Fuzzy logic for decision support in chronic care

Computerized clinical guidelines can provide significant benefits in terms of health outcomes and costs, however, their effective computer implementation presents significant problems. Vagueness and ambiguity inherent in natural language (textual) clinical guidelines makes them problematic for formulating automated alerts or advice. Fuzzy logic allows us to formalize the treatment of vagueness in a decision support architecture. In care plan on-line (CPOL), an intranet-based chronic disease care planning system for general practitioners (GPs) in use in South Australia, we formally treat fuzziness in interpretation of quantitative data, formulation of recommendations and unequal importance of clinical indicators. We use expert judgment on cases, as well as direct estimates by experts, to optimize aggregation operators and treat heterogeneous combinations of conjunction and disjunction that are present in the natural language decision rules formulated by specialist teams.

Macleod and the offence of defrauding the company in one-person businesses: the divergence between legal principle and logic widens

The recent High Court decision in Macleod v R establishes that a director and sole shareholder may be convicted of fraudulently applying a company's property even though the person has consented to the personal use of the company's property. It is contended that while this decision is consistent with the weight of precedent, it is wrong in principle. The decision implies that corporations are not only separate legal entities, but that they are highly virtuous legal entities -- incapable of being imbued with the dishonest intentions and activities of the individuals controlling the company.

Fuzzy logic based metric in software testing

How to provide cost-effective strategies for Software Testing has been one of the research focuses in Software Engineering for a long time. Many researchers in Software Engineering have addressed the effectiveness and quality metric of Software Testing, and many interesting results have been obtained. However, one issue of paramount importance in software testing – the intrinsic imprecise and uncertain relationships within testing metrics – is left unaddressed. To this end, a new quality and effectiveness measurement based on fuzzy logic is proposed. The software quality features and analogy-based reasoning are discussed, which can deal with quality and effectiveness consistency between different test projects. Experimental results are also provided to verify the proposed measurement.

A fuzzy logic based approach for software testing

How to provide cost-effective strategies for Software Testing has been one of the research focuses in Software Engineering for a long time. Many researchers in Software Engineering have addressed the effectiveness and quality metric of Software Testing, and many interesting results have been obtained. However, one issue of paramount importance in software testing — the intrinsic imprecise and uncertain relationships within testing metrics — is left unaddressed. To this end, a new quality and effectiveness measurement based on fuzzy logic is proposed. Related issues like the software quality features and fuzzy reasoning for test project similarity measurement are discussed, which can deal with quality and effectiveness consistency between different test projects. Experiments were conducted to verify the proposed measurement using real data from actual software testing projects. Experimental results show that the proposed fuzzy logic based metrics is effective and efficient to measure and evaluate the quality and effectiveness of test projects.

Logic games

Discusses innovations on logic games which will develop the problem solving and spatial thinking of students. Variations of existing logic games; Description of the innovated games; Advice on introducing logic games to students.

Fuzzy logic in clinical practice decision support systems

Computerized clinical guidelines can provide significant benefits to health outcomes and costs, however, their effective implementation presents significant problems. Vagueness and ambiguity inherent in natural (textual) clinical guidelines is not readily amenable to formulating automated alerts or advice. Fuzzy logic allows us to formalize the treatment of vagueness in a decision support architecture. This paper discusses sources of fuzziness in clinical practice guidelines. We consider how fuzzy logic can be applied and give a set of heuristics for the clinical guideline knowledge engineer for addressing uncertainty in practice guidelines. We describe the specific applicability of fuzzy logic to the decision support behavior of Care Plan On-Line, an intranet-based chronic care planning system for General Practitioners.

Non-smooth optimization methods for computation of the conditional value-at-risk and portfolio optimization

We examine numerical performance of various methods of calculation of the Conditional Value-at-risk (CVaR), and portfolio optimization with respect to this risk measure. We concentrate on the method proposed by Rockafellar and Uryasev in (Rockafellar, R.T. and Uryasev, S., 2000, Optimization of conditional value-at-risk. Journal of Risk, 2, 21-41), which converts this problem to that of convex optimization. We compare the use of linear programming techniques against a non-smooth optimization method of the discrete gradient, and establish the supremacy of the latter. We show that non-smooth optimization can be used efficiently for large portfolio optimization, and also examine parallel execution of this method on computer clusters.

The ultrasound appearance of the patellar tendon attachment to the tibia in young athletes is conditional on gender and pubertal stage

This cross-sectional study investigated the imaging appearance of the previous termpatellarnext term tendon attachment to the tibia in young male and female tennis players of different ages and pubertal status. Forty-four competitive young players, who had been playing tennis at least for 2 years, were recruited from a tennis school and local tennis clubs. All subjects had bilateral ultrasound imaging of the previous termpatellarnext term tendon attachment to the tibia. Standard anthropometric measurements, pubertal status and injury history were recorded. Ultrasound appearance of the previous termpatellarnext term tendon attachment was categorised into three stages: cartilage attachment, insertional cartilage and mature attachment. Cartilage attachment was more prevalent in boys (32%) and extended further into puberty (until Tanner stage 4) compared to girls (6% and Tanner stage 1). Tendons with Osgood–Schlatter Disease symptoms (n = 3) did not have a cartilage attachment. Imaging appearance commonly seen in young active athletes, consistent with a clinical diagnosis of OSD, was more common in boys and in the pre- and peri-pubertal stages.

Parametric conditional frailty models for recurrent cardiovascular events in the lipid study

Background Analysis of recurrent event data is frequently needed in clinical and epidemiological studies. An important issue in such analysis is how to account for the dependence of the events in an individual and any unobserved heterogeneity of the event propensity across individuals.Methods We applied a number of conditional frailty and nonfrailty models in an analysis involving recurrent myocardial infarction events in the Long-Term Intervention with Pravastatin in Ischaemic Disease study. A multiple variable risk prediction model was developed for both males and females. Results A Weibull model with a gamma frailty term fitted the data better than other frailty models for each gender. Among nonfrailty models the stratified survival model fitted the data best for each gender. The relative risk estimated by the elapsed time model was close to that estimated by the gap time model. We found that a cholesterol-lowering drug, pravastatin (the intervention being tested in the trial) had significant protective effect against the occurrence of myocardial infarction in men (HR¼0.71, 95% CI0.60–0.83). However, the treatment effect was not significant in women due to smaller sample size (HR¼0.75, 95% CI 0.51–1.10). There were no significant interactions between the treatment effect and each recurrent MI event (p¼0.24 for men and p¼0.55 for women). The risk of developing an MI event for a male who had an MI event during follow-up was about 3.4 (95% CI 2.6–4.4) times the risk compared with those who did not have an MI event. The corresponding relative risk for a female was about 7.8 (95% CI 4.4–13.6). Limitations The number of female patients was relatively small compared with their male counterparts, which may result in low statistical power to find real differences in the effect of treatment and other potential risk factors.Conclusions The conditional frailty model suggested that after accounting for all the risk factors in the model, there was still unmeasured heterogeneity of the risk for myocardial infarction, indicating the effect of subject-specific risk factors. These risk prediction models can be used to classify cardiovascular disease patients into different risk categories and may be useful for the most effective targeting of preventive therapies for cardiovascular disease.