Decision support and the effectiveness of web-based delivery and information tailoring for bowel cancer screening : an exploratory study

Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females throughout the developed world. Population screening using fecal occult blood tests (FOBTs) facilitates early detection and greater chance of survival, but participation rates are low. We developed a Web-based decision tool to provide information tailored to an individual’s decision stage for CRC screening and attitude toward screening utilizing the Preventive Health Model (PHM) and Precaution Adoption Process Model (PAPM) as theoretical frameworks for screening behavior. We describe the practical steps employed in the tool’s design and the subsequent conduct of an exploratory study.
Objective: To design a decision tool for CRC screening and conduct an exploratory study among average-risk men and women to (1) test the impact of message type (tailored vs non-tailored) and message delivery modality (Web-based vs paper-based) on attitudes toward screening and screening uptake, and (2) investigate the acceptability of the decision tool and relevance of materials.
Methods: Participants (n = 100), recruited from a population sample of men and women aged 50-76 residing in urban Adelaide, Australia, were randomly assigned to a control group or one of 4 interventions: (1) Web-based and tailored information, (2) paper-based and tailored information, (3) Web-based and non-tailored (generic) information, or (4) paper-based and non-tailored information. Participation was augmented by snowball recruitment (n = 19). Questionnaires based on PHM variables were administered pre- and post-intervention. Participants were given the opportunity to request an FOBT. Following the intervention, participants discussed the acceptability of the tool.
Results: Full data were available for 87.4% (104/119) of participants. Post-intervention, perceived susceptibility scores for individuals receiving tailored information increased from mean 10.6 (SD 2.1) to mean 11.8 (SD 2.2). Scores on self-efficacy increased in the tailored group from mean 11.7 (SD 2.0) to mean 12.6 (SD 1.8). There were significant time x modality x message effects for social influence and salience and coherence, reflecting an increase in these scores for tailored Web-based participants only; social influence scores increased from mean 11.7 (SD 2.6) to mean 14.9 (SD 2.3), and salience and coherence scores increased from mean 16.0 (SD 2.2) to mean 17.7 (SD 2.1). There was no greater influence of modality or message type on movement toward a decision to screen or screening uptake, indicating that neither tailored messages nor a Web modality had superior effect. Overall, participants regarded tailored messages positively, but thought that the Web tool lacked “media richness.”
Conclusions: This exploratory study confirms that tailoring on PHM predictors of CRC screening has the potential to positively address attitudes toward screening. However, tailoring on these variables did not result in significantly increased screening uptake. Future research should consider other possible psychosocial influences. Mode of delivery did not affect outcomes, but as a delivery medium, the Web has economic and logistical advantages over paper.

A decision support system for sustainable urban development : the integrated land use and transportation indexing model

The broad definition of sustainable development at the early stage of its introduction has caused confusion and hesitation among local authorities and planning professionals. The main difficulties are experience in employing loosely-defined principles of sustainable development in setting policies and goals. The question of how this theory/rhetoric-practice gap could be filled will be the theme of this study. One of the widely employed sustainability accounting approaches by governmental organisations, triple bottom line, and applicability of this approach to sustainable urban development policies will be examined. When incorporating triple bottom line considerations with the environmental impact assessment techniques, the framework of GIS-based decision support system that helps decision-makers in selecting policy option according to the economic, environmental and social impacts will be introduced. In order to embrace sustainable urban development policy considerations, the relationship between urban form, travel pattern and socio-economic attributes should be clarified. This clarification associated with other input decision support systems will picture the holistic state of the urban settings in terms of sustainability. In this study, grid-based indexing methodology will be employed to visualise the degree of compatibility of selected scenarios with the designated sustainable urban future. In addition, this tool will provide valuable knowledge about the spatial dimension of the sustainable development. It will also give fine details about the possible impacts of urban development proposals by employing disaggregated spatial data analysis (e.g. land-use, transportation, urban services, population density, pollution, etc.). The visualisation capacity of this tool will help decision makers and other stakeholders compare and select alternative of future urban developments.

A decision support system for sustainable urban development : the integrated land use and transportation indexing model

Broad, early definitions of sustainable development have caused confusion and hesitation among local authorities and planning professionals. This confusion has arisen because loosely defined principles of sustainable development have been employed when setting policies and planning projects, and when gauging the efficiencies of these policies in the light of designated sustainability goals. The question of how this theory-rhetoric-practice gap can be filled is the main focus of this chapter. It examines the triple bottom line approach–one of the sustainability accounting approaches widely employed by governmental organisations–and the applicability of this approach to sustainable urban development. The chapter introduces the ‘Integrated Land Use and Transportation Indexing Model’ that incorporates triple bottom line considerations with environmental impact assessment techniques via a geographic, information systems-based decision support system. This model helps decision-makers in selecting policy options according to their economic, environmental and social impacts. Its main purpose is to provide valuable knowledge about the spatial dimensions of sustainable development, and to provide fine detail outputs on the possible impacts of urban development proposals on sustainability levels. In order to embrace sustainable urban development policy considerations, the model is sensitive to the relationship between urban form, travel patterns and socio-economic attributes. Finally, the model is useful in picturing the holistic state of urban settings in terms of their sustainability levels, and in assessing the degree of compatibility of selected scenarios with the desired sustainable urban future.

Decision support for the safe design and operation of unmanned aircraft systems

Unmanned Aircraft Systems (UAS) describe a diverse range of aircraft that are operated without a human pilot on-board. Unmanned aircraft range from small rotorcraft, which can fit in the palm of your hand, through to fixed wing aircraft comparable in size to that of a commercial passenger jet. The absence of a pilot on-board allows these aircraft to be developed with unique performance capabilities facilitating a wide range of applications in surveillance, environmental management, agriculture, defence, and search and rescue. However, regulations relating to the safe design and operation of UAS first need to be developed before the many potential benefits from these applications can be realised. According to the International Civil Aviation Organization (ICAO), a Risk Management Process (RMP) should support all civil aviation policy and rulemaking activities (ICAO 2009). The RMP is described in International standard, ISO 31000:2009 (ISO, 2009a). This standard is intentionally generic and high-level, providing limited guidance on how it can be effectively applied to complex socio-technical decision problems such as the development of regulations for UAS. Through the application of principles and tools drawn from systems philosophy and systems engineering, this thesis explores how the RMP can be effectively applied to support the development of safety regulations for UAS. A sound systems-theoretic foundation for the RMP is presented in this thesis. Using the case-study scenario of a UAS operation over an inhabited area and through the novel application of principles drawn from general systems modelling philosophy, a consolidated framework of the definitions of the concepts of: safe, risk and hazard is made. The framework is novel in that it facilitates the representation of broader subjective factors in an assessment of the safety of a system; describes the issues associated with the specification of a system-boundary; makes explicit the hierarchical nature of the relationship between the concepts and the subsequent constraints that exist between them; and can be evaluated using a range of analytic or deliberative modelling techniques. Following the general sequence of the RMP, the thesis explores the issues associated with the quantified specification of safety criteria for UAS. A novel risk analysis tool is presented. In contrast to existing risk tools, the analysis tool presented in this thesis quantifiably characterises both the societal and individual risk of UAS operations as a function of the flight path of the aircraft. A novel structuring of the risk evaluation and risk treatment decision processes is then proposed. The structuring is achieved through the application of the Decision Support Problem Technique; a modelling approach that has been previously used to effectively model complex engineering design processes and to support decision-making in relation to airspace design. The final contribution made by this thesis is in the development of an airworthiness regulatory framework for civil UAS. A novel "airworthiness certification matrix" is proposed as a basis for the definition of UAS "Part 21" regulations. The outcome airworthiness certification matrix provides a flexible, systematic and justifiable method for promulgating airworthiness regulations for UAS. In addition, an approach for deriving "Part 1309" regulations for UAS is presented. In contrast to existing approaches, the approach presented in this thesis facilitates a traceable and objective tailoring of system-level reliability requirements across the diverse range of UAS operations. The significance of the research contained in this thesis is clearly demonstrated by its practical real world outcomes. Industry regulatory development groups and the Civil Aviation Safety Authority have endorsed the proposed airworthiness certification matrix. The risk models have also been used to support research undertaken by the Australian Department of Defence. Ultimately, it is hoped that the outcomes from this research will play a significant part in the shaping of regulations for civil UAS, here in Australia and around the world.

An ingenious decision support system for remote health monitoring of pregnant women

Maternal deaths have been a critical issue for women living in rural and remote areas. The need to travel long distances, the shortage of primary care providers such as physicians, specialists and nurses, and the closing of small hospitals have been problems identified in many rural areas. Some research work has been undertaken and a few techniques have been developed to remotely measure the physiological condition of pregnant women through sophisticated ultrasound equipment. There are numerous ways to reduce maternal deaths, and an important step is to select the right approaches to achieving this reduction. One such approach is the provision of decision support systems in rural and remote areas. Decision support systems (DSSs) have already shown a great potential in many health fields. This thesis proposes an ingenious decision support system (iDSS) based on the methodology of survey instruments and identification of significant variables to be used in iDSS using statistical analysis. A survey was undertaken with pregnant women and factorial experimental design was chosen to acquire sample size. Variables with good reliability in any one of the statistical techniques such as Chi-square, Cronbach’s á and Classification Tree were incorporated in the iDSS. The decision support system was developed with significant variables such as: Place of residence, Seeing the same doctor, Education, Tetanus injection, Baby weight, Previous baby born, Place of birth, Assisted delivery, Pregnancy parity, Doctor visits and Occupation. The ingenious decision support system was implemented with Visual Basic as front end and Microsoft SQL server management as backend. Outcomes of the ingenious decision support system include advice on Symptoms, Diet and Exercise to pregnant women. On conditional system was sent and validated by the gynaecologist. Another outcome of ingenious decision support system was to provide better pregnancy health awareness and reduce long distance travel, especially for women in rural areas. The proposed system has qualities such as usefulness, accuracy and accessibility.

A decision support system for sustainable urban development : the integrated land use and transportation indexing model

Broad, early definitions of sustainable development have caused confusion and hesitation among local authorities and planning professionals. This confusion has arisen because loosely defined principles of sustainable development have been employed when setting policies and planning projects, and when gauging the efficiencies of these policies in the light of designated sustainability goals. The question of how this theory-rhetoric-practice gap can be filled is the main focus of this chapter. It examines the triple bottom line approach–one of the sustainability accounting approaches widely employed by governmental organisations–and the applicability of this approach to sustainable urban development. The chapter introduces the ‘Integrated Land Use and Transportation Indexing Model’ that incorporates triple bottom line considerations with environmental impact assessment techniques via a geographic, information systemsbased decision support system. This model helps decision-makers in selecting policy options according to their economic, environmental and social impacts. Its main purpose is to provide valuable knowledge about the spatial dimensions of sustainable development, and to provide fine detail outputs on the possible impacts of urban development proposals on sustainability levels. In order to embrace sustainable urban development policy considerations, the model is sensitive to the relationship between urban form, travel patterns and socio-economic attributes. Finally, the model is useful in picturing the holistic state of urban settings in terms of their sustainability levels, and in assessing the degree of compatibility of selected scenarios with the desired sustainable urban future.

An ingenuous Decision Support System (iDSS) approach for remote area pregnant women

This paper addresses development of an ingenious decision support system (iDSS) based on the methodology of survey instruments and identification of significant variables to be used in iDSS using statistical analysis. A survey was undertaken with pregnant women and factorial experimental design was chosen to acquire sample size. Variables with good reliability in any one of the statistical techniques such as Chi-square, Cronbach’s α and Classification Tree were incorporated in the iDSS. The ingenious decision support system was implemented with Visual Basic as front end and Microsoft SQL server management as backend. Outcome of the ingenious decision support system include advice on Symptoms, Diet and Exercise to pregnant women.

A demand-responsive decision support system for coal transportation

In this paper, a demand-responsive decision support system is proposed by integrating the operations of coal shipment, coal stockpiles and coal railing within a whole system. A generic and flexible scheduling optimisation methodology is developed to identify, represent, model, solve and analyse the coal transport problem in a standard and convenient way. As a result, the integrated train-stockpile-ship timetable is created and optimised for improving overall efficiency of coal transport system. A comprehensive sensitivity analysis based on extensive computational experiments is conducted to validate the proposed methodology. The mathematical proposition and proof are concluded as technical and insightful advices for industry practice. The proposed methodology provides better decision making on how to assign rail rolling-stocks and upgrade infrastructure in order to significantly improve capacity utilisation with the best resource-effectiveness ratio. The proposed decision support system with train-stockpile-ship scheduling optimisation techniques is promising to be applied in railway or mining industry, especially as a useful quantitative decision making tool on how to use more current rolling-stocks or whether to buy additional rolling-stocks for mining transportation.

Assessment of functional forms of crop yield loss models of invasive plant species applied in decision support tools and bioeconomic modelling

AbstractObjectives Decision support tools (DSTs) for invasive species management have had limited success in producing convincing results and meeting users' expectations. The problems could be linked to the functional form of model which represents the dynamic relationship between the invasive species and crop yield loss in the DSTs. The objectives of this study were: a) to compile and review the models tested on field experiments and applied to DSTs; and b) to do an empirical evaluation of some popular models and alternatives. Design and methods This study surveyed the literature and documented strengths and weaknesses of the functional forms of yield loss models. Some widely used models (linear, relative yield and hyperbolic models) and two potentially useful models (the double-scaled and density-scaled models) were evaluated for a wide range of weed densities, maximum potential yield loss and maximum yield loss per weed. Results Popular functional forms include hyperbolic, sigmoid, linear, quadratic and inverse models. Many basic models were modified to account for the effect of important factors (weather, tillage and growth stage of crop at weed emergence) influencing weed–crop interaction and to improve prediction accuracy. This limited their applicability for use in DSTs as they became less generalized in nature and often were applicable to a much narrower range of conditions than would be encountered in the use of DSTs. These factors' effects could be better accounted by using other techniques. Among the model empirically assessed, the linear model is a very simple model which appears to work well at sparse weed densities, but it produces unrealistic behaviour at high densities. The relative-yield model exhibits expected behaviour at high densities and high levels of maximum yield loss per weed but probably underestimates yield loss at low to intermediate densities. The hyperbolic model demonstrated reasonable behaviour at lower weed densities, but produced biologically unreasonable behaviour at low rates of loss per weed and high yield loss at the maximum weed density. The density-scaled model is not sensitive to the yield loss at maximum weed density in terms of the number of weeds that will produce a certain proportion of that maximum yield loss. The double-scaled model appeared to produce more robust estimates of the impact of weeds under a wide range of conditions. Conclusions Previously tested functional forms exhibit problems for use in DSTs for crop yield loss modelling. Of the models evaluated, the double-scaled model exhibits desirable qualitative behaviour under most circumstances.

Decision support requirements for intelligent operation of southern grid in India

Control centers (CC) play a very important role in power system operation. An overall view of the system with information about all existing resources and needs is implemented through SCADA (Supervisory control and data acquisition system) and an EMS (energy management system). As advanced technologies have made their way into the utility environment, the operators are flooded with huge amount of data. The last decade has seen extensive applications of AI techniques, knowledge-based systems, Artificial Neural Networks in this area. This paper focuses on the need for development of an intelligent decision support system to assist the operator in making proper decisions. The requirements for realization of such a system are recognized for the effective operation and energy management of the southern grid in India The application of Petri nets leading to decision support system has been illustrated considering 24 bus system that is a part of southern grid.

A scenario-driven decision support system for serious crime investigation

Q. Shen, J. Keppens, C. Aitken, B. Schafer, and M. Lee. A scenario driven decision support system for serious crime investigation. Law, Probability and Risk, 5(2):87-117, 2006. Sponsorship: UK Engineering and Physical Sciences Research Council grant GR/S63267; partially supported by grant GR/S98603

Compositional Bayesian modelling and its application to decision support in crime investigation

J. Keppens, Q. Shen and M. Lee. Compositional Bayesian modelling and its application to decision support in crime investigation. Proceedings of the 19th International Workshop on Qualitative Reasoning, pages 138-148.

Extending BPM Environments of Your Choice with Performance Related Decision Support

What-if Simulations have been identified as one solution for business performance related decision support. Such support is especially useful in cases where it can be automatically generated out of Business Process Management (BPM) Environments from the existing business process models and performance parameters monitored from the executed business process instances. Currently, some of the available BPM Environments offer basic-level performance prediction capabilities. However, these functionalities are normally too limited to be generally useful for performance related decision support at business process level. In this paper, an approach is presented which allows the non-intrusive integration of sophisticated tooling for what-if simulations, analytic performance prediction tools process optimizations or a combination Of Such solutions into already existing BPM environments. The approach abstracts from process modelling techniques which enable automatic decision support spanning processes across numerous BPM Environments. For instance, this enables end-to-end decision support for composite processes modelled with the Business Process Modelling Notation (BPMN) on top of existing Enterprise Resource Planning (ERP) processes modelled with proprietary languages.