Patients' preferences for a prostate cancer consultation, a discrete choice experiment

Four basic medical decision making models are commonly discussed in the literature in reference to physician-patient interactions. All fall short in their attempt to capture the nuances of physician-patient interactions, and none satisfactorily address patients' preferences for communication and other attributes of care. Prostate cancer consultations are one setting where preferences matter and are likely to vary among patients. Fortunately, discrete choice experiments are capable of casting light on patients' preferences for communication and other attributes of value that make up a consultation before the consultation occurs, which is crucial if patients are to derive the most utility from the process of reaching a decision as well as the decision itself. The results of my dissertation provide strong support to the notion that patients, at least in the hypothetical setting of a DCE, have identifiable preferences for the attributes of a prostate cancer consultation and that those preferences are capable of being elicited before a consultation takes place. Further, patients' willingness-to-pay for the non-cost attributes of the consultation is surprisingly robust to a variety of individual level variables of interest. ^

Mixture modeling for joint analysis of survival, discrete, and continuous data

Mixture modeling is commonly used to model categorical latent variables that represent subpopulations in which population membership is unknown but can be inferred from the data. In relatively recent years, the potential of finite mixture models has been applied in time-to-event data. However, the commonly used survival mixture model assumes that the effects of the covariates involved in failure times differ across latent classes, but the covariate distribution is homogeneous. The aim of this dissertation is to develop a method to examine time-to-event data in the presence of unobserved heterogeneity under a framework of mixture modeling. A joint model is developed to incorporate the latent survival trajectory along with the observed information for the joint analysis of a time-to-event variable, its discrete and continuous covariates, and a latent class variable. It is assumed that the effects of covariates on survival times and the distribution of covariates vary across different latent classes. The unobservable survival trajectories are identified through estimating the probability that a subject belongs to a particular class based on observed information. We applied this method to a Hodgkin lymphoma study with long-term follow-up and observed four distinct latent classes in terms of long-term survival and distributions of prognostic factors. Our results from simulation studies and from the Hodgkin lymphoma study demonstrated the superiority of our joint model compared with the conventional survival model. This flexible inference method provides more accurate estimation and accommodates unobservable heterogeneity among individuals while taking involved interactions between covariates into consideration.^

Evaluation of the Hosmer -Lemeshow global goodness -of-fit statistic for mixed variable logistic regression models

The performance of the Hosmer-Lemeshow global goodness-of-fit statistic for logistic regression models was explored in a wide variety of conditions not previously fully investigated. Computer simulations, each consisting of 500 regression models, were run to assess the statistic in 23 different situations. The items which varied among the situations included the number of observations used in each regression, the number of covariates, the degree of dependence among the covariates, the combinations of continuous and discrete variables, and the generation of the values of the dependent variable for model fit or lack of fit.^ The study found that the $\rm\ C$g* statistic was adequate in tests of significance for most situations. However, when testing data which deviate from a logistic model, the statistic has low power to detect such deviation. Although grouping of the estimated probabilities into quantiles from 8 to 30 was studied, the deciles of risk approach was generally sufficient. Subdividing the estimated probabilities into more than 10 quantiles when there are many covariates in the model is not necessary, despite theoretical reasons which suggest otherwise. Because it does not follow a X$\sp2$ distribution, the statistic is not recommended for use in models containing only categorical variables with a limited number of covariate patterns.^ The statistic performed adequately when there were at least 10 observations per quantile. Large numbers of observations per quantile did not lead to incorrect conclusions that the model did not fit the data when it actually did. However, the statistic failed to detect lack of fit when it existed and should be supplemented with further tests for the influence of individual observations. Careful examination of the parameter estimates is also essential since the statistic did not perform as desired when there was moderate to severe collinearity among covariates.^ Two methods studied for handling tied values of the estimated probabilities made only a slight difference in conclusions about model fit. Neither method split observations with identical probabilities into different quantiles. Approaches which create equal size groups by separating ties should be avoided. ^

An efficient ‘a priori’ model reduction for boundary element models

The Boundary Element Method (BEM) is a discretisation technique for solving partial differential equations, which offers, for certain problems, important advantages over domain techniques. Despite the high CPU time reduction that can be achieved, some 3D problems remain today untreatable because the extremely large number of degrees of freedom—dof—involved in the boundary description. Model reduction seems to be an appealing choice for both, accurate and efficient numerical simulations. However, in the BEM the reduction in the number of degrees of freedom does not imply a significant reduction in the CPU time, because in this technique the more important part of the computing time is spent in the construction of the discrete system of equations. In this way, a reduction also in the number of weighting functions, seems to be a key point to render efficient boundary element simulations.

Improving the analysis of road pricing acceptability surveys by using hybrid models

Several international studies have analyzed the acceptability of road pricing schemes by means of an attitude survey in combination with the results of a stated choice experiment using both a descriptive analysis and a discrete-choice model with binary choice (?accept? or ?not accept? the toll). However, the use of hybrid discrete choice models constitutes an innovative alternative for integrating subjective attitudes and perceptions deriving from the survey of attitudes with the more objective variables from the stated choice experiment. This paper analyzes the results of applying these models to measure the acceptability of interurban road pricing among different groups of stakeholders (road freight and passenger operators, highway concessionaires, and associations of private car users) with qualitatively significant opinions on road pricing measures. Our results show that hybrid models are better suited to explaining the acceptability of a road pricing scheme by different groups of stakeholders than a separate analysis of the survey of attitudes and a discrete-choice model applied on a stated choice experiment. A particular finding was that the strong psycho-social latent variable of the perception of fairness explains the rejection or acceptance of a toll scheme by road stakeholders.

Load displacement in grape harvesters: Discrete Element Analysis.

Dynamic weighing of the hopper in grape harvesters is affected by a number of factors. One of them is the displacement of the load inside the hopper as a consequence of the terrain topography. In this work, the weight obtained by a load cell in a grape harvester has been analysed and quantified using the discrete element method (DEM). Different models have been developed considering different scenarios for the terrain.

Gear dynamics monitoring using discrete wavelet transformation and multi-layer perceptron neural networks

This paper presents a multi-stage algorithm for the dynamic condition monitoring of a gear. The algorithm provides information referred to the gear status (fault or normal condition) and estimates the mesh stiffness per shaft revolution in case that any abnormality is detected. In the first stage, the analysis of coefficients generated through discrete wavelet transformation (DWT) is proposed as a fault detection and localization tool. The second stage consists in establishing the mesh stiffness reduction associated with local failures by applying a supervised learning mode and coupled with analytical models. To do this, a multi-layer perceptron neural network has been configured using as input features statistical parameters sensitive to torsional stiffness decrease and derived from wavelet transforms of the response signal. The proposed method is applied to the gear condition monitoring and results show that it can update the mesh dynamic properties of the gear on line.

Decision boundary for discrete Bayesian network classifiers

Bayesian network classifiers are a powerful machine learning tool. In order to evaluate the expressive power of these models, we compute families of polynomials that sign-represent decision functions induced by Bayesian network classifiers. We prove that those families are linear combinations of products of Lagrange basis polynomials. In absence of V-structures in the predictor sub-graph, we are also able to prove that this family of polynomials does in- deed characterize the specific classifier considered. We then use this representation to bound the number of decision functions representable by Bayesian network classifiers with a given structure and we compare these bounds to the ones obtained using Vapnik-Chervonenkis dimension.

Discrete (MD) and continuum (DD) simulations of void growth in single crystals.

Void growth in ductile materials is an important problem from the fundamental and technological viewpoint. Most of the models developed to quantify and understand the void growth process did not take into account two important factors: the anisotropic nature of plastic flow in single crystals and the size effects that appear when plastic flow is confined into very small regions.

Decision boundary for discrete Bayesian network classifiers

Bayesian network classifiers are a powerful machine learning tool. In order to evaluate the expressive power of these models, we compute families of polynomials that sign-represent decision functions induced by Bayesian network classifiers. We prove that those families are linear combinations of products of Lagrange basis polynomials. In absence of V-structures in the predictor sub-graph, we are also able to prove that this family of polynomials does in- deed characterize the specific classifier considered. We then use this representation to bound the number of decision functions representable by Bayesian network classifiers with a given structure and we compare these bounds to the ones obtained using Vapnik-Chervonenkis dimension.

Discrete element analysis for the assessment of the accuracy of load cell-based dynamic weighing systems in grape harvesters under different ground conditions

Dynamic weighing systems based on load cells are commonly used to estimate crop yields in the field. There is lack of data, however, regarding the accuracy of such weighing systems mounted on harvesting machinery, especially on that used to collect high value crops such as fruits and vegetables. Certainly, dynamic weighing systems mounted on the bins of grape harvesters are affected by the displacement of the load inside the bin when moving over terrain of changing topography. In this work, the load that would be registered in a grape harvester bin by a dynamic weighing system based on the use of a load cell was inferred by using the discrete element method (DEM). DEM is a numerical technique capable of accurately describing the behaviour of granular materials under dynamic situations and it has been proven to provide successful predictions in many different scenarios. In this work, different DEM models of a grape harvester bin were developed contemplating different influencing factors. Results obtained from these models were used to infer the output given by the load cell of a real bin. The mass detected by the load cell when the bin was inclined depended strongly on the distribution of the load within the bin, but was underestimated in all scenarios. The distribution of the load was found to be dependent on the inclination of the bin caused by the topography of the terrain, but also by the history of inclination (inclination rate, presence of static periods, etc.) since the effect of the inertia of the particles (i.e., representing the grapes) was not negligible. Some recommendations are given to try to improve the accuracy of crop load measurement in the field.

A discrete spectral model for intermediate crack debonding in FRP-strengthened RC beams

One of the common failure modes of reinforced concrete (RC) beams strengthened in flexure with a bonded fibre-reinforced polymer (FRP) is intermediate crack (IC) debonding, which is originated at a critical section in the vicinity of flexural cracks and propagates to a plate end. Despite considerable research over the last years, few reliable and simplified IC debonding strength models have been developed. This paper firstly presents a one-dimensional model based on the discrete crack approach for concrete and the spectral element method for the numerical simulation of the IC debonding process. The progressive formation of flexural cracks and subsequent concrete-FRP interfacial debonding is formulated by the introduction of a new element able to represent both phenomena simultaneously without perturbing the numerical procedure. Furthermore, with the proposed model, high frequency dynamic response for these kinds of structures can also be obtained in a very simple and non-expensive way, which makes this procedure very useful as a tool for diagnoses and detection of debonding in its initial stage by monitoring the change in local dynamic characteristics.

Discrete Multi-Criteria Methods for lands use and conservation planning on La Colacha in Arroyos Menores (Río Cuarto, Province of Córdoba, Argentina)

The study area is La Colacha sub-basins from Arroyos Menores basins, natural areas at West and South of Río Cuarto in Province of Córdoba of Argentina, fertile with loess soils and monsoon temperate climate, but with soil erosions including regressive gullies that degrade them progressively. Cultivated gently since some hundred sixty years, coordinated action planning became necessary to conserve lands while keeping good agro-production. The authors had improved data on soils and on hydrology for the study area, evaluated systems of soil uses and actions to be recommended and applied Decision Support Systems (DSS) tools for that, and were conducted to use discrete multi-criteria models (MCDM) for the more global views about soil conservation and hydraulic management actions and about main types of use of soils. For that they used weighted PROMETHEE, ELECTRE, and AHP methods with a system of criteria grouped as environmental, economic and social, and criteria from their data on effects of criteria. The alternatives resulting offer indication for planning depending somehow on sub basins and on selections of weights, but actions for conservation of soils and water management measures are recommended to conserve the basins conditions, actually sensibly degrading, mainly keeping actual uses of the lands.

Decision boundary for discrete Bayesian network classifiers

Bayesian network classifiers are a powerful machine learning tool. In order to evaluate the expressive power of these models, we compute families of polynomials that sign-represent decision functions induced by Bayesian network classifiers. We prove that those families are linear combinations of products of Lagrange basis polynomials. In absence of V -structures in the predictor sub-graph, we are also able to prove that this family of polynomials does indeed characterize the specific classifier considered. We then use this representation to bound the number of decision functions representable by Bayesian network classifiers with a given structure.

Rock friction and its implications for earthquake prediction examined via models of Parkfield earthquakes.

The friction of rocks in the laboratory is a function of time, velocity of sliding, and displacement. Although the processes responsible for these dependencies are unknown, constitutive equations have been developed that do a reasonable job of describing the laboratory behavior. These constitutive laws have been used to create a model of earthquakes at Parkfield, CA, by using boundary conditions appropriate for the section of the fault that slips in magnitude 6 earthquakes every 20-30 years. The behavior of this model prior to the earthquakes is investigated to determine whether or not the model earthquakes could be predicted in the real world by using realistic instruments and instrument locations. Premonitory slip does occur in the model, but it is relatively restricted in time and space and detecting it from the surface may be difficult. The magnitude of the strain rate at the earth's surface due to this accelerating slip seems lower than the detectability limit of instruments in the presence of earth noise. Although not specifically modeled, microseismicity related to the accelerating creep and to creep events in the model should be detectable. In fact the logarithm of the moment rate on the hypocentral cell of the fault due to slip increases linearly with minus the logarithm of the time to the earthquake. This could conceivably be used to determine when the earthquake was going to occur. An unresolved question is whether this pattern of accelerating slip could be recognized from the microseismicity, given the discrete nature of seismic events. Nevertheless, the model results suggest that the most likely solution to earthquake prediction is to look for a pattern of acceleration in microseismicity and thereby identify the microearthquakes as foreshocks.