Enhanced clinical pharmacy service targeting tools: risk-predictive algorithms

Rationale, aims and objectives: This study aimed to determine the value of using a mix of clinical pharmacy data and routine hospital admission spell data in the development of predictive algorithms. Exploration of risk factors in hospitalized patients, together with the targeting strategies devised, will enable the prioritization of clinical pharmacy services to optimize patient outcomes. 

Methods: Predictive algorithms were developed using a number of detailed steps using a 75% sample of integrated medicines management (IMM) patients, and validated using the remaining 25%. IMM patients receive targeted clinical pharmacy input throughout their hospital stay. The algorithms were applied to the validation sample, and predicted risk probability was generated for each patient from the coefficients. Risk threshold for the algorithms were determined by identifying the cut-off points of risk scores at which the algorithm would have the highest discriminative performance. Clinical pharmacy staffing levels were obtained from the pharmacy department staffing database. 

Results: Numbers of previous emergency admissions and admission medicines together with age-adjusted co-morbidity and diuretic receipt formed a 12-month post-discharge and/or readmission risk algorithm. Age-adjusted co-morbidity proved to be the best index to predict mortality. Increased numbers of clinical pharmacy staff at ward level was correlated with a reduction in risk-adjusted mortality index (RAMI). 

Conclusions: Algorithms created were valid in predicting risk of in-hospital and post-discharge mortality and risk of hospital readmission 3, 6 and 12 months post-discharge. The provision of ward-based clinical pharmacy services is a key component to reducing RAMI and enabling the full benefits of pharmacy input to patient care to be realized.

Efficient Algorithms for Answering the m-Closest Keywords Query

As an important type of spatial keyword query, the m-closest keywords (mCK) query finds a group of objects such that they cover all query keywords and have the smallest diameter, which is defined as the largest distance between any pair of objects in the group. The query is useful in many applications such as detecting locations of web resources. However, the existing work does not study the intractability of this problem and only provides exact algorithms, which are computationally expensive.

In this paper, we prove that the problem of answering mCK queries is NP-hard. We first devise a greedy algorithm that has an approximation ratio of 2. Then, we observe that an mCK query can be approximately answered by finding the circle with the smallest diameter that encloses a group of objects together covering all query keywords. We prove that the group enclosed in the circle can answer the mCK query with an approximation ratio of 2 over 3. Based on this, we develop an algorithm for finding such a circle exactly, which has a high time complexity. To improve efficiency, we propose another two algorithms that find such a circle approximately, with a ratio of 2 over √3 + ε. Finally, we propose an exact algorithm that utilizes the group found by the 2 over √3 + ε)-approximation algorithm to obtain the optimal group. We conduct extensive experiments using real-life datasets. The experimental results offer insights into both efficiency and accuracy of the proposed approximation algorithms, and the results also demonstrate that our exact algorithm outperforms the best known algorithm by an order of magnitude.

Optimal Route Search with the Coverage of Users' Preferences

The preferences of users are important in route search and planning. For example, when a user plans a trip within a city, their preferences can be expressed as keywords shopping mall, restaurant, and museum, with weights 0.5, 0.4, and 0.1, respectively. The resulting route should best satisfy their weighted preferences. In this paper, we take into account the weighted user preferences in route search, and present a keyword coverage problem, which finds an optimal route from a source location to a target location such that the keyword coverage is optimized and that the budget score satisfies a specified constraint. We prove that this problem is NP-hard. To solve this complex problem, we pro- pose an optimal route search based on an A* variant for which we have defined an admissible heuristic function. The experiments conducted on real-world datasets demonstrate both the efficiency and accu- racy of our proposed algorithms.

Anytime Algorithms for Solving Possibilistic MDPs and Hybrid MDPs

The ability of an agent to make quick, rational decisions in an uncertain environment is paramount for its applicability in realistic settings. Markov Decision Processes (MDP) provide such a framework, but can only model uncertainty that can be expressed as probabilities. Possibilistic counterparts of MDPs allow to model imprecise beliefs, yet they cannot accurately represent probabilistic sources of uncertainty and they lack the efficient online solvers found in the probabilistic MDP community. In this paper we advance the state of the art in three important ways. Firstly, we propose the first online planner for possibilistic MDP by adapting the Monte-Carlo Tree Search (MCTS) algorithm. A key component is the development of efficient search structures to sample possibility distributions based on the DPY transformation as introduced by Dubois, Prade, and Yager. Secondly, we introduce a hybrid MDP model that allows us to express both possibilistic and probabilistic uncertainty, where the hybrid model is a proper extension of both probabilistic and possibilistic MDPs. Thirdly, we demonstrate that MCTS algorithms can readily be applied to solve such hybrid models.

Exact and heuristic methods for solving Boolean games

Boolean games are a framework for reasoning about the rational behavior of agents whose goals are formalized using propositional formulas. Compared to normal form games, a well-studied and related game framework, Boolean games allow for an intuitive and more compact representation of the agents’ goals. So far, Boolean games have been mainly studied in the literature from the Knowledge Representation perspective, and less attention has been paid on the algorithmic issues underlying the computation of solution concepts. Although some suggestions for solving specific classes of Boolean games have been made in the literature, there is currently no work available on the practical performance. In this paper, we propose the first technique to solve general Boolean games that does not require an exponential translation to normal-form games. Our method is based on disjunctive answer set programming and computes solutions (equilibria) of arbitrary Boolean games. It can be applied to a wide variety of solution concepts, and can naturally deal with extensions of Boolean games such as constraints and costs. We present detailed experimental results in which we compare the proposed method against a number of existing methods for solving specific classes of Boolean games, as well as adaptations of methods that were initially designed for normal-form games. We found that the heuristic methods that do not require all payoff matrix entries performed well for smaller Boolean games, while our ASP based technique is faster when the problem instances have a higher number of agents or action variables.

Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting

Purpose
The Strengths and Difficulties Questionnaire (SDQ) is a behavioural screening tool for children. The SDQ is increasingly used as the primary outcome measure in population health interventions involving children, but it is not preference based; therefore, its role in allocative economic evaluation is limited. The Child Health Utility 9D (CHU9D) is a generic preference-based health-related quality of-life measure. This study investigates the applicability of the SDQ outcome measure for use in economic evaluations and examines its relationship with the CHU9D by testing previously published mapping algorithms. The aim of the paper is to explore the feasibility of using the SDQ within economic evaluations of school-based population health interventions.
Methods
Data were available from children participating in a cluster randomised controlled trial of the school-based roots of empathy programme in Northern Ireland. Utility was calculated using the original and alternative CHU9D tariffs along with two SDQ mapping algorithms. t tests were performed for pairwise differences in utility values from the preference-based tariffs and mapping algorithms.
Results
Mean (standard deviation) SDQ total difficulties and prosocial scores were 12 (3.2) and 8.3 (2.1). Utility values obtained from the original tariff, alternative tariff, and mapping algorithms using five and three SDQ subscales were 0.84 (0.11), 0.80 (0.13), 0.84 (0.05), and 0.83 (0.04), respectively. Each method for calculating utility produced statistically significantly different values except the original tariff and five SDQ subscale algorithm.
Conclusion
Initial evidence suggests the SDQ and CHU9D are related in some of their measurement properties. The mapping algorithm using five SDQ subscales was found to be optimal in predicting mean child health utility. Future research valuing changes in the SDQ scores would contribute to this research.

FPGA-based Tabu Search for Detection in Large-Scale MIMO Systems

The increasing scale of Multiple-Input Multiple- Output (MIMO) topologies employed in forthcoming wireless communications standards presents a substantial implementation challenge to designers of embedded baseband signal processing architectures for MIMO transceivers. Specifically the increased scale of such systems has a substantial impact on the perfor- mance/cost balance of detection algorithms for these systems. Whilst in small-scale systems Sphere Decoding (SD) algorithms offer the best quasi-ML performance/cost balance, in larger systems heuristic detectors, such Tabu-Search (TS) detectors are superior. This paper addresses a dearth of research in architectures for TS-based MIMO detection, presenting the first known realisations of TS detectors for 4 × 4 and 10 × 10 MIMO systems. To the best of the authors’ knowledge, these are the largest single-chip detectors on record.

Novel Application of Genetic Sequencing algorithms to optimisation of hardware resource sharing for DSP

Field programmable gate array (FPGA) technology is a powerful platform for implementing computationally complex, digital signal processing (DSP) systems. Applications that are multi-modal, however, are designed for worse case conditions. In this paper, genetic sequencing techniques are applied to give a more sophisticated decomposition of the algorithmic variations, thus allowing an unified hardware architecture which gives a 10-25% area saving and 15% power saving for a digital radar receiver.

A new Nawaz–Enscore–Ham-based heuristic for permutation flow-shop problem with bicriteria of makespan and machine idle-time

A new heuristic based on Nawaz–Enscore–Ham (NEH) algorithm is proposed for solving permutation flowshop scheduling problem in this paper. A new priority rule is proposed by accounting for the average, mean absolute deviation, skewness and kurtosis, in order to fully describe the distribution style of processing times. A new tie-breaking rule is also introduced for achieving effective job insertion for the objective of minimizing both makespan and machine idle-time. Statistical tests illustrate better solution quality of the proposed algorithm, comparing to existing benchmark heuristics.