Design and implementation of a multicriteria medical decision support system for diagnosis and treatment

Health care providers face the problem of trying to make decisions with inadequate information and also with an overload of (often contradictory) information. Physicians often choose treatment long before they know which disease is present. Indeed, uncertainty is intrinsic to the practice of medicine. Decision analysis can help physicians structure and work through a medical decision problem, and can provide reassurance that decisions are rational and consistent with the beliefs and preferences of other physicians and patients. ^ The primary purpose of this research project is to develop the theory, methods, techniques and tools necessary for designing and implementing a system to support solving medical decision problems. A case study involving “abdominal pain” serves as a prototype for implementing the system. The research, however, focuses on a generic class of problems and aims at covering theoretical as well as practical aspects of the system developed. ^ The main contributions of this research are: (1) bridging the gap between the statistical approach and the knowledge-based (expert) approach to medical decision making; (2) linking a collection of methods, techniques and tools together to allow for the design of a medical decision support system, based on a framework that involves the Analytic Network Process (ANP), the generalization of the Analytic Hierarchy Process (AHP) to dependence and feedback, for problems involving diagnosis and treatment; (3) enhancing the representation and manipulation of uncertainty in the ANP framework by incorporating group consensus weights; and (4) developing a computer program to assist in the implementation of the system. ^

El problema del rozamiento en el análisis de estructuras de fábrica mediante modelos de sólidos rígidos

La evaluación de la seguridad de estructuras antiguas de fábrica es un problema abierto.El material es heterogéneo y anisótropo, el estado previo de tensiones difícil de conocer y las condiciones de contorno inciertas. A comienzos de los años 50 se demostró que el análisis límite era aplicable a este tipo de estructuras, considerándose desde entonces como una herramienta adecuada. En los casos en los que no se produce deslizamiento la aplicación de los teoremas del análisis límite estándar constituye una herramienta formidable por su simplicidad y robustez. No es necesario conocer el estado real de tensiones. Basta con encontrar cualquier solución de equilibrio, y que satisfaga las condiciones de límite del material, en la seguridad de que su carga será igual o inferior a la carga real de inicio de colapso. Además esta carga de inicio de colapso es única (teorema de la unicidad) y se puede obtener como el óptimo de uno cualquiera entre un par de programas matemáticos convexos duales. Sin embargo, cuando puedan existir mecanismos de inicio de colapso que impliquen deslizamientos, cualquier solución debe satisfacer tanto las restricciones estáticas como las cinemáticas, así como un tipo especial de restricciones disyuntivas que ligan las anteriores y que pueden plantearse como de complementariedad. En este último caso no está asegurada la existencia de una solución única, por lo que es necesaria la búsqueda de otros métodos para tratar la incertidumbre asociada a su multiplicidad. En los últimos años, la investigación se ha centrado en la búsqueda de un mínimo absoluto por debajo del cual el colapso sea imposible. Este método es fácil de plantear desde el punto de vista matemático, pero intratable computacionalmente, debido a las restricciones de complementariedad 0 y z 0 que no son ni convexas ni suaves. El problema de decisión resultante es de complejidad computacional No determinista Polinomial (NP)- completo y el problema de optimización global NP-difícil. A pesar de ello, obtener una solución (sin garantía de exito) es un problema asequible. La presente tesis propone resolver el problema mediante Programación Lineal Secuencial, aprovechando las especiales características de las restricciones de complementariedad, que escritas en forma bilineal son del tipo y z = 0; y 0; z 0 , y aprovechando que el error de complementariedad (en forma bilineal) es una función de penalización exacta. Pero cuando se trata de encontrar la peor solución, el problema de optimización global equivalente es intratable (NP-difícil). Además, en tanto no se demuestre la existencia de un principio de máximo o mínimo, existe la duda de que el esfuerzo empleado en aproximar este mínimo esté justificado. En el capítulo 5, se propone hallar la distribución de frecuencias del factor de carga, para todas las soluciones de inicio de colapso posibles, sobre un sencillo ejemplo. Para ello, se realiza un muestreo de soluciones mediante el método de Monte Carlo, utilizando como contraste un método exacto de computación de politopos. El objetivo final es plantear hasta que punto está justificada la busqueda del mínimo absoluto y proponer un método alternativo de evaluación de la seguridad basado en probabilidades. Las distribuciones de frecuencias, de los factores de carga correspondientes a las soluciones de inicio de colapso obtenidas para el caso estudiado, muestran que tanto el valor máximo como el mínimo de los factores de carga son muy infrecuentes, y tanto más, cuanto más perfecto y contínuo es el contacto. Los resultados obtenidos confirman el interés de desarrollar nuevos métodos probabilistas. En el capítulo 6, se propone un método de este tipo basado en la obtención de múltiples soluciones, desde puntos de partida aleatorios y calificando los resultados mediante la Estadística de Orden. El propósito es determinar la probabilidad de inicio de colapso para cada solución.El método se aplica (de acuerdo a la reducción de expectativas propuesta por la Optimización Ordinal) para obtener una solución que se encuentre en un porcentaje determinado de las peores. Finalmente, en el capítulo 7, se proponen métodos híbridos, incorporando metaheurísticas, para los casos en que la búsqueda del mínimo global esté justificada. Abstract Safety assessment of the historic masonry structures is an open problem. The material is heterogeneous and anisotropic, the previous state of stress is hard to know and the boundary conditions are uncertain. In the early 50's it was proven that limit analysis was applicable to this kind of structures, being considered a suitable tool since then. In cases where no slip occurs, the application of the standard limit analysis theorems constitutes an excellent tool due to its simplicity and robustness. It is enough find any equilibrium solution which satisfy the limit constraints of the material. As we are certain that this load will be equal to or less than the actual load of the onset of collapse, it is not necessary to know the actual stresses state. Furthermore this load for the onset of collapse is unique (uniqueness theorem), and it can be obtained as the optimal from any of two mathematical convex duals programs However, if the mechanisms of the onset of collapse involve sliding, any solution must satisfy both static and kinematic constraints, and also a special kind of disjunctive constraints linking the previous ones, which can be formulated as complementarity constraints. In the latter case, it is not guaranted the existence of a single solution, so it is necessary to look for other ways to treat the uncertainty associated with its multiplicity. In recent years, research has been focused on finding an absolute minimum below which collapse is impossible. This method is easy to set from a mathematical point of view, but computationally intractable. This is due to the complementarity constraints 0 y z 0 , which are neither convex nor smooth. The computational complexity of the resulting decision problem is "Not-deterministic Polynomialcomplete" (NP-complete), and the corresponding global optimization problem is NP-hard. However, obtaining a solution (success is not guaranteed) is an affordable problem. This thesis proposes solve that problem through Successive Linear Programming: taking advantage of the special characteristics of complementarity constraints, which written in bilinear form are y z = 0; y 0; z 0 ; and taking advantage of the fact that the complementarity error (bilinear form) is an exact penalty function. But when it comes to finding the worst solution, the (equivalent) global optimization problem is intractable (NP-hard). Furthermore, until a minimum or maximum principle is not demonstrated, it is questionable that the effort expended in approximating this minimum is justified. XIV In chapter 5, it is proposed find the frequency distribution of the load factor, for all possible solutions of the onset of collapse, on a simple example. For this purpose, a Monte Carlo sampling of solutions is performed using a contrast method "exact computation of polytopes". The ultimate goal is to determine to which extent the search of the global minimum is justified, and to propose an alternative approach to safety assessment based on probabilities. The frequency distributions for the case study show that both the maximum and the minimum load factors are very infrequent, especially when the contact gets more perfect and more continuous. The results indicates the interest of developing new probabilistic methods. In Chapter 6, is proposed a method based on multiple solutions obtained from random starting points, and qualifying the results through Order Statistics. The purpose is to determine the probability for each solution of the onset of collapse. The method is applied (according to expectations reduction given by the Ordinal Optimization) to obtain a solution that is in a certain percentage of the worst. Finally, in Chapter 7, hybrid methods incorporating metaheuristics are proposed for cases in which the search for the global minimum is justified.

Phase transition in the countdown problem

We present a combinatorial decision problem, inspired by the celebrated quiz show called Countdown, that involves the computation of a given target number T from a set of k randomly chosen integers along with a set of arithmetic operations. We find that the probability of winning the game evidences a threshold phenomenon that can be understood in the terms of an algorithmic phase transition as a function of the set size k. Numerical simulations show that such probability sharply transitions from zero to one at some critical value of the control parameter, hence separating the algorithm's parameter space in different phases. We also find that the system is maximally efficient close to the critical point. We derive analytical expressions that match the numerical results for finite size and permit us to extrapolate the behavior in the thermodynamic limit.

A decision model for it supplier selection

En los últimos años la externalización de TI ha ganado mucha importancia en el mercado y, por ejemplo, el mercado externalización de servicios de TI sigue creciendo cada año. Ahora más que nunca, las organizaciones son cada vez más los compradores de las capacidades necesarias mediante la obtención de productos y servicios de los proveedores, desarrollando cada vez menos estas capacidades dentro de la empresa. La selección de proveedores de TI es un problema de decisión complejo. Los gerentes que enfrentan una decisión sobre la selección de proveedores de TI tienen dificultades en la elaboración de lo que hay que pensar, además en sus discursos. También de acuerdo con un estudio del SEI (Software Engineering Institute) [40], del 20 al 25 por ciento de los grandes proyectos de adquisición de TI fracasan en dos años y el 50 por ciento fracasan dentro de cinco años. La mala gestión, la mala definición de requisitos, la falta de evaluaciones exhaustivas, que pueden ser utilizadas para llegar a los mejores candidatos para la contratación externa, la selección de proveedores y los procesos de contratación inadecuados, la insuficiencia de procedimientos de selección tecnológicos, y los cambios de requisitos no controlados son factores que contribuyen al fracaso del proyecto. La mayoría de los fracasos podrían evitarse si el cliente aprendiese a comprender los problemas de decisión, hacer un mejor análisis de decisiones, y el buen juicio. El objetivo principal de este trabajo es el desarrollo de un modelo de decisión para la selección de proveedores de TI que tratará de reducir la cantidad de fracasos observados en las relaciones entre el cliente y el proveedor. La mayor parte de estos fracasos son causados por una mala selección, por parte del cliente, del proveedor. Además de estos problemas mostrados anteriormente, la motivación para crear este trabajo es la inexistencia de cualquier modelo de decisión basado en un multi modelo (mezcla de modelos adquisición y métodos de decisión) para el problema de la selección de proveedores de TI. En el caso de estudio, nueve empresas españolas fueron analizadas de acuerdo con el modelo de decisión para la selección de proveedores de TI desarrollado en este trabajo. Dos softwares se utilizaron en este estudio de caso: Expert Choice, y D-Sight. ABSTRACT In the past few years IT outsourcing has gained a lot of importance in the market and, for example, the IT services outsourcing market is still growing every year. Now more than ever, organizations are increasingly becoming acquirers of needed capabilities by obtaining products and services from suppliers and developing less and less of these capabilities in-house. IT supplier selection is a complex and opaque decision problem. Managers facing a decision about IT supplier selection have difficulty in framing what needs to be thought about further in their discourses. Also according to a study from SEI (Software Engineering Institute) [40], 20 to 25 percent of large information technology (IT) acquisition projects fail within two years and 50 percent fail within five years. Mismanagement, poor requirements definition, lack of comprehensive evaluations, which can be used to come up with the best candidates for outsourcing, inadequate supplier selection and contracting processes, insufficient technology selection procedures, and uncontrolled requirements changes are factors that contribute to project failure. The majority of project failures could be avoided if the acquirer learns how to understand the decision problems, make better decision analysis, and good judgment. The main objective of this work is the development of a decision model for IT supplier selection that will try to decrease the amount of failures seen in the relationships between the client-supplier. Most of these failures are caused by a not well selection of the supplier. Besides these problems showed above, the motivation to create this work is the inexistence of any decision model based on multi model (mixture of acquisition models and decision methods) for the problem of IT supplier selection. In the case study, nine different Spanish companies were analyzed based on the IT supplier selection decision model developed in this work. Two software products were used in this case study, Expert Choice and D-Sight.

Phase transitions in number theory: from the birthday problem to Sidon sets

In this work, we show how number theoretical problems can be fruitfully approached with the tools of statistical physics. We focus on g-Sidon sets, which describe sequences of integers whose pairwise sums are different, and propose a random decision problem which addresses the probability of a random set of k integers to be g-Sidon. First, we provide numerical evidence showing that there is a crossover between satisfiable and unsatisfiable phases which converts to an abrupt phase transition in a properly defined thermodynamic limit. Initially assuming independence, we then develop a mean-field theory for the g-Sidon decision problem. We further improve the mean-field theory, which is only qualitatively correct, by incorporating deviations from independence, yielding results in good quantitative agreement with the numerics for both finite systems and in the thermodynamic limit. Connections between the generalized birthday problem in probability theory, the number theory of Sidon sets and the properties of q-Potts models in condensed matter physics are briefly discussed

Stability analysis of tree structured decision functions

In multicriteria decision problems many values must be assigned, such as the importance of the different criteria and the values of the alternatives with respect to subjective criteria. Since these assignments are approximate, it is very important to analyze the sensitivity of results when small modifications of the assignments are made. When solving a multicriteria decision problem, it is desirable to choose a decision function that leads to a solution as stable as possible. We propose here a method based on genetic programming that produces better decision functions than the commonly used ones. The theoretical expectations are validated by case studies. © 2003 Elsevier B.V. All rights reserved.

What are dynamic optimization problems?

Dynamic Optimization Problems (DOPs) have been widely studied using Evolutionary Algorithms (EAs). Yet, a clear and rigorous definition of DOPs is lacking in the Evolutionary Dynamic Optimization (EDO) community. In this paper, we propose a unified definition of DOPs based on the idea of multiple-decision-making discussed in the Reinforcement Learning (RL) community. We draw a connection between EDO and RL by arguing that both of them are studying DOPs according to our definition of DOPs. We point out that existing EDO or RL research has been mainly focused on some types of DOPs. A conceptualized benchmark problem, which is aimed at the systematic study of various DOPs, is then developed. Some interesting experimental studies on the benchmark reveal that EDO and RL methods are specialized in certain types of DOPs and more importantly new algorithms for DOPs can be developed by combining the strength of both EDO and RL methods.

A decision support framework for infrastructure maintenance investment decision-making

Infrastructure management agencies are facing multiple challenges, including aging infrastructure, reduction in capacity of existing infrastructure, and availability of limited funds. Therefore, decision makers are required to think innovatively and develop inventive ways of using available funds. Maintenance investment decisions are generally made based on physical condition only. It is important to understand that spending money on public infrastructure is synonymous with spending money on people themselves. This also requires consideration of decision parameters, in addition to physical condition, such as strategic importance, socioeconomic contribution and infrastructure utilization. Consideration of multiple decision parameters for infrastructure maintenance investments can be beneficial in case of limited funding. Given this motivation, this dissertation presents a prototype decision support framework to evaluate trade-off, among competing infrastructures, that are candidates for infrastructure maintenance, repair and rehabilitation investments. Decision parameters' performances measured through various factors are combined to determine the integrated state of an infrastructure using Multi-Attribute Utility Theory (MAUT). The integrated state, cost and benefit estimates of probable maintenance actions are utilized alongside expert opinion to develop transition probability and reward matrices for each probable maintenance action for a particular candidate infrastructure. These matrices are then used as an input to the Markov Decision Process (MDP) for the finite-stage dynamic programming model to perform project (candidate)-level analysis to determine optimized maintenance strategies based on reward maximization. The outcomes of project (candidate)-level analysis are then utilized to perform network-level analysis taking the portfolio management approach to determine a suitable portfolio under budgetary constraints. The major decision support outcomes of the prototype framework include performance trend curves, decision logic maps, and a network-level maintenance investment plan for the upcoming years. The framework has been implemented with a set of bridges considered as a network with the assistance of the Pima County DOT, AZ. It is expected that the concept of this prototype framework can help infrastructure management agencies better manage their available funds for maintenance.

Towards a model for exploring the relationship between managerial decision problems and decision support opportunities

The organisational decision making environment is complex, and decision makers must deal with uncertainty and ambiguity on a continuous basis. Managing and handling decision problems and implementing a solution, requires an understanding of the complexity of the decision domain to the point where the problem and its complexity, as well as the requirements for supporting decision makers, can be described. Research in the Decision Support Systems domain has been extensive over the last thirty years with an emphasis on the development of further technology and better applications on the one hand, and on the other hand, a social approach focusing on understanding what decision making is about and how developers and users should interact. This research project considers a combined approach that endeavours to understand the thinking behind managers’ decision making, as well as their informational and decisional guidance and decision support requirements. This research utilises a cognitive framework, developed in 1985 by Humphreys and Berkeley that juxtaposes the mental processes and ideas of decision problem definition and problem solution that are developed in tandem through cognitive refinement of the problem, based on the analysis and judgement of the decision maker. The framework facilitates the separation of what is essentially a continuous process, into five distinct levels of abstraction of manager’s thinking, and suggests a structure for the underlying cognitive activities. Alter (2004) argues that decision support provides a richer basis than decision support systems, in both practice and research. The constituent literature on decision support, especially in regard to modern high profile systems, including Business Intelligence and Business analytics, can give the impression that all ‘smart’ organisations utilise decision support and data analytics capabilities for all of their key decision making activities. However this empirical investigation indicates a very different reality.

Decision Making for Teams of Mobile Robots

In the past years, we could observe a significant amount of new robotic systems in science, industry, and everyday life. To reduce the complexity of these systems, the industry constructs robots that are designated for the execution of a specific task such as vacuum cleaning, autonomous driving, observation, or transportation operations. As a result, such robotic systems need to combine their capabilities to accomplish complex tasks that exceed the abilities of individual robots. However, to achieve emergent cooperative behavior, multi-robot systems require a decision process that copes with the communication challenges of the application domain. This work investigates a distributed multi-robot decision process, which addresses unreliable and transient communication. This process composed by five steps, which we embedded into the ALICA multi-agent coordination language guided by the PROViDE negotiation middleware. The first step encompasses the specification of the decision problem, which is an integral part of the ALICA implementation. In our decision process, we describe multi-robot problems by continuous nonlinear constraint satisfaction problems. The second step addresses the calculation of solution proposals for this problem specification. Here, we propose an efficient solution algorithm that integrates incomplete local search and interval propagation techniques into a satisfiability solver, which forms a satisfiability modulo theories (SMT) solver. In the third decision step, the PROViDE middleware replicates the solution proposals among the robots. This replication process is parameterized with a distribution method, which determines the consistency properties of the proposals. In a fourth step, we investigate the conflict resolution. Therefore, an acceptance method ensures that each robot supports one of the replicated proposals. As we integrated the conflict resolution into the replication process, a sound selection of the distribution and acceptance methods leads to an eventual convergence of the robot proposals. In order to avoid the execution of conflicting proposals, the last step comprises a decision method, which selects a proposal for implementation in case the conflict resolution fails. The evaluation of our work shows that the usage of incomplete solution techniques of the constraint satisfaction solver outperforms the runtime of other state-of-the-art approaches for many typical robotic problems. We further show by experimental setups and practical application in the RoboCup environment that our decision process is suitable for making quick decisions in the presence of packet loss and delay. Moreover, PROViDE requires less memory and bandwidth compared to other state-of-the-art middleware approaches.

Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting

Background: The Analytic Hierarchy Process (AHP), developed by Saaty in the late 1970s, is one of the methods for multi-criteria decision making. The AHP disaggregates a complex decision problem into different hierarchical levels. The weight for each criterion and alternative are judged in pairwise comparisons and priorities are calculated by the Eigenvector method. The slowly increasing application of the AHP was the motivation for this study to explore the current state of its methodology in the healthcare context. Methods: A systematic literature review was conducted by searching the Pubmed and Web of Science databases for articles with the following keywords in their titles or abstracts: "Analytic Hierarchy Process," "Analytical Hierarchy Process," "multi-criteria decision analysis," "multiple criteria decision," "stated preference," and "pairwise comparison." In addition, we developed reporting criteria to indicate whether the authors reported important aspects and evaluated the resulting studies' reporting. Results: The systematic review resulted in 121 articles. The number of studies applying AHP has increased since 2005. Most studies were from Asia (almost 30 %), followed by the US (25.6 %). On average, the studies used 19.64 criteria throughout their hierarchical levels. Furthermore, we restricted a detailed analysis to those articles published within the last 5 years (n = 69). The mean of participants in these studies were 109, whereas we identified major differences in how the surveys were conducted. The evaluation of reporting showed that the mean of reported elements was about 6.75 out of 10. Thus, 12 out of 69 studies reported less than half of the criteria. Conclusion: The AHP has been applied inconsistently in healthcare research. A minority of studies described all the relevant aspects. Thus, the statements in this review may be biased, as they are restricted to the information available in the papers. Hence, further research is required to discover who should be interviewed and how, how inconsistent answers should be dealt with, and how the outcome and stability of the results should be presented. In addition, we need new insights to determine which target group can best handle the challenges of the AHP. © 2015 Schmidt et al.

Designing Efficient Subsidy Policies in a Regional Economy: A Multicriteria Decision-Making (MCDM)-Computable General Equilibrium (CGE) Approach

Since policy-makers usually pursue several conflicting objectives, policy-making can be understood as a multicriteria decision problem. Following the methodological proposal by André and Cardenete (2005) André, F. J. and Cardenete, M. A. 2005. Multicriteria Policy Making. Defining Efficient Policies in a General Equilibrium Model, Seville: Centro de Estudios Andaluces. Working Paper No. E2005/04, multi-objective programming is used in connection with a computable general equilibrium model to represent optimal policy-making and to obtain so-called efficient policies in an application to a regional economy (Andalusia, Spain). This approach is applied to the design of subsidy policies under two different scenarios. In the first scenario, it is assumed that the government is concerned just about two objectives: ensuring the profitability of a key strategic sector and increasing overall output. Finally, the scope of the exercise is enlarged by solving a problem with seven policy objectives, including both general and sectorial objectives. It is concluded that the observed policy could have been Pareto-improved in several directions.

Definition of priority areas for forest conservation through the ordered weighted averaging method

The general objective of this study was to evaluate the ordered weighted averaging (OWA) method, integrated to a geographic information systems (GIS), in the definition of priority areas for forest conservation in a Brazilian river basin, aiming at to increase the regional biodiversity. We demonstrated how one could obtain a range of alternatives by applying OWA, including the one obtained by the weighted linear combination method and, also the use of the analytic hierarchy process (AHP) to structure the decision problem and to assign the importance to each criterion. The criteria considered important to this study were: proximity to forest patches; proximity among forest patches with larger core area; proximity to surface water; distance from roads: distance from urban areas; and vulnerability to erosion. OWA requires two sets of criteria weights: the weights of relative criterion importance and the order weights. Thus, Participatory Technique was used to define the criteria set and the criterion importance (based in AHP). In order to obtain the second set of weights we considered the influence of each criterion, as well as the importance of each one, on this decision-making process. The sensitivity analysis indicated coherence among the criterion importance weights, the order weights, and the solution. According to this analysis, only the proximity to surface water criterion is not important to identify priority areas for forest conservation. Finally, we can highlight that the OWA method is flexible, easy to be implemented and, mainly, it facilitates a better understanding of the alternative land-use suitability patterns. (C) 2008 Elsevier B.V. All rights reserved.

Structure optimization combining soft-core interaction functions, the diffusion equation method, and molecular dynamics

Smoothing the potential energy surface for structure optimization is a general and commonly applied strategy. We propose a combination of soft-core potential energy functions and a variation of the diffusion equation method to smooth potential energy surfaces, which is applicable to complex systems such as protein structures; The performance of the method was demonstrated by comparison with simulated annealing using the refinement of the undecapeptide Cyclosporin A as a test case. Simulations were repeated many times using different initial conditions and structures since the methods are heuristic and results are only meaningful in a statistical sense.

An heuristic approach for optimal location of gas supply units in transportation system

The best places to locate the Gas Supply Units (GSUs) on a natural gas systems and their optimal allocation to loads are the key factors to organize an efficient upstream gas infrastructure. The number of GSUs and their optimal location in a gas network is a decision problem that can be formulated as a linear programming problem. Our emphasis is on the formulation and use of a suitable location model, reflecting real-world operations and constraints of a natural gas system. This paper presents a heuristic model, based on lagrangean approach, developed for finding the optimal GSUs location on a natural gas network, minimizing expenses and maximizing throughput and security of supply.The location model is applied to the Iberian high pressure natural gas network, a system modelised with 65 demand nodes. These nodes are linked by physical and virtual pipelines – road trucks with gas in liquefied form. The location model result shows the best places to locate, with the optimal demand allocation and the most economical gas transport mode: by pipeline or by road truck.