A concept-based framework for retrieving evidence to support emergency physician decision making at the point of care

The goal of evidence-based medicine is to uniformly apply evidence gained from scientific research to aspects of clinical practice. In order to achieve this goal, new applications that integrate increasingly disparate health care information resources are required. Access to and provision of evidence must be seamlessly integrated with existing clinical workflow and evidence should be made available where it is most often required - at the point of care. In this paper we address these requirements and outline a concept-based framework that captures the context of a current patient-physician encounter by combining disease and patient-specific information into a logical query mechanism for retrieving relevant evidence from the Cochrane Library. Returned documents are organized by automatically extracting concepts from the evidence-based query to create meaningful clusters of documents which are presented in a manner appropriate for point of care support. The framework is currently being implemented as a prototype software agent that operates within the larger context of a multi-agent application for supporting workflow management of emergency pediatric asthma exacerbations. © 2008 Springer-Verlag Berlin Heidelberg.

Study of management decision making by ward sisters in a hospital and the effects on decision making after the implementation of a decision support sytem

This thesis considers management decision making at the ward level in hospitals especially by ward sisters, and the effectiveness of the intervention of a decision support system. Nursing practice theories were related to organisation and management theories in order to conceptualise a decision making framework for nurse manpower planning and deployment at the ward level. Decision and systems theories were explored to understand the concepts of decision making and the realities of power in an organisation. In essence, the hypothesis was concerned with changes in patterns of decision making that could occur with the intervention of a decision support system and that the degree of change would be governed by a set of `difficulty' factors within wards in a hospital. During the course of the study, a classification of ward management decision making was created, together with the development and validation of measuring instruments to test the research hypothesis. The decision support system used was rigorously evaluated to test whether benefits did accrue from its implementation. Quantitative results from sample wards together with qualitative information collected, were used to test this hypothesis and the outcomes postulated were supported by these findings. The main conclusion from this research is that a more rational approach to management decision making is feasible, using information from a decision support system. However, wards and ward sisters that need the most assistance, where the `difficulty' factors in the organisation are highest, benefit the least from this type of system. Organisational reviews are needed on these identified wards, involving managers and doctors, to reduce the levels of un-coordinated activities and disruption.

Designing a safety management support system using open architecture databases: the requirements of information representation in the support of managers' risk-related decision-making

This research was conducted at the Space Research and Technology Centre o the European Space Agency at Noordvijk in the Netherlands. ESA is an international organisation that brings together a range of scientists, engineers and managers from 14 European member states. The motivation for the work was to enable decision-makers, in a culturally and technologically diverse organisation, to share information for the purpose of making decisions that are well informed about the risk-related aspects of the situations they seek to address. The research examined the use of decision support system DSS) technology to facilitate decision-making of this type. This involved identifying the technology available and its application to risk management. Decision-making is a complex activity that does not lend itself to exact measurement or precise understanding at a detailed level. In view of this, a prototype DSS was developed through which to understand the practical issues to be accommodated and to evaluate alternative approaches to supporting decision-making of this type. The problem of measuring the effect upon the quality of decisions has been approached through expert evaluation of the software developed. The practical orientation of this work was informed by a review of the relevant literature in decision-making, risk management, decision support and information technology. Communication and information technology unite the major the,es of this work. This allows correlation of the interests of the research with European public policy. The principles of communication were also considered in the topic of information visualisation - this emerging technology exploits flexible modes of human computer interaction (HCI) to improve the cognition of complex data. Risk management is itself an area characterised by complexity and risk visualisation is advocated for application in this field of endeavour. The thesis provides recommendations for future work in the fields of decision=making, DSS technology and risk management.

Developing a forest data portal to support multi-scale decision making

Forests play a pivotal role in timber production, maintenance and development of biodiversity and in carbon sequestration and storage in the context of the Kyoto Protocol. Policy makers and forest experts therefore require reliable information on forest extent, type and change for management, planning and modeling purposes. It is becoming increasingly clear that such forest information is frequently inconsistent and unharmonised between countries and continents. This research paper presents a forest information portal that has been developed in line with the GEOSS and INSPIRE frameworks. The web portal provides access to forest resources data at a variety of spatial scales, from global through to regional and local, as well as providing analytical capabilities for monitoring and validating forest change. The system also allows for the utilisation of forest data and processing services within other thematic areas. The web portal has been developed using open standards to facilitate accessibility, interoperability and data transfer.

Unsupervised KDD to creatively support managers' decision making with fuzzy association rules:a distribution channel application

To be competitive in contemporary turbulent environments, firms must be capable of processing huge amounts of information, and effectively convert it into actionable knowledge. This is particularly the case in the marketing context, where problems are also usually highly complex, unstructured and ill-defined. In recent years, the development of marketing management support systems has paralleled this evolution in informational problems faced by managers, leading to a growth in the study (and use) of artificial intelligence and soft computing methodologies. Here, we present and implement a novel intelligent system that incorporates fuzzy logic and genetic algorithms to operate in an unsupervised manner. This approach allows the discovery of interesting association rules, which can be linguistically interpreted, in large scale databases (KDD or Knowledge Discovery in Databases.) We then demonstrate its application to a distribution channel problem. It is shown how the proposed system is able to return a number of novel and potentially-interesting associations among variables. Thus, it is argued that our method has significant potential to improve the analysis of marketing and business databases in practice, especially in non-programmed decisional scenarios, as well as to assist scholarly researchers in their exploratory analysis. © 2013 Elsevier Inc.

Integrated project evaluation and selection using multiple-attribute decision-making technique

The evaluation and selection of industrial projects before investment decision is customarily done using marketing, technical and financial information. Subsequently, environmental impact assessment and social impact assessment are carried out mainly to satisfy the statutory agencies. Because of stricter environment regulations in developed and developing countries, quite often impact assessment suggests alternate sites, technologies, designs, and implementation methods as mitigating measures. This causes considerable delay to complete project feasibility analysis and selection as complete analysis requires to be taken up again and again till the statutory regulatory authority approves the project. Moreover, project analysis through above process often results sub-optimal project as financial analysis may eliminate better options, as more environment friendly alternative will always be cost intensive. In this circumstance, this study proposes a decision support system, which analyses projects with respect to market, technicalities, and social and environmental impact in an integrated framework using analytic hierarchy process, a multiple-attribute decision-making technique. This not only reduces duration of project evaluation and selection, but also helps select optimal project for the organization for sustainable development. The entire methodology has been applied to a cross-country oil pipeline project in India and its effectiveness has been demonstrated. © 2005 Elsevier B.V. All rights reserved.

CORD an object model supporting statistical summary information for management decision making

Information systems have developed to the stage that there is plenty of data available in most organisations but there are still major problems in turning that data into information for management decision making. This thesis argues that the link between decision support information and transaction processing data should be through a common object model which reflects the real world of the organisation and encompasses the artefacts of the information system. The CORD (Collections, Objects, Roles and Domains) model is developed which is richer in appropriate modelling abstractions than current Object Models. A flexible Object Prototyping tool based on a Semantic Data Storage Manager has been developed which enables a variety of models to be stored and experimented with. A statistical summary table model COST (Collections of Objects Statistical Table) has been developed within CORD and is shown to be adequate to meet the modelling needs of Decision Support and Executive Information Systems. The COST model is supported by a statistical table creator and editor COSTed which is also built on top of the Object Prototyper and uses the CORD model to manage its metadata.

Planning and decision-making for energy recovery from waste at the sub-regional level

This research project has developed a novel decision support system using Geographical Information Systems and Multi Criteria Decision Analysis and used it to develop and evaluate energy-from-waste policy options. The system was validated by applying it to the UK administrative areas of Cornwall and Warwickshire. Different strategies have been defined by the size and number of the facilities, as well as the technology chosen. Using sensitivity on the results from the decision support system, it was found that key decision criteria included those affected by cost, energy efficiency, transport impacts and air/dioxin emissions. The conclusions of this work are that distributed small-scale energy-from-waste facilities score most highly overall and that scale is more important than technology design in determining overall policy impact. This project makes its primary contribution to energy-from-waste planning by its development of a Decision Support System that can be used to assist waste disposal authorities to identify preferred energy-from-waste options that have been tailored specifically to the socio-geographic characteristics of their jurisdictional areas. The project also highlights the potential of energy-from-waste policies that are seldom given enough attention to in the UK, namely those of a smaller-scale and distributed nature that often have technology designed specifically to cater for this market.

Does reviewing lead to better learning and decision making? Answers from a randomized stock market experiment

Background - The literature is not univocal about the effects of Peer Review (PR) within the context of constructivist learning. Due to the predominant focus on using PR as an assessment tool, rather than a constructivist learning activity, and because most studies implicitly assume that the benefits of PR are limited to the reviewee, little is known about the effects upon students who are required to review their peers. Much of the theoretical debate in the literature is focused on explaining how and why constructivist learning is beneficial. At the same time these discussions are marked by an underlying presupposition of a causal relationship between reviewing and deep learning. Objectives - The purpose of the study is to investigate whether the writing of PR feedback causes students to benefit in terms of: perceived utility about statistics, actual use of statistics, better understanding of statistical concepts and associated methods, changed attitudes towards market risks, and outcomes of decisions that were made. Methods - We conducted a randomized experiment, assigning students randomly to receive PR or non–PR treatments and used two cohorts with a different time span. The paper discusses the experimental design and all the software components that we used to support the learning process: Reproducible Computing technology which allows students to reproduce or re–use statistical results from peers, Collaborative PR, and an AI–enhanced Stock Market Engine. Results - The results establish that the writing of PR feedback messages causes students to experience benefits in terms of Behavior, Non–Rote Learning, and Attitudes, provided the sequence of PR activities are maintained for a period that is sufficiently long.

A method for systematic artifact selection decision making

Artifact selection decisions typically involve the selection of one from a number of possible/candidate options (decision alternatives). In order to support such decisions, it is important to identify and recognize relevant key issues of problem solving and decision making (Albers, 1996; Harris, 1998a, 1998b; Jacobs & Holten, 1995; Loch & Conger, 1996; Rumble, 1991; Sauter, 1999; Simon, 1986). Sauter classifies four problem solving/decision making styles: (1) left-brain style, (2) right-brain style, (3) accommodating, and (4) integrated (Sauter, 1999). The left-brain style employs analytical and quantitative techniques and relies on rational and logical reasoning. In an effort to achieve predictability and minimize uncertainty, problems are explicitly defined, solution methods are determined, orderly information searches are conducted, and analysis is increasingly refined. Left-brain style decision making works best when it is possible to predict/control, measure, and quantify all relevant variables, and when information is complete. In direct contrast, right-brain style decision making is based on intuitive techniques—it places more emphasis on feelings than facts. Accommodating decision makers use their non-dominant style when they realize that it will work best in a given situation. Lastly, integrated style decision makers are able to combine the left- and right-brain styles—they use analytical processes to filter information and intuition to contend with uncertainty and complexity.

Dynamic decision networks for decision-making in self-adaptive systems:a case study

Bayesian decision theory is increasingly applied to support decision-making processes under environmental variability and uncertainty. Researchers from application areas like psychology and biomedicine have applied these techniques successfully. However, in the area of software engineering and speci?cally in the area of self-adaptive systems (SASs), little progress has been made in the application of Bayesian decision theory. We believe that techniques based on Bayesian Networks (BNs) are useful for systems that dynamically adapt themselves at runtime to a changing environment, which is usually uncertain. In this paper, we discuss the case for the use of BNs, speci?cally Dynamic Decision Networks (DDNs), to support the decision-making of self-adaptive systems. We present how such a probabilistic model can be used to support the decision making in SASs and justify its applicability. We have applied our DDN-based approach to the case of an adaptive remote data mirroring system. We discuss results, implications and potential bene?ts of the DDN to enhance the development and operation of self-adaptive systems, by providing mechanisms to cope with uncertainty and automatically make the best decision.

The interactive effects of mood and trait negative affect in group decision making

Extending the growing interest in affect in work groups, we propose that groups with distributed information make higher quality decisions when they are in a negative rather than a positive mood, but that these effects are moderated by group members' trait negative affect. In support of this hypothesis, an experiment (N = 175 groups) showed that positive mood led to lower quality decisions than did negative or neutral moods when group members were low in trait negative affect, whereas such mood effects were not observed in groups higher in trait negative affect. Mediational analysis based on behavioral observations of group process confirmed that group information elaboration mediated this effect. These results provide an important caveat on the benefits of positive moods in work groups, and suggest that the study of trait × state affect interactions is an important avenue for future research.

A method for systematic artifact selection decision making

Artifact selection decisions typically involve the selection of one from a number of possible/candidate options (decision alternatives). In order to support such decisions, it is important to identify and recognize relevant key issues of problem solving and decision making (Albers, 1996; Harris, 1998a, 1998b; Jacobs & Holten, 1995; Loch & Conger, 1996; Rumble, 1991; Sauter, 1999; Simon, 1986). Sauter classifies four problem solving/decision making styles: (1) left-brain style, (2) right-brain style, (3) accommodating, and (4) integrated (Sauter, 1999). The left-brain style employs analytical and quantitative techniques and relies on rational and logical reasoning. In an effort to achieve predictability and minimize uncertainty, problems are explicitly defined, solution methods are determined, orderly information searches are conducted, and analysis is increasingly refined. Left-brain style decision making works best when it is possible to predict/control, measure, and quantify all relevant variables, and when information is complete. In direct contrast, right-brain style decision making is based on intuitive techniques—it places more emphasis on feelings than facts. Accommodating decision makers use their non-dominant style when they realize that it will work best in a given situation. Lastly, integrated style decision makers are able to combine the left- and right-brain styles—they use analytical processes to filter information and intuition to contend with uncertainty and complexity.

An investigation of Albanian EFL teachers' decision-making in their use of CLT-oriented textbooks

Against a backdrop of ongoing educational reforms that seek to introduce Communicative Language Teaching (CLT) in Albanian primary and secondary state schools, Albanian teachers, among others, are officially required to use communication-based textbooks in their classes. Authorities in a growing number of countries that are seeking to improve and westernise their educational systems are also using communication-based textbooks as agents of change. Behind these actions, there is the commonly held belief that textbooks can be used to support teacher learning as they provide a visible framework teachers can follow. Communication-based textbooks are used in thousands of EFL classrooms around the world to help teachers to “fully understand and routinize change” (Hutchinson and Torres, 1994:323). However, empirical research on the role materials play in the classroom, and in particular the role of textbook as an agent of change, is still very little, and what does exist is rather inconclusive. This study aims to fulfill this gap. It is predominately a qualitative investigation into how and why four Albanian EFL teachers use Western teaching resources in their classes. Aiming at investigating the decision-making processes that teachers go through in their teaching, and specifically at investigating the relationship between Western-published textbooks, teachers’ decision making, and teachers’ classroom delivery, the current study contributes to an extensive discussion on the development of communicative L2 teaching concepts and methods, teacher decision making, as well as a growing discussion on how best to make institutional reforms effective, particularly in East-European ex-communist countries and in other developing countries. Findings from this research indicate that, prompted by the content of Western-published textbooks, the four research participants, who had received little formal training in CLT teaching, accommodated some communicative teaching behaviours into their teaching. The use of communicative textbooks, however, does not seem to account for radical, methodological changes in teachers’ practices. Teacher cognitions based on teachers’ previous learning experience are likely to act as a lens through which teachers judge classroom realities. As such, they shape, to a great degree, the decisions teachers make regarding the use of Western-published textbooks in their classes.

Dynamic decision-making based on NFR for managing software variability and configuration selection

Due to dynamic variability, identifying the specific conditions under which non-functional requirements (NFRs) are satisfied may be only possible at runtime. Therefore, it is necessary to consider the dynamic treatment of relevant information during the requirements specifications. The associated data can be gathered by monitoring the execution of the application and its underlying environment to support reasoning about how the current application configuration is fulfilling the established requirements. This paper presents a dynamic decision-making infrastructure to support both NFRs representation and monitoring, and to reason about the degree of satisfaction of NFRs during runtime. The infrastructure is composed of: (i) an extended feature model aligned with a domain-specific language for representing NFRs to be monitored at runtime; (ii) a monitoring infrastructure to continuously assess NFRs at runtime; and (iii) a exible decision-making process to select the best available configuration based on the satisfaction degree of the NRFs. The evaluation of the approach has shown that it is able to choose application configurations that well fit user NFRs based on runtime information. The evaluation also revealed that the proposed infrastructure provided consistent indicators regarding the best application configurations that fit user NFRs. Finally, a benefit of our approach is that it allows us to quantify the level of satisfaction with respect to NFRs specification.