Mixed-initiative decision support for care planning based on clinical practice guidelines

Care Plan On-Line (CPOL) is an intranet based system that supports a “Coordinated Care” model for chronic/complex disease management. CPOL combines provision of solicited and unsolicited advice features based on integration of the electronic medical record (EMR) with its decision support logic. The objective is to support General Practitioners (GPs) in formulating a 12-month care plan of services such that: (a) the plan is proactive and patient-centered; (b) the GP is kept in awareness of project- and diseasespecific clinical practice guidelines; and (c) the support integrates with GP workflow in a natural fashion. A key feature of our approach is to blur the distinction of EMR and decision support by presenting guidelines in layers with the top-most being a problem-oriented presentation of patient status, progressing on through to patient-independent supporting evidence. In conjunction with a degree of automated inclusion of care planning services, the system demonstrates mixed user and software initiative. We describe the CPOL deployment setting, the challenges of guideline-based clinical decision support, our approach to guideline delivery, and the CPOL architecture.

A scenario-driven decision support system for serious crime investigation

Consideration of a wide range of plausible crime scenarios during any crime investigation is important to seek convincing evidence and hence to minimize the likelihood of miscarriages of justice. It is equally important for crime investigators to be able to employ effective and efficient evidence-collection strategies that are likely to produce the most conclusive information under limited available resources. An intelligent decision support system that can assist human investigators by automatically constructing plausible scenarios, and reasoning with the likely best investigating actions will clearly be very helpful in addressing these challenging problems. This paper presents a system for creating scenario spaces from given evidence, based on an integrated application of techniques for compositional modelling and Bayesian network-based evidence evaluation. Methods of analysis are also provided by the use of entropy to exploit the synthesized scenario spaces in order to prioritize investigating actions and hypotheses. These theoretical developments are illustrated by realistic examples of serious crime investigation.

A decision support tool for resource allocation in batch manufacturing

A decision support tool for production planning is discussed in this paper to perform the job of machine grouping and labour allocation within a machining line. The production plans within the industrial partner have been historically inefficient because the relationship between the cycle times, the machine group size, and the operator's utilisation hasn't been properly understood. Starting with a simulation model, a rule-base has been generated to predict the operator's utilisation for a range of production settings. The resource allocation problem is then solved by breaking the problem into a series of smaller sized tasks. The objective is to minimise the number of operators and the difference between the maximum and minimum cycle times of machines within each group. The results from this decision support tool is presented for the particular case study.

Multiple-criteria decision analysis for integrated catchment management

Implementation of integrated catchment management (ICM) is hampered by the lack of a conceptual framework for explaining how landowners select farming systems for their properties. Benefit–cost analysis (a procedure that estimates the costs and benefits of alternative actions or policies) has limitations in this regard, which might be overcome by using multiple-criteria decision analysis (MCDA). MCDA evaluates and ranks alternatives based on a landowner's preferences (weights) for multiple-criteria and the values of those criteria. A MCDA approach to ICM is superior to benefit–cost analysis which focuses only on the monetary benefits and costs, because it: 1) recognizes that human activities within a catchment are motivated by multiple and often competing criteria and/or constraints; 2) does not require monetary valuation of criteria; 3) allows trade-offs between criteria to be measured and evaluated; 4) explicitly considers how the spatial configuration of farming systems in a catchment influences the values of criteria; 5) is comprehensive, knowledge-based, and stakeholder oriented which greatly increases the likelihood of resolving catchment problems; and 6) allows consideration of the fairness and sustainability of land and water resource management decisions. A MCDA based on an additive, multiple-criteria utility function containing five economic and environmental criteria was used to score and rank five farming systems. The rankings were based on the average criteria weights for a sample of 20 farmers in a US catchment. The most profitable farming system was the lowest-ranked farming system. Three possible reasons for this result are evaluated. First, the MCDA method might cause respondents to express socially acceptable attitudes towards environmental criteria even when they are not important from a personal viewpoint. Second, the MCDA method could inflate the ranks of less profitable farming systems for the simple reason that it allows the respondent to assign non-zero weights to non-economic criteria. Third, the MCDA might provide a better framework for evaluating a landowner's selection of farming systems than the profit maximization model.

The development of a mobile decision support system

The emergence of mobile computing environments brings out various changes in the requirements and applications involving distributed data and has made the traditional Intelligent Decision Support System (IDSS) architectures based on the client/server model ineffective in mobile computing environments. This paper discusses the deficiencies of the current IDSS architectures based on data warehouse, on-line analysis processing (OLAP), model base (MB) and knowledge based (KB) technologies. By adopting the agent technology, the paper extends the IDSS system architecture to the Mobile Decision Support System (MDSS) architecture. The logical structure and the application architecture of the MDSS and the mechanisms and implementation strategies of the User Access Agent System, a major component of the MDSS, are described in this paper.

Interlink decision making index (IDMI) -- a simple tool/concept to assist decision making for sustainability Part 1: definition of IDMI

There is an apparent gap between the LCA or other assessment's outcomes and its effective application in the decision making process. It is needed to provide to the decision makers a simple, less human interfered mechanism that integrates all the key criteria (environmental, economic, technical and safety etc.). The proposed index: Interlink Decision Making Index (IDMI) has all these features: simple, interlink (all criteria) and automatically and quantified influence of critical criteria (ie. no human weighting needed) and is able to assist the multi-criteria decision making for sustainability based on the outcomes of specific assessments (eg. LCA, ElA etc.). The index represents a pure numerical value and does not necessarily have any physical meanings, but it reflects the total merits of a particular option once the normal decision making criteria and (up to two) critical criteria (CC) have been chosen. Then, without arbitrarily weighting process, the comparison and selection of the best possible option, ie. decision can be made based on the derived IDMI results. Two hypothetical examples are presented in part 2 of the paper to demonstrate the application of the IDMI concept and it's differences with the traditional "tabular method" in the decision making process.

Interlink decision making index (IDMI) : a simple tool/concept to assist decision making for sustainability part 2 : calculation and examples of IDMI

There is an apparent gap between the LCA or other assessment's outcomes and its effective application in the decision making process. It is needed to provide to the decision makers a simple, less human interfered mechanism that integrates all the key criteria (environmental, economic, technical and safety etc.). The proposed index: Interlink Decision Making Index (IDMI) has all these features: simple, interlink (all criteria) and automatically and quantified influence of critical criteria (ie. no human weighting needed) and is able to assist the multi-criteria decision making for sustainability based on the outcomes of specific assessments (eg. LCA, BIA etc.). The index represents a pure numerical value and does not necessarily have any physical meanings, but it reflects the total merits of a particular option once the normal decision making criteria and (up to two) critical criteria (Ce) have been chosen. Then, without arbitrarily weighting process, the comparison and selection of the best possible option, ie. decision can be made based on the derived IDMI results. Two hypothetical examples are presented in the part 2 of the paper to demonstrate the application of the IDMI concept and it's differences with the traditional "tabular method" in the decision making process.

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.

Building information modelling project decision support framework

Building Information Modelling (BIM) is an information technology [IT] enabled approach to managing design data in the AEC/FM (Architecture, Engineering and Construction/ Facilities Management) industry. BIM enables improved interdisciplinary collaboration across distributed teams, intelligent documentation and information retrieval, greater consistency in building data, better conflict detection and enhanced facilities management. Despite the apparent benefits the adoption of BIM in practice has been slow. Workshops with industry focus groups were conducted to identify the industry needs, concerns and expectations from participants who had implemented BIM or were BIM “ready”. Factors inhibiting BIM adoption include lack of training, low business incentives, perception of lack of rewards, technological concerns, industry fragmentation related to uneven ICT adoption practices, contractual matters and resistance to changing current work practice. Successful BIM usage depends on collective adoption of BIM across the different disciplines and support by the client. The relationship of current work practices to future BIM scenarios was identified as an important strategy as the participants believed that BIM cannot be efficiently used with traditional practices and methods. The key to successful implementation is to explore the extent to which current work practices must change. Currently there is a perception that all work practices and processes must adopt and change for effective usage of BIM. It is acknowledged that new roles and responsibilities are emerging and that different parties will lead BIM on different projects. A contingency based approach to the problem of implementation was taken which relies upon integration of BIM project champion, procurement strategy, team capability analysis, commercial software availability/applicability and phase decision making and event analysis. Organizations need to understand: (a) their own work processes and requirements; (b) the range of BIM applications available in the market and their capabilities (c) the potential benefits of different BIM applications and their roles in different phases of the project lifecycle, and (d) collective supply chain adoption capabilities. A framework is proposed to support organizations selection of BIM usage strategies that meet their project requirements. Case studies are being conducted to develop the framework. The results of the preliminary design management case study is presented for contractor led BIM specific to the design and construct procurement strategy.

Neurofuzzy decision support system for efficient risk allocation in public-private partnership infrastructure projects

The performance of public-private partnership (PPP) infrastructure projects is largely contingent on whether the adopted risk allocation (RA) strategy is efficient. Theoretical frameworks drawing on the transaction cost economics and the resource-based view of organizational capability are able to explain the underlying mechanism but unable to accurately forecast efficient RA strategies. In this paper, a neurofuzzy decision support system (NFDSS) was developed to assist in the RA decision-making process in PPP projects. By combining fuzzy and neural network techniques, a synthesized fuzzy inference system was established and taken as the core component of the NFDSS. Evaluation results show that the NFDSS can forecast efficient RA strategies for PPP infrastructure projects at a highly accurate and effective level. A real PPP infrastructure project is used to demonstrate the NFDSS and its practical significance.