, are greatly needed. In this project, rapid prototyping capabilities (RPC) are utilized for an invasive species application. More precisely, our recently developed analysis techniques for hyperspectral imagery are being prototyped for inclusion in the national Invasive Species Forecasting System (ISFS). The current ecological forecasting tools in ISFS will be compared to our hyperspectral-based invasives prediction algorithms to determine if/how the newer algorithms enhance the performance of ISFS. The PIs have researched the use of remotely sensed multispectral and hyperspectral reflectance data for the detection of invasive vegetative species. As a result, the PI has designed, implemented, and benchmarked various target detection systems that utilize remotely sensed data. These systems have been designed to make decisions based on a variety of remotely sensed data, including high spectral/spatial resolution hyperspectral signatures (1000's of spectral bands, such as those measured using ASD handheld devices), moderate spectral/spatial resolution hyperspectral images (100's of spectral bands, such

  19. Semiquantitative Decision Tools for FMD Emergency Vaccination Informed by Field Observations and Simulated Outbreak Data

    PubMed Central

    Willeberg, Preben William; AlKhamis, Mohammad; Boklund, Anette; Perez, Andres M.; Enøe, Claes; Halasa, Tariq

    2017-01-01

    We present two simple, semiquantitative model-based decision tools, based on the principle of first 14 days incidence (FFI). The aim is to estimate the likelihood and the consequences, respectively, of the ultimate size of an ongoing FMD epidemic. The tools allow risk assessors to communicate timely, objectively, and efficiently to risk managers and less technically inclined stakeholders about the potential of introducing FMD suppressive emergency vaccination. To explore the FFI principle with complementary field data, we analyzed the FMD outbreaks in Argentina in 2001, with the 17 affected provinces as the units of observation. Two different vaccination strategies were applied during this extended epidemic. In a series of 5,000 Danish simulated FMD epidemics, the numbers of outbreak herds at day 14 and at the end of the epidemics were estimated under different control strategies. To simplify and optimize the presentation of the resulting data for urgent decisions to be made by the risk managers, we estimated the sensitivity, specificity, as well as the negative and positive predictive values, using a chosen day-14 outbreak number as predictor of the magnitude of the number of remaining post-day-14 outbreaks under a continued basic control strategy. Furthermore, during an ongoing outbreak, the actual cumulative number of detected infected herds at day 14 will be known exactly. Among the number of epidemics lasting >14 days out of the 5,000 simulations under the basic control scenario, we selected those with an assumed accumulated number of detected outbreaks at day 14. The distribution of the estimated number of detected outbreaks at the end of the simulated epidemics minus the number at day 14 was estimated for the epidemics lasting more than 14 days. For comparison, the same was done for identical epidemics (i.e., seeded with the same primary outbreak herds) under a suppressive vaccination scenario. The results indicate that, during the course of an FMD

  20. Semiquantitative Decision Tools for FMD Emergency Vaccination Informed by Field Observations and Simulated Outbreak Data.

    PubMed

    Willeberg, Preben William; AlKhamis, Mohammad; Boklund, Anette; Perez, Andres M; Enøe, Claes; Halasa, Tariq

    2017-01-01

    We present two simple, semiquantitative model-based decision tools, based on the principle of first 14 days incidence (FFI). The aim is to estimate the likelihood and the consequences, respectively, of the ultimate size of an ongoing FMD epidemic. The tools allow risk assessors to communicate timely, objectively, and efficiently to risk managers and less technically inclined stakeholders about the potential of introducing FMD suppressive emergency vaccination. To explore the FFI principle with complementary field data, we analyzed the FMD outbreaks in Argentina in 2001, with the 17 affected provinces as the units of observation. Two different vaccination strategies were applied during this extended epidemic. In a series of 5,000 Danish simulated FMD epidemics, the numbers of outbreak herds at day 14 and at the end of the epidemics were estimated under different control strategies. To simplify and optimize the presentation of the resulting data for urgent decisions to be made by the risk managers, we estimated the sensitivity, specificity, as well as the negative and positive predictive values, using a chosen day-14 outbreak number as predictor of the magnitude of the number of remaining post-day-14 outbreaks under a continued basic control strategy. Furthermore, during an ongoing outbreak, the actual cumulative number of detected infected herds at day 14 will be known exactly. Among the number of epidemics lasting >14 days out of the 5,000 simulations under the basic control scenario, we selected those with an assumed accumulated number of detected outbreaks at day 14. The distribution of the estimated number of detected outbreaks at the end of the simulated epidemics minus the number at day 14 was estimated for the epidemics lasting more than 14 days. For comparison, the same was done for identical epidemics (i.e., seeded with the same primary outbreak herds) under a suppressive vaccination scenario. The results indicate that, during the course of an FMD

  1. Decision analysis applications and the CERCLA process

    SciTech Connect

    Purucker, S.T.; Lyon, B.F. |

    1994-06-01

    Quantitative decision methods can be developed during environmental restoration projects that incorporate stakeholder input and can complement current efforts that are undertaken for data collection and alternatives evaluation during the CERCLA process. These decision-making tools can supplement current EPA guidance as well as focus on problems that arise as attempts are made to make informed decisions regarding remedial alternative selection. In examining the use of such applications, the authors discuss the use of decision analysis tools and their impact on collecting data and making environmental decisions from a risk-based perspective. They will look at the construction of objective functions for quantifying different risk-based perspective. They will look at the construction of objective functions for quantifying different risk-based decision rules that incorporate stakeholder concerns. This represents a quantitative method for implementing the Data Quality Objective (DQO) process. These objective functions can be expressed using a variety of indices to analyze problems that currently arise in the environmental field. Examples include cost, magnitude of risk, efficiency, and probability of success or failure. Based on such defined objective functions, a project can evaluate the impact of different risk and decision selection strategies on data worth and alternative selection.

  2. Risk-based versus deterministic explosives safety criteria

    SciTech Connect

    Wright, R.E.

    1996-12-01

    The Department of Defense Explosives Safety Board (DDESB) is actively considering ways to apply risk-based approaches in its decision- making processes. As such, an understanding of the impact of converting to risk-based criteria is required. The objectives of this project are to examine the benefits and drawbacks of risk-based criteria and to define the impact of converting from deterministic to risk-based criteria. Conclusions will be couched in terms that allow meaningful comparisons of deterministic and risk-based approaches. To this end, direct comparisons of the consequences and impacts of both deterministic and risk-based criteria at selected military installations are made. Deterministic criteria used in this report are those in DoD 6055.9-STD, `DoD Ammunition and Explosives Safety Standard.` Risk-based criteria selected for comparison are those used by the government of Switzerland, `Technical Requirements for the Storage of Ammunition (TLM 75).` The risk-based criteria used in Switzerland were selected because they have been successfully applied for over twenty-five years.

  3. Pathologic nodal staging score for bladder cancer: a decision tool for adjuvant therapy after radical cystectomy.

    PubMed

    Shariat, Shahrokh F; Rink, Michael; Ehdaie, Behfar; Xylinas, Evanguelos; Babjuk, Marek; Merseburger, Axel S; Svatek, Robert S; Cha, Eugene K; Tagawa, Scott T; Fajkovic, Harun; Novara, Giacomo; Karakiewicz, Pierre I; Trinh, Quoc-Dien; Daneshmand, Siamak; Lotan, Yair; Kassouf, Wassim; Fritsche, Hans-Martin; Chun, Felix K; Sonpavde, Guru; Joual, Abdennabi; Scherr, Douglas S; Gonen, Mithat

    2013-02-01

    Radical cystectomy (RC) with pelvic lymph node dissection (PLND) is the standard of care for high-risk non-muscle-invasive and muscle-invasive bladder cancer (BCa). To develop a model that allows quantification of the likelihood that a pathologically node-negative patient has, indeed, no positive nodes. We analyzed data from 4335 patients treated with RC and PLND without neoadjuvant chemotherapy at 12 international academic centers. Patients underwent RC and PLND. We estimated the sensitivity of pathologic nodal staging using a beta-binomial model and developed a pathologic (postoperative) nodal staging score (pNSS) that represents the probability that a patient is correctly staged as node negative as a function of the number of examined nodes. Overall, the probability of missing a positive node decreases with the increasing number of nodes examined (52% if 3 nodes are examined, 40% if 5 are examined, and 26% if 10 are examined). The proportion of having a positive node increased proportionally with advancing pathologic T stage and lymphovascular invasion (LVI). Patients with LVI who had 25 examined nodes would have a pNSS of 80% (pT1), 88% (pT2), and 66% (pT3-T4), whereas 10 examined nodes were sufficient for pNSS exceeding 90% in patients without LVI and pT0-T2 tumors. This study is limited because of its retrospective design and multicenter nature. We developed a tool that estimates the likelihood of lymph node (LN) metastasis in BCa patients treated with RC by evaluating the number of examined nodes, the pathologic T stage, and LVI. The pNSS indicates the adequacy of nodal staging in LN-negative patients. This tool could help to refine clinical decision making regarding adjuvant chemotherapy, follow-up scheduling, and inclusion in clinical trials. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  4. Decision Support Tool for the Management of Debris from Radiological Dispersal Devices and Other Incidents of National Significance

    SciTech Connect

    Lemieux, P.; Thorneloe, S.; Hayes, C.; Rodgers, M.; Christman, R.

    2008-07-01

    Unique challenges exist for the handling, transport, and disposal of debris resulting from homeland security incidents, disasters or other national emergencies. Access to guidance to facilitate decision making to ensure the safe and timely disposal of debris is critical to helping restore a community or region and prevent further contamination or spread of disease. For a radiological dispersal device (RDD), proper characterization of the quantity, properties, and level of contamination of debris can have a significant impact on cleanup costs and timelines. A suite of decision support tools (DSTs) is being developed by the U.S. EPA's Office of Research and Development to assist individuals responsible for making decisions associated with handling, transport, and disposal of such debris. The DSTs are location-specific to help identify specific facilities and contacts for making final disposal decisions. The DSTs provide quick reference to technical information, regulations, and other information to provide decision makers with assistance in guiding disposal decisions that are important for the protection of public health, first responders, and the environment. These tools are being developed in partnership with other U.S. government agencies, EPA program offices, industry, and state and local emergency response programs. (authors)

  5. Development of a 2nd Generation Decision Support Tool to Optimize Resource and Energy Recovery for Municipal Solid Waste

    EPA Science Inventory

    In 2012, EPA’s Office of Research and Development released the MSW decision support tool (MSW-DST) to help identify strategies for more sustainable MSW management. Depending upon local infrastructure, energy grid mix, population density, and waste composition and quantity, the m...

  6. Development of a 2nd Generation Decision Support Tool to Optimize Resource and Energy Recovery for Municipal Solid Waste

    EPA Science Inventory

    In 2012, EPA’s Office of Research and Development released the MSW decision support tool (MSW-DST) to help identify strategies for more sustainable MSW management. Depending upon local infrastructure, energy grid mix, population density, and waste composition and quantity, the m...

  7. Implementation of a Tool to Enhance Evidence-Informed Decision Making in Public Health: Identifying Barriers and Facilitating Factors

    ERIC Educational Resources Information Center

    van der Heide, Iris; van der Noordt, Maaike; Proper, Karin I.; Schoemaker, Casper; van den Berg, Matthijs; Hamberg-van Reenen, Heleen H.

    2016-01-01

    One of the barriers regarding evidence-informed decision making is the gap between the needs of policy makers and the ways researchers present evidence. This pilot study evaluates the barriers and facilitators to the implementation of a tool to enhance transparent and unambiguous communication on scientific evidence by knowledge workers.…

  8. INTRODUCTION TO SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS-ELECTRONIC (SMARTE): IMPROVING REVITALIZATION DECISIONS IN DAKOTA CITY, NEBRASKA

    EPA Science Inventory

    SMARTe (Sustainable Management Approaches and Revitalization Tools-electronic) is a web-based decision support tool being developed by the Office of Research and Development (ORD) in partnership with the Office of Brownfields Cleanup and ...

  9. Implementation of a Tool to Enhance Evidence-Informed Decision Making in Public Health: Identifying Barriers and Facilitating Factors

    ERIC Educational Resources Information Center

    van der Heide, Iris; van der Noordt, Maaike; Proper, Karin I.; Schoemaker, Casper; van den Berg, Matthijs; Hamberg-van Reenen, Heleen H.

    2016-01-01

    One of the barriers regarding evidence-informed decision making is the gap between the needs of policy makers and the ways researchers present evidence. This pilot study evaluates the barriers and facilitators to the implementation of a tool to enhance transparent and unambiguous communication on scientific evidence by knowledge workers.…

  10. INTRODUCTION TO SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS-ELECTRONIC (SMARTE): IMPROVING REVITALIZATION DECISIONS IN STELLA, MISSOURI

    EPA Science Inventory

    SMARTe (Sustainable Management Approaches and Revitalization Tools-electronic) is a web-based decision support tool being developed by the Office of Research and Development (ORD) in partnership with the Office of Brownfields Cleanup and ...

  11. INTRODUCTION TO SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS-ELECTRONIC (SMARTE): IMPROVING REVITALIZATION DECISIONS IN DAKOTA CITY, NEBRASKA

    EPA Science Inventory

    SMARTe (Sustainable Management Approaches and Revitalization Tools-electronic) is a web-based decision support tool being developed by the Office of Research and Development (ORD) in partnership with the Office of Brownfields Cleanup and ...

  12. INTRODUCTION TO SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS-ELECTRONIC (SMARTE): IMPROVING REVITALIZATION DECISIONS IN STELLA, MISSOURI

    EPA Science Inventory

    SMARTe (Sustainable Management Approaches and Revitalization Tools-electronic) is a web-based decision support tool being developed by the Office of Research and Development (ORD) in partnership with the Office of Brownfields Cleanup and ...

  13. An investigation of the validity of the Work Assessment Triage Tool clinical decision support tool for selecting optimal rehabilitation interventions for workers with musculoskeletal injuries.

    PubMed

    Qin, Ziling; Armijo-Olivo, Susan; Woodhouse, Linda J; Gross, Douglas P

    2016-03-01

    To evaluate the concurrent validity of a clinical decision support tool (Work Assessment Triage Tool (WATT)) developed to select rehabilitation treatments for injured workers with musculoskeletal conditions. Methodological study with cross-sectional and prospective components. Data were obtained from the Workers' Compensation Board of Alberta rehabilitation facility in Edmonton, Canada. A total of 432 workers' compensation claimants evaluated between November 2011 and June 2012. Percentage agreement between the Work Assessment Triage Tool and clinician recommendations was used to determine concurrent validity. In claimants returning to work, frequencies of matching were calculated and compared between clinician and Work Assessment Triage Tool recommendations and the actual programs undertaken by claimants. The frequency of each intervention recommended by clinicians, Work Assessment Triage Tool, and case managers were also calculated and compared. Percentage agreement between clinician and Work Assessment Triage Tool recommendations was poor (19%) to moderate (46%) and Kappa = 0.37 (95% CI -0.02, 0.76). The Work Assessment Triage Tool did not improve upon clinician recommendations as only 14 out of 31 claimants returning to work had programs that contradicted clinician recommendations, but were consistent with Work Assessment Triage Tool recommendations. Clinicians and case managers were inclined to recommend functional restoration, physical therapy, or no rehabilitation while the Work Assessment Triage Tool recommended additional evidence-based interventions, such as workplace-based interventions. Our findings do not provide evidence of concurrent validity for the Work Assessment Triage Tool compared with clinician recommendations. Based on these results, we cannot recommend further implementation of the Work Assessment Triage Tool. However, the Work Assessment Triage Tool appeared more likely than clinicians to recommend interventions supported by evidence

  14. Collaborative Aviation Weather Statement - An Impact-based Decision Support Tool

    NASA Astrophysics Data System (ADS)

    Blondin, Debra

    2016-04-01

    Historically, convection causes the highest number of air traffic constraints on the United States National Air Space (NAS). Increased NAS predictability allows traffic flow managers to more effectively initiate, amend or terminate planned or active traffic management initiatives, resulting in more efficient use of available airspace. A Collaborative Aviation Weather Statement (CAWS) is an impact-based decision support tool used for the timely delivery of high-confidence, high-relevance aviation convective weather forecasts to air traffic managers. The CAWS is a graphical and textual forecast produced by a collaborative team of meteorologists from the Aviation Weather Center (AWC), Center Weather Service Units, and airlines to bring attention to high impact areas of thunderstorms. The CAWS addresses thunderstorm initiation or movement into the airports having the highest volume of traffic or into traffic sensitive jet routes. These statements are assessed by planners at the Federal Aviation Administration's (FAA) Air Route Traffic Control Centers and are used for planning traffic management initiatives to balance air traffic flow across the United States. The FAA and the airline industry use the CAWS to plan, manage, and execute operations in the NAS, thereby improving the system efficiency and safety and also saving dollars for industry and the traveling public.

  15. Our wealth, our health--bellwether industries for decision tools and symbiotic stewardships.

    PubMed

    Wooldridge, Jean A

    2002-01-01

    This chapter examines the tea leaves of emerging technologies for the most fruitful areas of crossover value to health decisions, by spotting bellwether industries of similar information asymmetries. It examines changing tools and roles for growing consumer-centrism in personal finance, healthcare, private aviation, and law. It seeks to understand the technologies of managing and measuring, the transformations of growing transparencies in our processes, and how an increasing sense of collective stewardship forged between people and their machines can lead beyond effectiveness to wisdom, for individuals, communities, and the world. "The whole thing reminds me of the uncomfortable feeling I experienced when I first sought out investment advice. . . ..I concluded that I had to undertake the generalist's job myself; I had to take the high-level management of my investments into my own hands. Similarly, given the structure of the medical practice associated with prostate cancer, that's the only viable choice any patient has." Andy Grove, Co-Founder and Chair, Intel. "In the end, a symbiotic culture composed of human and digital individuals may be a more effective steward of the earth's resources than humans would be by themselves." Donald D. Chamberlin, author and ACM Fellow.

  16. Use of an Electronic Decision Support Tool Improves Management of Simulated In-Hospital Cardiac Arrest

    PubMed Central

    McEvoy, Matthew D; Smalley, Jeremy C; Clark, Carlee A; McEvoy, Michael B; Rieke, Horst; Nietert, Paul J; Furse, Cory M

    2014-01-01

    INTRODUCTION Adherence to Advanced Cardiac Life Support (ACLS) guidelines during in69 hospital cardiac arrest (IHCA) is associated with improved outcomes, but current evidence shows that sub-optimal care is common. Successful execution of such protocols during IHCA requires rapid patient assessment and the performance of a number of ordered, time-sensitive interventions. Accordingly, we sought to determine whether the use of an electronic decision support tool (DST) improves performance during high-fidelity simulations of IHCA. METHODS After IRB approval and written informed consent was obtained, 47 senior medical students were enrolled. All participants were ACLS certified and within one month of graduation. Each participant was issued an iPod Touch device with a DST installed that contained all ACLS management algorithms. Participants managed two scenarios of IHCA and were allowed to use the DST in one scenario and prohibited from using it in the other. All participants managed the same scenarios. Simulation sessions were video recorded and graded by trained raters according to previously validated checklists. RESULTS Performance of correct protocol steps was significantly greater with the DST than without (84.7% v 73.8%, p< 0.001) and participants committed significantly fewer additional errors when using the DST (2.5 errors v. 3.8 errors, p< 0.012). CONCLUSION Use of an electronic DST provided a significant improvement in the management of simulated IHCA by senior medical students as measured by adherence to published guidelines. PMID:24056391

  17. Soil-Bacterium Compatibility Model as a Decision-Making Tool for Soil Bioremediation.

    PubMed

    Horemans, Benjamin; Breugelmans, Philip; Saeys, Wouter; Springael, Dirk

    2017-02-07

    Bioremediation of organic pollutant contaminated soil involving bioaugmentation with dedicated bacteria specialized in degrading the pollutant is suggested as a green and economically sound alternative to physico-chemical treatment. However, intrinsic soil characteristics impact the success of bioaugmentation. The feasibility of using partial least-squares regression (PLSR) to predict the success of bioaugmentation in contaminated soil based on the intrinsic physico-chemical soil characteristics and, hence, to improve the success of bioaugmentation, was examined. As a proof of principle, PLSR was used to build soil-bacterium compatibility models to predict the bioaugmentation success of the phenanthrene-degrading Novosphingobium sp. LH128. The survival and biodegradation activity of strain LH128 were measured in 20 soils and correlated with the soil characteristics. PLSR was able to predict the strain's survival using 12 variables or less while the PAH-degrading activity of strain LH128 in soils that show survival was predicted using 9 variables. A three-step approach using the developed soil-bacterium compatibility models is proposed as a decision making tool and first estimation to select compatible soils and organisms and increase the chance of success of bioaugmentation.

  18. Generation of Look-Up Tables for Dynamic Job Shop Scheduling Decision Support Tool

    NASA Astrophysics Data System (ADS)

    Oktaviandri, Muchamad; Hassan, Adnan; Mohd Shaharoun, Awaluddin

    2016-02-01

    Majority of existing scheduling techniques are based on static demand and deterministic processing time, while most job shop scheduling problem are concerned with dynamic demand and stochastic processing time. As a consequence, the solutions obtained from the traditional scheduling technique are ineffective wherever changes occur to the system. Therefore, this research intends to develop a decision support tool (DST) based on promising artificial intelligent that is able to accommodate the dynamics that regularly occur in job shop scheduling problem. The DST was designed through three phases, i.e. (i) the look-up table generation, (ii) inverse model development and (iii) integration of DST components. This paper reports the generation of look-up tables for various scenarios as a part in development of the DST. A discrete event simulation model was used to compare the performance among SPT, EDD, FCFS, S/OPN and Slack rules; the best performances measures (mean flow time, mean tardiness and mean lateness) and the job order requirement (inter-arrival time, due dates tightness and setup time ratio) which were compiled into look-up tables. The well-known 6/6/J/Cmax Problem from Muth and Thompson (1963) was used as a case study. In the future, the performance measure of various scheduling scenarios and the job order requirement will be mapped using ANN inverse model.

  19. Existing air sparging model and literature review for the development of an air sparging optimization decision tool

    SciTech Connect

    1995-08-01

    The objectives of this Report are two-fold: (1) to provide overviews of the state-of-the-art and state-of-the-practice with respect to air sparging technology, air sparging models and related or augmentation technologies (e.g., soil vapor extraction); and (2) to provide the basis for the development of the conceptual Decision Tool. The Project Team conducted an exhaustive review of available literature. The complete listing of the documents, numbering several hundred and reviewed as a part of this task, is included in Appendix A. Even with the large amount of material written regarding the development and application of air sparging, there still are significant gaps in the technical community`s understanding of the remediation technology. The results of the literature review are provided in Section 2. In Section 3, an overview of seventeen conceptual, theoretical, mathematical and empirical models is presented. Detailed descriptions of each of the models reviewed is provided in Appendix B. Included in Appendix D is a copy of the questionnaire used to compile information about the models. The remaining sections of the document reflect the analysis and synthesis of the information gleaned during the literature and model reviews. The results of these efforts provide the basis for development of the decision tree and conceptual decision tool for determining applicability and optimization of air sparging. The preliminary decision tree and accompanying information provided in Section 6 describe a three-tiered approach for determining air sparging applicability: comparison with established scenarios; calculation of conceptual design parameters; and the conducting of pilot-scale studies to confirm applicability. The final two sections of this document provide listings of the key success factors which will be used for evaluating the utility of the Decision Tool and descriptions of potential applications for Decision Tool use.

  20. AdViSHE: A Validation-Assessment Tool of Health-Economic Models for Decision Makers and Model Users.

    PubMed

    Vemer, P; Corro Ramos, I; van Voorn, G A K; Al, M J; Feenstra, T L

    2016-04-01

    A trade-off exists between building confidence in health-economic (HE) decision models and the use of scarce resources. We aimed to create a practical tool providing model users with a structured view into the validation status of HE decision models, to address this trade-off. A Delphi panel was organized, and was completed by a workshop during an international conference. The proposed tool was constructed iteratively based on comments from, and the discussion amongst, panellists. During the Delphi process, comments were solicited on the importance and feasibility of possible validation techniques for modellers, their relevance for decision makers, and the overall structure and formulation in the tool. The panel consisted of 47 experts in HE modelling and HE decision making from various professional and international backgrounds. In addition, 50 discussants actively engaged in the discussion at the conference workshop and returned 19 questionnaires with additional comments. The final version consists of 13 items covering all relevant aspects of HE decision models: the conceptual model, the input data, the implemented software program, and the model outcomes. Assessment of the Validation Status of Health-Economic decision models (AdViSHE) is a validation-assessment tool in which model developers report in a systematic way both on validation efforts performed and on their outcomes. Subsequently, model users can establish whether confidence in the model is justified or whether additional validation efforts should be undertaken. In this way, AdViSHE enhances transparency of the validation status of HE models and supports efficient model validation.

  1. Application of the US decision support tool for materials and waste management

    SciTech Connect

    Thorneloe, Susan A. Weitz, Keith Jambeck, Jenna

    2007-07-01

    The US Environmental Protection Agency (US EPA) launched the Resource Conservation Challenge (RCC) in 2002 to help reduce waste and move towards more sustainable resource consumption. The objective of the RCC is to help communities, industries, and the public think in terms of materials management rather than waste disposal. Reducing cost, finding more efficient and effective strategies to manage municipal waste, and thinking in terms of materials management requires a holistic approach that considers life-cycle environmental tradeoffs. The US EPA's National Risk Management Research Laboratory has led the development of a municipal solid waste decision support tool (MSW-DST). The computer software can be used to calculate life-cycle environmental tradeoffs and full costs of different waste management or materials recovery programs. The environmental methodology is based on the use of life-cycle assessment and the cost methodology is based on the use of full-cost accounting. Life-cycle inventory (LCI) environmental impacts and costs are calculated from the point of collection, handling, transport, treatment, and disposal. For any materials that are recovered for recycling, offsets are calculated to reflect potential emissions savings from use of virgin materials. The use of the MSW-DST provides a standardized format and consistent basis to compare alternatives. This paper provides an illustration of how the MSW-DST can be used by evaluating ten management strategies for a hypothetical medium-sized community to compare the life-cycle environmental and cost tradeoffs. The LCI results from the MSW-DST are then used as inputs into another US EPA tool, the Tool for the reduction and assessment of chemical and other environmental impacts, to convert the LCI results into impact indicators. The goal of this paper is to demonstrate how the MSW-DST can be used to identify and balance multiple criteria (costs and environmental impacts) when evaluating options for materials and

  2. Linking optimization and ecological models in a decision support tool for oyster restoration and management.

    PubMed

    North, E W; King, D M; Xu, J; Hood, R R; Newell, R I E; Paynter, K; Kellogg, M L; Liddel, M K; Boesch, D F

    2010-04-01

    Restoration of ecologically important marine species and habitats is restricted by funding constraints and hindered by lack of information about trade-offs among restoration goals and the effectiveness of alternative restoration strategies. Because ecosystems provide diverse human and ecological benefits, achieving one restoration benefit may take place at the expense of other benefits. This poses challenges when attempting to allocate limited resources to optimally achieve multiple benefits, and when defining measures of restoration success. We present a restoration decision-support tool that links ecosystem prediction and human use in a flexible "optimization" framework that clarifies important restoration trade-offs, makes location-specific recommendations, predicts benefits, and quantifies the associated costs (in the form of lost opportunities). The tool is illustrated by examining restoration options related to the eastern oyster, Crassostrea virginica, which supported an historically important fishery in Chesapeake Bay and provides a range of ecosystem services such as removing seston, enhancing water clarity, and creating benthic habitat. We use an optimization approach to identify the locations where oyster restoration efforts are most likely to maximize one or more benefits such as reduction in seston, increase in light penetration, spawning stock enhancement, and harvest, subject to funding constraints and other limitations. This proof-of-concept Oyster Restoration Optimization model (ORO) incorporates predictions from three-dimensional water quality (nutrients-phytoplankton zooplankton-detritus [NPZD] with oyster filtration) and larval transport models; calculates size- and salinity-dependent growth, mortality, and fecundity of oysters; and includes economic costs of restoration efforts. Model results indicate that restoration of oysters in different regions of the Chesapeake Bay would maximize different suites of benefits due to interactions between

  3. The Design of an IEP Decision Aid: A Tool for Diverse Parents of Children with Autism

    ERIC Educational Resources Information Center

    Schuttler, Jessica Oeth

    2012-01-01

    Decision-making is a universal process that occurs constantly in life. Parent participation in educational decision-making is recognized as important by special education law, by special education and school psychology literature (Christenson & Sheridan, 2001; IDEIA, 2004;). Partnership in decision-making is especially important for parents of…

  4. Decision analysis in anaesthesia: a tool for developing and analysing clinical management plans.

    PubMed

    Yentis, S M

    2006-07-01

    Traditional medical decision making is unstructured and incorporates evidence haphazardly. I present a more structured approach based on decision analysis, a model that considers all relevant options and outcomes informed by evidence where appropriate. This method is useful both for planning clinical management and for analysing decisions already taken.

  5. The Design of an IEP Decision Aid: A Tool for Diverse Parents of Children with Autism

    ERIC Educational Resources Information Center

    Schuttler, Jessica Oeth

    2012-01-01

    Decision-making is a universal process that occurs constantly in life. Parent participation in educational decision-making is recognized as important by special education law, by special education and school psychology literature (Christenson & Sheridan, 2001; IDEIA, 2004;). Partnership in decision-making is especially important for parents of…

  6. Ready, Set, Change! Development and usability testing of an online readiness for change decision support tool for healthcare organizations.

    PubMed

    Timmings, Caitlyn; Khan, Sobia; Moore, Julia E; Marquez, Christine; Pyka, Kasha; Straus, Sharon E

    2016-02-24

    To address challenges related to selecting a valid, reliable, and appropriate readiness assessment measure in practice, we developed an online decision support tool to aid frontline implementers in healthcare settings in this process. The focus of this paper is to describe a multi-step, end-user driven approach to developing this tool for use during the planning stages of implementation. A multi-phase, end-user driven approach was used to develop and test the usability of a readiness decision support tool. First, readiness assessment measures that are valid, reliable, and appropriate for healthcare settings were identified from a systematic review. Second, a mapping exercise was performed to categorize individual items of included measures according to key readiness constructs from an existing framework. Third, a modified Delphi process was used to collect stakeholder ratings of the included measures on domains of feasibility, relevance, and likelihood to recommend. Fourth, two versions of a decision support tool prototype were developed and evaluated for usability. Nine valid and reliable readiness assessment measures were included in the decision support tool. The mapping exercise revealed that of the nine measures, most measures (78 %) focused on assessing readiness for change at the organizational versus the individual level, and that four measures (44 %) represented all constructs of organizational readiness. During the modified Delphi process, stakeholders rated most measures as feasible and relevant for use in practice, and reported that they would be likely to recommend use of most measures. Using data from the mapping exercise and stakeholder panel, an algorithm was developed to link users to a measure based on characteristics of their organizational setting and their readiness for change assessment priorities. Usability testing yielded recommendations that were used to refine the Ready, Set, Change! decision support tool . Ready, Set, Change! decision

  7. Contemporary health-related decision aids: tools for social work practice.

    PubMed

    Cummings, Cory R; Bentley, Kia J

    2014-01-01

    The escalating complexity in health-related decisions that people face have important implications for social work interventions. This article explores the nature of these implications within the context of decisional conflict, shared decision making, and the use of decision aids. In addition, the authors present the findings of a content analysis of 29 contemporary health-related decision aids. Emergent categories from this analysis are presented as a resource for social workers as they encounter, adapt, and create decision aids in their work to help address the health-related needs of their clients.

  8. Middle-aged women's decisions about body weight management: needs assessment and testing of a knowledge translation tool.

    PubMed

    Stacey, Dawn; Jull, Janet; Beach, Sarah; Dumas, Alex; Strychar, Irene; Adamo, Kristi; Brochu, Martin; Prud'homme, Denis

    2015-04-01

    This study aims to assess middle-aged women's needs when making body weight management decisions and to evaluate a knowledge translation tool for addressing their needs. A mixed-methods study used an interview-guided theory-based survey of professional women aged 40 to 65 years. The tool summarized evidence to address their needs and enabled women to monitor actions taken. Acceptability and usability were reported descriptively. Sixty female participants had a mean body mass index of 28.0 kg/m(2) (range, 17.0-44.9 kg/m(2)), and half were premenopausal. Common options for losing (82%) or maintaining (18%) weight included increasing physical activity (60%), eating healthier (57%), and getting support (40%). Decision-making involved getting information on options (52%), soliciting others' decisions/advice (20%), and being self-motivated (20%). Preferred information sources included written information (97%), counseling (90%), and social networking websites (43%). Five professionals (dietitian, personal trainer, occupational therapist, and two physicians) had similar responses. Of 53 women sent the tool, 27 provided acceptability feedback. They rated it as good to excellent for information on menopause (96%), body weight changes (85%), and managing body weight (85%). Most would tell others about it (81%). After 4 weeks of use, 25 women reported that the wording made sense (96%) and that the tool had clear instructions (92%) and was easy to use across time (88%). The amount of information was rated as just right (64%), but the tool had limited space for responding (72%). When making decisions about body weight management, women's needs were "getting information" and "getting support." The knowledge translation tool was acceptable and usable, but further evaluation is required.

  9. Middle-aged women’s decisions about body weight management: needs assessment and testing of a knowledge translation tool

    PubMed Central

    Stacey, Dawn; Jull, Janet; Beach, Sarah; Dumas, Alex; Strychar, Irene; Adamo, Kristi; Brochu, Martin; Prud’homme, Denis

    2015-01-01

    Abstract Objective This study aims to assess middle-aged women’s needs when making body weight management decisions and to evaluate a knowledge translation tool for addressing their needs. Methods A mixed-methods study used an interview-guided theory-based survey of professional women aged 40 to 65 years. The tool summarized evidence to address their needs and enabled women to monitor actions taken. Acceptability and usability were reported descriptively. Results Sixty female participants had a mean body mass index of 28.0 kg/m2 (range, 17.0-44.9 kg/m2), and half were premenopausal. Common options for losing (82%) or maintaining (18%) weight included increasing physical activity (60%), eating healthier (57%), and getting support (40%). Decision-making involved getting information on options (52%), soliciting others’ decisions/advice (20%), and being self-motivated (20%). Preferred information sources included written information (97%), counseling (90%), and social networking websites (43%). Five professionals (dietitian, personal trainer, occupational therapist, and two physicians) had similar responses. Of 53 women sent the tool, 27 provided acceptability feedback. They rated it as good to excellent for information on menopause (96%), body weight changes (85%), and managing body weight (85%). Most would tell others about it (81%). After 4 weeks of use, 25 women reported that the wording made sense (96%) and that the tool had clear instructions (92%) and was easy to use across time (88%). The amount of information was rated as just right (64%), but the tool had limited space for responding (72%). Conclusions When making decisions about body weight management, women’s needs were “getting information” and “getting support.” The knowledge translation tool was acceptable and usable, but further evaluation is required. PMID:25816120

  10. 5As Team obesity intervention in primary care: development and evaluation of shared decision-making weight management tools.

    PubMed

    Osunlana, A M; Asselin, J; Anderson, R; Ogunleye, A A; Cave, A; Sharma, A M; Campbell-Scherer, D L

    2015-08-01

    Despite several clinical practice guidelines, there remains a considerable gap in prevention and management of obesity in primary care. To address the need for changing provider behaviour, a randomized controlled trial with convergent mixed method evaluation, the 5As Team (5AsT) study, was conducted. As part of the 5AsT intervention, the 5AsT tool kit was developed. This paper describes the development process and evaluation of these tools. Tools were co-developed by the multidisciplinary research team and the 5AsT, which included registered nurses/nurse practitioners (n = 15), mental health workers (n = 7) and registered dieticians (n = 7), who were previously randomized to the 5AsT intervention group at a primary care network in Edmonton, Alberta, Canada. The 5AsT tool development occurred through a practice/implementation-oriented, need-based, iterative process during learning collaborative sessions of the 5AsT intervention. Feedback during tool development was received through field notes and final provider evaluation was carried out through anonymous questionnaires. Twelve tools were co-developed with 5AsT. All tools were evaluated as either 'most useful' or 'moderately useful' in primary care practice by the 5AsT. Four key findings during 5AsT tool development were the need for: tools that were adaptive, tools to facilitate interdisciplinary practice, tools to help patients understand realistic expectations for weight loss and shared decision-making tools for goal setting and relapse prevention. The 5AsT tools are primary care tools which extend the utility of the 5As of obesity management framework in clinical practice.

  11. Clinical decision support tools: personal digital assistant versus online dietary supplement databases.

    PubMed

    Clauson, Kevin A; Polen, Hyla H; Peak, Amy S; Marsh, Wallace A; DiScala, Sandra L

    2008-11-01

    Clinical decision support tools (CDSTs) on personal digital assistants (PDAs) and online databases assist healthcare practitioners who make decisions about dietary supplements. To assess and compare the content of PDA dietary supplement databases and their online counterparts used as CDSTs. A total of 102 question-and-answer pairs were developed within 10 weighted categories of the most clinically relevant aspects of dietary supplement therapy. PDA versions of AltMedDex, Lexi-Natural, Natural Medicines Comprehensive Database, and Natural Standard and their online counterparts were assessed by scope (percent of correct answers present), completeness (3-point scale), ease of use, and a composite score integrating all 3 criteria. Descriptive statistics and inferential statistics, including a chi(2) test, Scheffé's multiple comparison test, McNemar's test, and the Wilcoxon signed rank test were used to analyze data. The scope scores for PDA databases were: Natural Medicines Comprehensive Database 84.3%, Natural Standard 58.8%, Lexi-Natural 50.0%, and AltMedDex 36.3%, with Natural Medicines Comprehensive Database statistically superior (p < 0.01). Completeness scores were: Natural Medicines Comprehensive Database 78.4%, Natural Standard 51.0%, Lexi-Natural 43.5%, and AltMedDex 29.7%. Lexi-Natural was superior in ease of use (p < 0.01). Composite scores for PDA databases were: Natural Medicines Comprehensive Database 79.3, Natural Standard 53.0, Lexi-Natural 48.0, and AltMedDex 32.5, with Natural Medicines Comprehensive Database superior (p < 0.01). There was no difference between the scope for PDA and online database pairs with Lexi-Natural (50.0% and 53.9%, respectively) or Natural Medicines Comprehensive Database (84.3% and 84.3%, respectively) (p > 0.05), whereas differences existed for AltMedDex (36.3% vs 74.5%, respectively) and Natural Standard (58.8% vs 80.4%, respectively) (p < 0.01). For composite scores, AltMedDex and Natural Standard online were better than

  12. A Randomized Controlled Trial of a CPR and Intubation Video Decision Support Tool for Hospitalized Patients.

    PubMed

    El-Jawahri, Areej; Mitchell, Susan L; Paasche-Orlow, Michael K; Temel, Jennifer S; Jackson, Vicki A; Rutledge, Renee R; Parikh, Mihir; Davis, Aretha D; Gillick, Muriel R; Barry, Michael J; Lopez, Lenny; Walker-Corkery, Elizabeth S; Chang, Yuchiao; Finn, Kathleen; Coley, Christopher; Volandes, Angelo E

    2015-08-01

    Decisions about cardiopulmonary resuscitation (CPR) and intubation are a core part of advance care planning, particularly for seriously ill hospitalized patients. However, these discussions are often avoided. We aimed to examine the impact of a video decision tool for CPR and intubation on patients' choices, knowledge, medical orders, and discussions with providers. This was a prospective randomized trial conducted between 9 March 2011 and 1 June 2013 on the internal medicine services at two hospitals in Boston. One hundred and fifty seriously ill hospitalized patients over the age of 60 with an advanced illness and a prognosis of 1 year or less were included. Mean age was 76 and 51% were women. Three-minute video describing CPR and intubation plus verbal communication of participants' preferences to their physicians (intervention) (N = 75) or control arm (usual care) (N = 75). The primary outcome was participants' preferences for CPR and intubation (immediately after viewing the video in the intervention arm). Secondary outcomes included: orders to withhold CPR/intubation, documented discussions with providers during hospitalization, and participants' knowledge of CPR/ intubation (five-item test, range 0-5, higher scores indicate greater knowledge). Intervention participants (vs. controls) were more likely not to want CPR (64% vs. 32%, p <0.0001) and intubation (72% vs. 43%, p < 0.0001). Intervention participants (vs. controls) were also more likely to have orders to withhold CPR (57% vs. 19%, p < 0.0001) and intubation (64% vs.19%, p < 0.0001) by hospital discharge, documented discussions about their preferences (81% vs. 43%, p < 0.0001), and higher mean knowledge scores (4.11 vs. 2.45; p < 0.0001). Seriously ill patients who viewed a video about CPR and intubation were more likely not to want these treatments, be better informed about their options, have orders to forgo CPR/ intubation, and discuss preferences with providers

  13. Towards Risk Based Design for NASA's Missions

    NASA Technical Reports Server (NTRS)

    Tumer, Irem Y.; Barrientos, Francesca; Meshkat, Leila

    2004-01-01

    This paper describes the concept of Risk Based Design in the context of NASA s low volume, high cost missions. The concept of accounting for risk in the design lifecycle has been discussed and proposed under several research topics, including reliability, risk analysis, optimization, uncertainty, decision-based design, and robust design. This work aims to identify and develop methods to enable and automate a means to characterize and optimize risk, and use risk as a tradeable resource to make robust and reliable decisions, in the context of the uncertain and ambiguous stage of early conceptual design. This paper first presents a survey of the related topics explored in the design research community as they relate to risk based design. Then, a summary of the topics from the NASA-led Risk Colloquium is presented, followed by current efforts within NASA to account for risk in early design. Finally, a list of "risk elements", identified for early-phase conceptual design at NASA, is presented. The purpose is to lay the foundation and develop a roadmap for future work and collaborations for research to eliminate and mitigate these risk elements in early phase design.

  14. Evaluating the quality of shared decision making during the patient-carer encounter: a systematic review of tools.

    PubMed

    Bouniols, Nathalie; Leclère, Brice; Moret, Leïla

    2016-08-02

    The concept of shared decision making (SDM) has been developing in many countries since the 1990s. The main challenge of SDM, based on the principles of respect for the person's autonomy, is to improve patients' participation, should they so wish, in decisions concerning their personal health. To our knowledge, there is only one SDM evaluation tool validated in metropolitan French that does not measure the entire SDM construct. The aim of this review was to identify existing and validated SDM measurement tools to determine which of them could be adapted in French to cover all the dimensions of SDM. A systematic literature review was conducted based on articles found in the PubMed and PsycINFO bibliographic databases and published between 2010 and 2014. Studies were included if the main goal of the article was the development and psychometric validation of an SDM measurement tool, not specific to any given disease or situation, in English, French and Spanish. We used the nine essential elements of the Makoul and Clayman's integrative model to describe the different existing tools. Nineteen studies were included. Seven new tools had been published since Scholl's previous review in 2011. We observed a recent spread of the multi-appraiser approach, which combines points of view of patients, healthcare professionals and sometimes external observers. Several models were used for the development of the seven newly identified tools. None of the identified tools assessed the nine elements of the Makoul's model. Three of these elements, however, were systematically measured in each of the new tools: "defining/explaining the problem", "patient values/preferences", and "checking/clarifying understanding". We identified several potentially interesting tools for the French context which could cover the whole elements of Makoul's model. The next step will be the development of a French-language instrument based on these tools.

  15. Safe use of antithrombotics for stroke prevention in atrial fibrillation: consideration of risk assessment tools to support decision-making

    PubMed Central

    Bajorek, Beata

    2014-01-01

    Clinical guidelines advocate stroke prevention therapy in atrial fibrillation (AF) patients, specifically anticoagulation. However, the decision to initiate treatment is based on the risk (bleeding) versus benefit (prevention of stroke) of therapy, which is often difficult to assess. This review identifies available risk assessment tools to facilitate the safe and optimal use of antithrombotic therapy for stroke prevention in AF. Using key databases and online clinical resources to search the literature (1992–2012), 19 tools have been identified and published to date: 11 addressing stroke risk, 7 addressing bleeding risk and 1 integrating both risk assessments. The stroke risk assessment tools (e.g. CHADS2, CHA2DS2-VASc) share common risk factors: age, hypertension, previous cerebrovascular attack. The bleeding risk assessment tools (e.g. HEMORR2HAGES, HAS-BLED) share common risk factors: age, previous bleeding, renal and liver impairment. In terms of their development, six of the stroke risk assessment tools have been derived from clinical studies, whilst five are based on refinement of existing tools or expert consensus. Many have been evaluated by prospective application to data from real patient cohorts. Bleeding risk assessment tools have been derived from trials, or generated from patient data and then validated via further studies. One identified tool (i.e. Computerised Antithrombotic Risk Assessment Tool [CARAT]) integrates both stroke and bleeding, and specifically considers other key factors in decision-making regarding antithrombotic therapy, particularly those increasing the risk of medication misadventure with treatment (e.g. function, drug interactions, medication adherence). This highlights that whilst separate tools are available to assess stroke and bleeding risk, they do not estimate the relative risk versus benefit of treatment in an individual patient nor consider key medication safety aspects. More effort is needed to synthesize these

  16. Five shared decision-making tools in 5 months: use of rapid reviews to develop decision boxes for seniors living with dementia and their caregivers.

    PubMed

    Lawani, Moulikatou Adouni; Valéra, Béatriz; Fortier-Brochu, Émilie; Légaré, France; Carmichael, Pierre-Hugues; Côté, Luc; Voyer, Philippe; Kröger, Edeltraut; Witteman, Holly; Rodriguez, Charo; Giguere, Anik M C

    2017-03-15

    Decision support tools build upon comprehensive and timely syntheses of literature. Rapid reviews may allow supporting their development by omitting certain components of traditional systematic reviews. We thus aimed to describe a rapid review approach underlying the development of decision support tools, i.e., five decision boxes (DB) for shared decision-making between seniors living with dementia, their caregivers, and healthcare providers. We included studies based on PICO questions (Participant, Intervention, Comparison, Outcome) describing each of the five specific decision. We gave priority to higher quality evidence (e.g., systematic reviews). For each DB, we first identified secondary sources of literature, namely, clinical summaries, clinical practice guidelines, and systematic reviews. After an initial extraction, we searched for primary studies in academic databases and grey literature to fill gaps in evidence. We extracted study designs, sample sizes, populations, and probabilities of benefits/harms of the health options. A single reviewer conducted the literature search and study selection. The data extracted by one reviewer was verified by a second experienced reviewer. Two reviewers assessed the quality of the evidence. We converted all probabilities into absolute risks for ease of understanding. Two to five experts validated the content of each DB. We conducted descriptive statistical analyses on the review processes and resources required. The approach allowed screening of a limited number of references (range: 104 to 406/review). For each review, we included 15 to 26 studies, 2 to 10 health options, 11 to 62 health outcomes and we conducted 9 to 47 quality assessments. A team of ten reviewers with varying levels of expertise was supported at specific steps by an information specialist, a biostatistician, and a graphic designer. The time required to complete a rapid review varied from 7 to 31 weeks per review (mean ± SD, 19 ± 10

  17. A survey tool for measuring evidence-based decision making capacity in public health agencies.

    PubMed

    Jacobs, Julie A; Clayton, Paula F; Dove, Cassandra; Funchess, Tanya; Jones, Ellen; Perveen, Ghazala; Skidmore, Brandon; Sutton, Victor; Worthington, Sarah; Baker, Elizabeth A; Deshpande, Anjali D; Brownson, Ross C

    2012-03-09

    While increasing attention is placed on using evidence-based decision making (EBDM) to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA) to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability) in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence-based. The survey can serve as a valuable tool for other health

  18. A survey tool for measuring evidence-based decision making capacity in public health agencies

    PubMed Central

    2012-01-01

    Background While increasing attention is placed on using evidence-based decision making (EBDM) to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. Methods Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA) to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability) in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. Results In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. Conclusions The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence-based. The survey can serve as

  19. Development of a Transplantation Risk Index in Patients With Mechanical Circulatory Support: A Decision Support Tool.

    PubMed

    Johnston, Lily E; Grimm, Joshua C; Magruder, J Trent; Shah, Ashish S

    2016-04-01

    The aim of this study was to develop a risk index specific to patients on mechanical circulatory support that accurately predicts 1-year mortality after orthotopic heart transplantation using the United Network for Organ Sharing database. Few clinical tools are available to aid in the decision between continuing long-term device support and performing transplantation in patients bridging with mechanical circulatory support. Using a prospectively collected, open cohort, 6,036 patients receiving mechanical circulatory support who underwent orthotopic heart transplantation between 2000 and 2013 were evaluated and randomly separated into derivation (80%) and validation (20%) groups. Multivariate logistic regression models were constructed using variables that improved the explanatory power of the model, which was determined using multiple methods. Points for a simple additive risk index were apportioned on the basis of relative effect on odds of 1-year mortality. A 75-point scoring system was created from 9 recipient and 4 donor variables. The average score in the validation cohort was 14.4 ± 7.7, and scores ranged from 0 to 57; these values were similar to those in the derivation cohort. Each 1-point increase predicted an 8.3% increase in the odds of 1-year mortality (odds ratio: 1.08; 95% confidence interval: 1.06 to 1.11). Low (0 to 10), intermediate (11 to 20), and high (>20) risk score cohorts were created, with predicted average 1-year mortalities of 8.6%, 12.8%, and 31%, respectively, in the validation cohort. The investigators present a novel, internally cross-validated risk index that accurately predicts mortality in bridge-to-transplantation patients. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. The Global Drought Information System - A Decision Support Tool with Global Applications

    NASA Astrophysics Data System (ADS)

    Arndt, D. S.; Brewer, M.; Heim, R. R., Jr.

    2014-12-01

    Drought is a natural hazard which can cause famine in developing countries and severe economic hardship in developed countries. Given current concerns with the increasing frequency and magnitude of droughts in many regions of the world, especially in the light of expected climate change, drought monitoring and dissemination of early warning information in a timely fashion on a global scale is a critical concern as an important adaptation and mitigation strategy. While a number of nations, and a few continental-scale activities have developed drought information system activities, a global drought early warning system (GDEWS) remains elusive, despite the benefits highlighted by ministers to the Global Earth Observation System of System in 2008. In an effort to begin a process of drought monitoring with international collaboration, the National Integrated Drought Information System's (NIDIS) U.S. Drought Portal, a web-based information system created to address drought services and early warning in the United States, including drought monitoring, forecasting, impacts, mitigation, research, and education, volunteered to develop a prototype Global Drought Monitoring Portal (GDMP). Through integration of data and information at the global level, and with four continental-level partners, the GDMP has proven successful as a tool to monitor drought around the globe. At a past meeting between NIDIS, the World Meteorological Organization, and the Global Earth Observation System of Systems, it was recommended that the GDMP form the basis for a Global Drought Information System (GDIS). Currently, GDIS activities are focused around providing operational global drought monitoring products and assessments, incorporating additional drought monitoring information, especially from those areas without regional or continental-scale input, and incorporating drought-specific climate forecast information from the World Climate Research Programme. Additional GDIS pilot activities are

  1. Evaluation of a novel electronic genetic screening and clinical decision support tool in prenatal clinical settings.

    PubMed

    Edelman, Emily A; Lin, Bruce K; Doksum, Teresa; Drohan, Brian; Edelson, Vaughn; Dolan, Siobhan M; Hughes, Kevin; O'Leary, James; Vasquez, Lisa; Copeland, Sara; Galvin, Shelley L; DeGroat, Nicole; Pardanani, Setul; Gregory Feero, W; Adams, Claire; Jones, Renee; Scott, Joan

    2014-07-01

    "The Pregnancy and Health Profile" (PHP) is a free prenatal genetic screening and clinical decision support (CDS) software tool for prenatal providers. PHP collects family health history (FHH) during intake and provides point-of-care risk assessment for providers and education for patients. This pilot study evaluated patient and provider responses to PHP and effects of using PHP in practice. PHP was implemented in four clinics. Surveys assessed provider confidence and knowledge and patient and provider satisfaction with PHP. Data on the implementation process were obtained through semi-structured interviews with administrators. Quantitative survey data were analyzed using Chi square test, Fisher's exact test, paired t tests, and multivariate logistic regression. Open-ended survey questions and interviews were analyzed using qualitative thematic analysis. Of the 83% (513/618) of patients that provided feedback, 97% felt PHP was easy to use and 98% easy to understand. Thirty percent (21/71) of participating physicians completed both pre- and post-implementation feedback surveys [13 obstetricians (OBs) and 8 family medicine physicians (FPs)]. Confidence in managing genetic risks significantly improved for OBs on 2/6 measures (p values ≤0.001) but not for FPs. Physician knowledge did not significantly change. Providers reported value in added patient engagement and reported mixed feedback about the CDS report. We identified key steps, resources, and staff support required to implement PHP in a clinical setting. To our knowledge, this study is the first to report on the integration of patient-completed, electronically captured and CDS-enabled FHH software into primary prenatal practice. PHP is acceptable to patients and providers. Key to successful implementation in the future will be customization options and interoperability with electronic health records.

  2. Evaluation of nursing-specific drug information PDA databases used as clinical decision support tools.

    PubMed

    Polen, Hyla H; Clauson, Kevin A; Thomson, Wendy; Zapantis, Antonia; Lou, Jennie Q

    2009-10-01

    Nursing is arguably the most organizationally diverse healthcare profession. Educational backgrounds may vary, even among similarly credentialed nurses. Drug information databases used as clinical decision support tools can improve access to pharmacologic information at point-of-care when housed on personal digital assistants. They may also help address the disparity in drug information and pharmacology education between nurses. To evaluate nursing-specific drug information database content on personal digital assistants (PDAs). Seven nursing-specific PDA databases were evaluated for scope (absence or presence of an answer) and completeness (three-point scale) via the use of 80 general category and 80 subspecialty drug information questions. Erroneous information was also tracked. Individual scope and completeness scores were delineated by rank order and chi square was performed to determine differences in scope and completeness scores between the databases. Davis's Drug Guide for Nurses (DDGN) and Nursing Lexi-Drugs (NLD) tied for the highest scores for scope, including each answering 72.5% of the 160 evaluation questions. No significant differences existed between their scores and those earned by Nursing2008 Drug Handbook (p<0.05). The highest scores for completeness were earned by NLD with 58.1% and DDGN at 57.1%. Saunders Nursing Drug Handbook was the only database that showed a significantly lower score in completeness as compared to the other six databases (p<0.05). A 4.2% overall error rate was found among database answers. Significant differences were found among the performances in the databases evaluated in this study for their ability to answer commonly encountered drug information issues in nursing practice. All databases contained some erroneous information and even the top performers failed to provide answers to more than one-fourth of the questions posed. The availability of accurate and timely drug information at point-of-care can play a vital role

  3. The Global Drought Information System - A Decision Support Tool with Global Applications

    NASA Astrophysics Data System (ADS)

    Heim, R. R.; Brewer, M.

    2012-12-01

    Drought is a natural hazard which can cause famine in developing countries and severe economic hardship in developed countries. Given current concerns with the increasing frequency and magnitude of droughts in many regions of the world, especially in the light of expected climate change, drought monitoring and dissemination of early warning information in a timely fashion on a global scale is a critical concern as an important adaptation and mitigation strategy. While a number of nations, and a few continental-scale activities have developed drought information system activities, a global drought early warning system (GDEWS) remains elusive, despite the benefits highlighted by ministers to the Global Earth Observation System of System in 2008. In an effort to begin a process of drought monitoring with international collaboration, the National Integrated Drought Information System's (NIDIS) U.S. Drought Portal, a web-based information system created to address drought services and early warning in the United States, including drought monitoring, forecasting, impacts, mitigation, research, and education, volunteered to develop a prototype Global Drought Monitoring Portal (GDMP). Through integration of data and information at the global level, and with four continental-level partners, the GDMP has proven successful as a tool to monitor drought around the globe. At a recent meeting between NIDIS, the World Meteorological Organization, and the Global Earth Observation System of Systems, it was recommended that the GDMP form the basis for a Global Drought Information System (GDIS). Currently, GDIS activities are focused around incorporating additional drought monitoring information, especially from those areas without regional or continental-scale input, and incorporating drought-specific climate forecast information from the World Climate Research Programme. Additional GDIS pilot activities are underway with an emphasis on information and decision making, and how to

  4. Effects of Airport Tower Controller Decision Support Tool on Controllers Head-Up Time

    NASA Technical Reports Server (NTRS)

    Hayashi, Miwa; Cruz Lopez, Jose M.

    2013-01-01

    Despite that aircraft positions and movements can be easily monitored on the radar displays at major airports nowadays, it is still important for the air traffic control tower (ATCT) controllers to look outside the window as much as possible to assure safe operations of traffic management. The present paper investigates whether an introduction of the NASA's proposed Spot and Runway Departure Advisor (SARDA), a decision support tool for the ATCT controller, would increase or decrease the controllers' head-up time. SARDA provides the controller departure-release schedule advisories, i.e., when to release each departure aircraft in order to minimize individual aircraft's fuel consumption on taxiways and simultaneously maximize the overall runway throughput. The SARDA advisories were presented on electronic flight strips (EFS). To investigate effects on the head-up time, a human-in-the-loop simulation experiment with two retired ATCT controller participants was conducted in a high-fidelity ATCT cab simulator with 360-degree computer-generated out-the-window view. Each controller participant wore a wearable video camera on a side of their head with the camera facing forward. The video data were later used to calculate their line of sight at each moment and eventually identify their head-up times. Four sessions were run with the SARDA advisories, and four sessions were run without (baseline). Traffic-load levels were varied in each session. The same set of user interface - EFS and the radar displays - were used in both the advisory and baseline sessions to make them directly comparable. The paper reports the findings and discusses their implications.

  5. An electronic clinical decision support tool to assist primary care providers in cardiovascular disease risk management: development and mixed methods evaluation.

    PubMed

    Peiris, David P; Joshi, Rohina; Webster, Ruth J; Groenestein, Patrick; Usherwood, Tim P; Heeley, Emma; Turnbull, Fiona M; Lipman, Alexandra; Patel, Anushka A

    2009-12-17

    Challenges remain in translating the well-established evidence for management of cardiovascular disease (CVD) risk into clinical practice. Although electronic clinical decision support (CDS) systems are known to improve practitioner performance, their development in Australian primary health care settings is limited. Study aims were to (1) develop a valid CDS tool that assists Australian general practitioners (GPs) in global CVD risk management, and (2) preliminarily evaluate its acceptability to GPs as a point-of-care resource for both general and underserved populations. CVD risk estimation (based on Framingham algorithms) and risk-based management advice (using recommendations from six Australian guidelines) were programmed into a software package. Tool validation: Data from 137 patients attending a physician's clinic were analyzed to compare the tool's risk scores with those obtained from an independently programmed algorithm in a separate statistics package. The tool's management advice was compared with a physician's recommendations based on a manual review of the guidelines. Field test: The tool was then tested with 21 GPs from eight general practices and three Aboriginal Medical Services. Customized CDS-based recommendations were generated for 200 routinely attending patients (33% Aboriginal) using information extracted from the health record by a research assistant. GPs reviewed these recommendations during each consultation. Changes in CVD risk factor measurement and management were recorded. In-depth interviews with GPs were conducted. Validation testing: the tool's risk assessment algorithm correlated very highly with the independently programmed version in the separate statistics package (intraclass correlation coefficient 0.999). For management advice, there were only two cases of disagreement between the tool and the physician. Field test: GPs found 77% (153/200) of patient outputs easy to understand and agreed with screening and prescribing

  6. Effect of a Novel Clinical Decision Support Tool on the Efficiency and Accuracy of Treatment Recommendations for Cholesterol Management.

    PubMed

    Scheitel, Marianne R; Kessler, Maya E; Shellum, Jane L; Peters, Steve G; Milliner, Dawn S; Liu, Hongfang; Komandur Elayavilli, Ravikumar; Poterack, Karl A; Miksch, Timothy A; Boysen, Jennifer; Hankey, Ron A; Chaudhry, Rajeev

    2017-02-08

    The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record. To assess the impact of our clinical decision support tool on the efficiency and accuracy of clinician calculation of cardiovascular risk and its effect on the delivery of guideline-consistent treatment recommendations. Clinicians were asked to review the EHR records of selected patients. We evaluated the amount of time and the number of clicks and keystrokes needed to calculate cardiovascular risk and provide a treatment recommendation with and without our clinical decision support tool. We also compared the treatment recommendation arrived at by clinicians with and without the use of our tool to those recommended by the guidelines. Clinicians saved 3 minutes and 38 seconds in completing both tasks with MayoExpertAdvisor, used 94 fewer clicks and 23 fewer key strokes, and improved accuracy from the baseline of 60.61% to 100% for both the risk score calculation and guideline-consistent treatment recommendation. Informatics solution can greatly improve the efficiency and accuracy of individualized treatment recommendations and have the potential to increase guideline compliance.

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

    PubMed

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

    2017-03-21

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

  8. Optimizing Clinical Decision Support in the Electronic Health Record. Clinical Characteristics Associated with the Use of a Decision Tool for Disposition of ED Patients with Pulmonary Embolism.

    PubMed

    Ballard, Dustin W; Vemula, Ridhima; Chettipally, Uli K; Kene, Mamata V; Mark, Dustin G; Elms, Andrew K; Lin, James S; Reed, Mary E; Huang, Jie; Rauchwerger, Adina S; Vinson, David R

    2016-09-21

    Adoption of clinical decision support (CDS) tools by clinicians is often limited by workflow barriers. We sought to assess characteristics associated with clinician use of an electronic health record-embedded clinical decision support system (CDSS). In a prospective study on emergency department (ED) activation of a CDSS tool across 14 hospitals between 9/1/14 to 4/30/15, the CDSS was deployed at 10 active sites with an on-site champion, education sessions, iterative feedback, and up to 3 gift cards/clinician as an incentive. The tool was also deployed at 4 passive sites that received only an introductory educational session. Activation of the CDSS - which calculated the Pulmonary Embolism Severity Index (PESI) score and provided guidance - and associated clinical data were collected prospectively. We used multivariable logistic regression with random effects at provider/facility levels to assess the association between activation of the CDSS tool and characteristics at: 1) patient level (PESI score), 2) provider level (demographics and clinical load at time of activation opportunity), and 3) facility level (active vs. passive site, facility ED volume, and ED acuity at time of activation opportunity). Out of 662 eligible patient encounters, the CDSS was activated in 55%: active sites: 68% (346/512); passive sites 13% (20/150). In bivariate analysis, active sites had an increase in activation rates based on the number of prior gift cards the physician had received (96% if 3 prior cards versus 60% if 0, p<0.0001). At passive sites, physicians < age 40 had higher rates of activation (p=0.03). In multivariable analysis, active site status, low ED volume at the time of diagnosis and PESI scores I or II (compared to III or higher) were associated with higher likelihood of CDSS activation. Performing on-site tool promotion significantly increased odds of CDSS activation. Optimizing CDSS adoption requires active education.

  9. Decision-making and referral processes for patients with motor neurone disease: a qualitative study of GP experiences and evaluation of a new decision-support tool.

    PubMed

    Baxter, Susan; McDermott, Christopher J

    2017-05-08

    The diagnosis of motor neurone disease (MND) is known to be challenging and there may be delay in patients receiving a correct diagnosis. This study investigated the referral process for patients who had been diagnosed with MND, and whether a newly-developed tool (The Red Flags checklist) might help General Practitioners (GPs) in making referral decisions. We carried out interviews with GPs who had recently referred a patient diagnosed with MND, and interviews/surveys with GPs who had not recently referred a patient with suspected MND. We collected data before the Red Flags checklist was introduced; and again one year later. We analysed the data to identify key recurring themes. Forty two GPs took part in the study. The presence of fasciculation was the clinical feature that most commonly led to consideration of a potential MND diagnosis. GPs perceived that their role was to make onward referrals rather than attempting to make a diagnosis, and delays in correct diagnosis tended to occur at the specialist level. A quarter of participants had some awareness of the newly-developed tool; most considered it useful, if incorporated into existing systems. While fasciculation is the most common symptom associated with MND, other bulbar, limb or respiratory features, together with progression should be considered. There is a need for further research into how decision-support tools should be designed and provided, in order to best assist GPs with referral decisions. There is also a need for further work at the level of secondary care, in order that referrals made are re-directed appropriately.

  10. The Carpe Diem West Academy: Connecting Water Resources Practitioners and Decision Support Tool Developers in Pursuit of Climate Change Adaptation

    NASA Astrophysics Data System (ADS)

    Hartmann, H. C.; morino, K.; Wiltshire, K.

    2012-12-01

    Water resources practitioners face a confusing and often overwhelming plethora of evolving tools and methods for considering climate change in planning and management. Many tools require substantial investments in data gathering, analysis, or stakeholder engagement. Many address only pieces of the climate change adaptation challenge without clear interconnection. Additionally, there are few standards of practice in the application of these tools. The Carpe Diem West Academy provides knowledge sharing, community building, and collaboration among water resources practitioners and decision support tool developers to facilitate use of science in adaptation efforts. The technical core of the Academy is a web portal (carpediemwestacademy.org) that uses multiple frameworks, including iterative risk management, to organize an interactive compendium of over 150 tools and training resources developed by others, that are useful for water resources planning and management, including consideration of interconnections with other resources such as energy and ecosystem services. Academy users are supported through a variety of experimental approaches, including webinars and facilitated web discussion, for efficiently engaging water resources practitioners, at a scale that is practical to sustain, that fosters shared learning about tools and their application in adaptation efforts, and that can support establishment of best practices for incorporating uncertainty and climate change. The Academy has also been useful for identifying gaps where additional tools, methods, or professional development training are needed, and for providing feedback to tool developers. We report on key findings on the effectiveness of the Academy's multiple approaches.

  11. Planning and Implementing Web-Based Instruction: Tools for Decision Analysis.

    ERIC Educational Resources Information Center

    Harmon, Stephen W.; Jones, Marshall G.

    This paper discusses issues and factors involved in making decisions on whether to use World Wide Web-based instruction. Five levels of Web-based instruction (no Web use, informational, supplemental, essential, communal, or immersive Web use) are discussed, and the following factors are identified to consider before making the decision to put…

  12. New Interoperable Tools to Facilitate Decision-Making to Support Community Sustainability

    EPA Science Inventory

    Communities, regional planning authorities, regulatory agencies, and other decision-making bodies do not currently have adequate access to spatially explicit information crucial to making decisions that allow them to consider a full accounting of the costs, benefits, and trade-of...

  13. New Interoperable Tools to Facilitate Decision-Making to Support Community Sustainability

    EPA Science Inventory

    Communities, regional planning authorities, regulatory agencies, and other decision-making bodies do not currently have adequate access to spatially explicit information crucial to making decisions that allow them to consider a full accounting of the costs, benefits, and trade-of...

  14. A Safety Risk Assessment Methodology for Decision Support Systems with an Application to the Expedite Departure Path Tool

    NASA Technical Reports Server (NTRS)

    Snyder, Phillip T.; Landis, Michael R. (Technical Monitor)

    2001-01-01

    In support of the NASA Advanced Air Transportation Technologies Project, the Volpe National Transportation Systems Center has developed a methodology to perform safety risk assessments for air traffic control/air traffic management decision Support systems and concepts. Changes in controller, pilot, and/or airline dispatcher tasks that are affected by the decision support system are related to associated hazards. These hazards are then assessed either qualitatively or quantitatively in terms of likelihood of occurring and the impact if they do occur. Those items that show a potential safety hazard level increase can then have research plans developed to address those safety risks areas. An application of this methodology will he demonstrated using the AATT decision support tool Expedite Departure Path.

  15. A Safety Risk Assessment Methodology for Decision Support Systems with an Application to the Expedite Departure Path Tool

    NASA Technical Reports Server (NTRS)

    Snyder, Phillip T.; Landis, Michael R. (Technical Monitor)

    2001-01-01

    In support of the NASA Advanced Air Transportation Technologies Project, the Volpe National Transportation Systems Center has developed a methodology to perform safety risk assessments for air traffic control/air traffic management decision Support systems and concepts. Changes in controller, pilot, and/or airline dispatcher tasks that are affected by the decision support system are related to associated hazards. These hazards are then assessed either qualitatively or quantitatively in terms of likelihood of occurring and the impact if they do occur. Those items that show a potential safety hazard level increase can then have research plans developed to address those safety risks areas. An application of this methodology will he demonstrated using the AATT decision support tool Expedite Departure Path.

  16. Risk-based decisionmaking (Panel)

    SciTech Connect

    Smith, T.H.

    1995-12-31

    By means of a panel discussion and extensive audience interaction, explore the current challenges and progress to date in applying risk considerations to decisionmaking related to low-level waste. This topic is especially timely because of the proposed legislation pertaining to risk-based decisionmaking and because of the increased emphasis placed on radiological performance assessments of low-level waste disposal.

  17. A Life-Cycle Cost Estimating Methodology for NASA-Developed Air Traffic Control Decision Support Tools

    NASA Technical Reports Server (NTRS)

    Wang, Jianzhong Jay; Datta, Koushik; Landis, Michael R. (Technical Monitor)

    2002-01-01

    This paper describes the development of a life-cycle cost (LCC) estimating methodology for air traffic control Decision Support Tools (DSTs) under development by the National Aeronautics and Space Administration (NASA), using a combination of parametric, analogy, and expert opinion methods. There is no one standard methodology and technique that is used by NASA or by the Federal Aviation Administration (FAA) for LCC estimation of prospective Decision Support Tools. Some of the frequently used methodologies include bottom-up, analogy, top-down, parametric, expert judgement, and Parkinson's Law. The developed LCC estimating methodology can be visualized as a three-dimensional matrix where the three axes represent coverage, estimation, and timing. This paper focuses on the three characteristics of this methodology that correspond to the three axes.

  18. An Interactive Web Tool for Facilitating Shared Decision-Making in Dementia-Care Networks: A Field Study.

    PubMed

    Span, Marijke; Smits, Carolien; Jukema, Jan; Groen-van de Ven, Leontine; Janssen, Ruud; Vernooij-Dassen, Myrra; Eefsting, Jan; Hettinga, Marike

    2015-01-01

    An interactive web tool has been developed for facilitating shared decision-making in dementia-care networks. The DecideGuide provides a chat function for easier communication between network members, a deciding together function for step-by-step decision-making, and an individual opinion function for eight dementia-related life domains. The aim of this study was to gain insight in the user friendliness of the DecideGuide, user acceptance and satisfaction, and participants' opinion of the DecideGuide for making decisions. A 5-month field study included four dementia-care networks (19 participants in total). The data derived from structured interviews, observations, and information that participants logged in the DecideGuide. Structured interviews took place at the start, middle, and end of the field study with people with dementia, informal caregivers, and case managers. Four observations of case managers' home visits focused on members' responses and use of the tool. (1) The user friendliness of the chat and individual opinion functions was adequate for case managers and most informal caregivers. Older participants, with or without dementia, had some difficulties using a tablet and the DecideGuide. The deciding together function does not yet provide adequate instructions for all. The user interface needs simplification. (2) User acceptance and satisfaction: everybody liked the chat's easy communication, handling difficult issues for discussion, and the option of individual opinions. (3) The DecideGuide helped participants structure their thoughts. They felt more involved and shared more information about daily issues than they had done previously. Participants found the DecideGuide valuable in decision-making. The chat function seems powerful in helping members engage with one another constructively. Such engagement is a prerequisite for making shared decisions. Regardless of participants' use of the tool, they saw the DecideGuide's added value.

  19. Intermittent preventive treatment for malaria in infants: a decision-support tool for sub-Saharan Africa

    PubMed Central

    Smith, Lucy; Ross, Amanda; Roca-Feltrer, Arantxa; Greenwood, Brian; Schellenberg, Joanna Armstrong; Smith, Thomas; Schellenberg, David

    2010-01-01

    Abstract Objective To develop a decision-support tool to help policy-makers in sub-Saharan Africa assess whether intermittent preventive treatment in infants (IPTi) would be effective for local malaria control. Methods An algorithm for predicting the effect of IPTi was developed using two approaches. First, study data on the age patterns of clinical cases of Plasmodium falciparum malaria, hospital admissions for infection with malaria parasites and malaria-associated death for different levels of malaria transmission intensity and seasonality were used to estimate the percentage of cases of these outcomes that would occur in children aged < 10 years targeted by IPTi. Second, a previously developed stochastic mathematical model of IPTi was used to predict the number of cases likely to be averted by implementing IPTi under different epidemiological conditions. The decision-support tool uses the data from these two approaches that are most relevant to the context specified by the user. Findings Findings from the two approaches indicated that the percentage of cases targeted by IPTi increases with the severity of the malaria outcome and with transmission intensity. The decision-support tool, available on the Internet, provides estimates of the percentage of malaria-associated deaths, hospitalizations and clinical cases that will be targeted by IPTi in a specified context and of the number of these outcomes that could be averted. Conclusion The effectiveness of IPTi varies with malaria transmission intensity and seasonality. Deciding where to implement IPTi must take into account the local epidemiology of malaria. The Internet-based decision-support tool described here predicts the likely effectiveness of IPTi under a wide range of epidemiological conditions. PMID:21076561

  20. Intermittent preventive treatment for malaria in infants: a decision-support tool for sub-Saharan Africa.

    PubMed

    Carneiro, Ilona; Smith, Lucy; Ross, Amanda; Roca-Feltrer, Arantxa; Greenwood, Brian; Schellenberg, Joanna Armstrong; Smith, Thomas; Schellenberg, David

    2010-11-01

    To develop a decision-support tool to help policy-makers in sub-Saharan Africa assess whether intermittent preventive treatment in infants (IPTi) would be effective for local malaria control. An algorithm for predicting the effect of IPTi was developed using two approaches. First, study data on the age patterns of clinical cases of Plasmodium falciparum malaria, hospital admissions for infection with malaria parasites and malaria-associated death for different levels of malaria transmission intensity and seasonality were used to estimate the percentage of cases of these outcomes that would occur in children aged <10 years targeted by IPTi. Second, a previously developed stochastic mathematical model of IPTi was used to predict the number of cases likely to be averted by implementing IPTi under different epidemiological conditions. The decision-support tool uses the data from these two approaches that are most relevant to the context specified by the user. Findings from the two approaches indicated that the percentage of cases targeted by IPTi increases with the severity of the malaria outcome and with transmission intensity. The decision-support tool, available on the Internet, provides estimates of the percentage of malaria-associated deaths, hospitalizations and clinical cases that will be targeted by IPTi in a specified context and of the number of these outcomes that could be averted. The effectiveness of IPTi varies with malaria transmission intensity and seasonality. Deciding where to implement IPTi must take into account the local epidemiology of malaria. The Internet-based decision-support tool described here predicts the likely effectiveness of IPTi under a wide range of epidemiological conditions.

  1. Family Group Decision Making (FGDM) with Lakota families in two tribal communities: tools to facilitate FGDM implementation and evaluation.

    PubMed

    Marcynyszyn, Lyscha A; Bear, Pete Small; Geary, Erin; Conti, Russ; Pecora, Peter J; Day, Priscilla A; Wilson, Stephen T

    2012-01-01

    This article describes an adapted Family Group Decision Making (FGDM) practice model for Native American communities, the FGDM family and community engagement process, and FGDM evaluation tools as one example for other native communities. Challenges and successes associated with the implementation and evaluation of these meetings are also described in the context of key historical and cultural factors, such as intergenerational grief and trauma, as well as past misuse of data in native communities.

  2. Modeling and Decision Support Tools Based on the Effects to Sediment Geochemistry and Microbial Populations on Contaminant Reactions in Sediments

    DTIC Science & Technology

    2011-09-01

    water, and soil/sediment transport processes have spread PCBs from local sites of contamination across the global environment , and PCBs have been found...sediment transport processes have distributed PCBs from local sites of contamination across the global environment , including the most remote areas...Final Report Modeling and Decision Support Tools Based on the Effects to Sediment Geochemistry and Microbial Populations on Contaminant

  3. Demonstration of Decision Support Tools for Sustainable Development - An Application on Alternative Fuels in the Greater Yellowstone-Teton Region

    SciTech Connect

    Shropshire, D.E.; Cobb, D.A.; Worhach, P.; Jacobson, J.J.; Berrett, S.

    2000-12-30

    The Demonstration of Decision Support Tools for Sustainable Development project integrated the Bechtel/Nexant Industrial Materials Exchange Planner and the Idaho National Engineering and Environmental Laboratory System Dynamic models, demonstrating their capabilities on alternative fuel applications in the Greater Yellowstone-Teton Park system. The combined model, called the Dynamic Industrial Material Exchange, was used on selected test cases in the Greater Yellow Teton Parks region to evaluate economic, environmental, and social implications of alternative fuel applications, and identifying primary and secondary industries. The test cases included looking at compressed natural gas applications in Teton National Park and Jackson, Wyoming, and studying ethanol use in Yellowstone National Park and gateway cities in Montana. With further development, the system could be used to assist decision-makers (local government, planners, vehicle purchasers, and fuel suppliers) in selecting alternative fuels, vehicles, and developing AF infrastructures. The system could become a regional AF market assessment tool that could help decision-makers understand the behavior of the AF market and conditions in which the market would grow. Based on this high level market assessment, investors and decision-makers would become more knowledgeable of the AF market opportunity before developing detailed plans and preparing financial analysis.

  4. [Improving shared decision-making for hospital patients: Description and evaluation of a treatment intensity assessment tool].

    PubMed

    Amblàs-Novellas, Jordi; Casas, Sílvia; Catalán, Rosa María; Oriol-Ruscalleda, Margarita; Lucchetti, Gianni Enrico; Quer-Vall, Francesc Xavier

    2016-01-01

    Shared decision-making between patients and healthcare professionals is crucial to guarantee adequate coherence between patient values and preferences, caring aims and treatment intensity, which is key for the provision of patient-centred healthcare. The assessment of such interventions are essential for caring continuity purposes. To do this, reliable and easy-to-use assessment systems are required. This study describes the results of the implementation of a hospital treatment intensity assessment tool. The pre-implementation and post-implementation results were compared between two cohorts of patients assessed for one month. Some record of care was registered in 6.1% of patients in the pre-implementation group (n=673) compared to 31.6% of patients in the post-implementation group (n=832) (P<.01), with differences between services. Hospital mortality in both cohorts is 1.9%; in the pre-implementation group, 93.75% of deceased patients had treatment intensity assessment. In hospital settings, the availability of a specific tool seems to encourage very significantly shared decision-making processes between patients and healthcare professionals -multiplying by more than 5 times the treatment intensity assessment. Moreover, such tools help in the caring continuity processes between different teams and the personalisation of caring interventions to be monitored. More research is needed to continue improving shared decision-making for hospital patients. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

  5. Multi-stage ranking of emergency technology alternatives for water source pollution accidents using a fuzzy group decision making tool.

    PubMed

    Qu, Jianhua; Meng, Xianlin; You, Hong

    2016-06-05

    Due to the increasing number of unexpected water source pollution events, selection of the most appropriate disposal technology for a specific pollution scenario is of crucial importance to the security of urban water supplies. However, the formulation of the optimum option is considerably difficult owing to the substantial uncertainty of such accidents. In this research, a multi-stage technical screening and evaluation tool is proposed to determine the optimal technique scheme, considering the areas of pollutant elimination both in drinking water sources and water treatment plants. In stage 1, a CBR-based group decision tool was developed to screen available technologies for different scenarios. Then, the threat degree caused by the pollution was estimated in stage 2 using a threat evaluation system and was partitioned into four levels. For each threat level, a corresponding set of technique evaluation criteria weights was obtained using Group-G1. To identify the optimization alternatives corresponding to the different threat levels, an extension of TOPSIS, a multi-criteria interval-valued trapezoidal fuzzy decision making technique containing the four arrays of criteria weights, to a group decision environment was investigated in stage 3. The effectiveness of the developed tool was elaborated by two actual thallium-contaminated scenarios associated with different threat levels.

  6. Tools to Support Policy Decisions Related to Treatment Strategies and Surveillance of Schistosomiasis Japonica towards Elimination

    PubMed Central

    Zhou, Xiao-Nong; Xu, Jing; Chen, Hong-Gen; Wang, Tian-Ping; Huang, Xi-Bao; Lin, Dan-Dan; Wang, Qi-Zhi; Tang, Li; Guo, Jia-Gang; Wu, Xiao-Hua; Feng, Ting; Chen, Jia-Xu; Guo, Jian; Chen, Shao-Hong; Li, Hao; Wu, Zhong-Dao; Peeling, Rosanna W.

    2011-01-01

    Background Appropriate diagnostics to monitor disease trends and assess the effectiveness and impact of interventions are essential for guiding treatment strategies at different thresholds of schistosomiasis transmission and for certifying elimination. Field validation of these assays is urgently needed before they can be adopted to support policy decisions of the national programme for control and elimination of schistosomiasis in P.R. China. We compared the efficacy and utility of different immunoassays in guiding control strategies and monitoring the endemic status of S. japonicum infections towards elimination. Methodology/Principal Findings A cross-sectional survey was conducted in seven villages with different transmission intensities settings to assess the performance and utility of three immunoassays, e.g., an indirect hemagglutination assay (IHA_JX), an enzyme linked immunosorbent assay (ELISA_SZ), and a dot immunogold filtration assay (DIGFA_SH). 6,248 individuals aged 6–65 years old who gave consent and supplied their stool and blood samples were included for data analysis. Results showed that ELISA_SZ performed significantly higher sensitivity (95.45%, 95%CI: 92.94–97.97%) than IHA_JX (87.59%, 95%CI: 83.51–91.49%) and DIGFA_SH (79.55%, 95%CI: 74.68–84.41%), especially in subgroups with very low infection intensity. The specificity of ELISA_SZ, IHA_JX, DIGFA_SH in 6–9 year olds with occasional exposure was nearly 90%. DIGFA_SH performed the highest screening efficacy for patients among three assays with overall positive predicative value of 13.07% (95%CI: 11.42–14.72%). We found a positive correlation of antibody positive rate of IHA_JX with results of stool examination in age strata (r = 0.70, P<0.001). Seropositivity of IHA_JX in children aged 6–9 years old showed an excellent correlation with prevalence of schistosome infection in the seven communities (r = 0.77, P<0.05). Conclusions/Significance Studies suggest that ELISA

  7. Homeland security R&D roadmapping : risk-based methodological options.

    SciTech Connect

    Brandt, Larry D.

    2008-12-01

    The Department of Energy (DOE) National Laboratories support the Department of Homeland Security (DHS) in the development and execution of a research and development (R&D) strategy to improve the nation's preparedness against terrorist threats. Current approaches to planning and prioritization of DHS research decisions are informed by risk assessment tools and processes intended to allocate resources to programs that are likely to have the highest payoff. Early applications of such processes have faced challenges in several areas, including characterization of the intelligent adversary and linkage to strategic risk management decisions. The risk-based analysis initiatives at Sandia Laboratories could augment the methodologies currently being applied by the DHS and could support more credible R&D roadmapping for national homeland security programs. Implementation and execution issues facing homeland security R&D initiatives within the national laboratories emerged as a particular concern in this research.

  8. Influence Diagrams as Decision-Making Tools for Pesticide Risk Management

    EPA Science Inventory

    The pesticide policy arena is filled with discussion of probabilistic approaches to assess ecological risk, however, similar discussions about implementing formal probabilistic methods in pesticide risk decision making are less common. An influence diagram approach is proposed f...

  9. Influence Diagrams as Decision-Making Tools for Pesticide Risk Management

    EPA Science Inventory

    The pesticide policy arena is filled with discussion of probabilistic approaches to assess ecological risk, however, similar discussions about implementing formal probabilistic methods in pesticide risk decision making are less common. An influence diagram approach is proposed f...

  10. Co-Production with Water Managers to Improve Applicability and Adoption of an Emerging Decision Support Tool

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

    In water management, changes in the frequency and intensity of extreme events (especially droughts and floods) are likely to require modifications of management strategies and, in some cases, new infrastructure. In light of these and other challenges, there is a serious need to improve the applicability of water resources research to real-world decision making. Multiobjective Evolutionary Algorithms (MOEAs) have shown promise in being able to generate and evaluate new planning alternatives under these conditions, but there has not yet been work that seeks to use a co-production framework to extensively test their efficacy. A group of engineering, social science, and climate researchers collaborated with practitioners from two municipal water providers to design this interdisciplinary study. The focus of the research is to co-produce and test a MOEA-based decision tool directly with a group of water managers from six water utilities from Colorado's Front Range: Cities of Boulder, Aurora, and Fort Collins, Denver Water, Colorado Springs Utilities, and Northern Water. As part of the co-production of the MOEA testbed, managers provided critical insight on problem formulations, hydrology and demand scenarios, and a hypothetical water supply network using a workshop format. A problem formulation consists of objectives that measure performance, management options that decision makers can change, and constraints that represent acceptable limits for performance. The hypothetical network is based on feedback from our participating utilities and is representative of the water management context along the Front Range of Colorado. This presentation will focus on results from an initial workshop with water managers and provide insights on how our approach can help bridge the gap between decision support research and real-world water management. Our study seeks to inform a set of best practices for incorporating a MOEA-based decision tool in the decision making processes of

  11. Mass casualty modelling: a spatial tool to support triage decision making.

    PubMed

    Amram, Ofer; Schuurman, Nadine; Hameed, Syed M

    2011-06-10

    During a mass casualty incident, evacuation of patients to the appropriate health care facility is critical to survival. Despite this, no existing system provides the evidence required to make informed evacuation decisions from the scene of the incident. To mitigate this absence and enable more informed decision making, a web based spatial decision support system (SDSS) was developed. This system supports decision making by providing data regarding hospital proximity, capacity, and treatment specializations to decision makers at the scene of the incident. This web-based SDSS utilizes pre-calculated driving times to estimate the actual driving time to each hospital within the inclusive trauma system of the large metropolitan region within which it is situated. In calculating and displaying its results, the model incorporates both road network and hospital data (e.g. capacity, treatment specialties, etc.), and produces results in a matter of seconds, as is required in a MCI situation. In addition, its application interface allows the user to map the incident location and assists in the execution of triage decisions. Upon running the model, driving time from the MCI location to the surrounding hospitals is quickly displayed alongside information regarding hospital capacity and capability, thereby assisting the user in the decision-making process. The use of SDSS in the prioritization of MCI evacuation decision making is potentially valuable in cases of mass casualty. The key to this model is the utilization of pre-calculated driving times from each hospital in the region to each point on the road network. The incorporation of real-time traffic and hospital capacity data would further improve this model.

  12. Mass casualty modelling: a spatial tool to support triage decision making

    PubMed Central

    2011-01-01

    Background During a mass casualty incident, evacuation of patients to the appropriate health care facility is critical to survival. Despite this, no existing system provides the evidence required to make informed evacuation decisions from the scene of the incident. To mitigate this absence and enable more informed decision making, a web based spatial decision support system (SDSS) was developed. This system supports decision making by providing data regarding hospital proximity, capacity, and treatment specializations to decision makers at the scene of the incident. Methods This web-based SDSS utilizes pre-calculated driving times to estimate the actual driving time to each hospital within the inclusive trauma system of the large metropolitan region within which it is situated. In calculating and displaying its results, the model incorporates both road network and hospital data (e.g. capacity, treatment specialties, etc.), and produces results in a matter of seconds, as is required in a MCI situation. In addition, its application interface allows the user to map the incident location and assists in the execution of triage decisions. Results Upon running the model, driving time from