Monitoring Programmes, Multiple Stress Analysis and Decision Support for River Basin Management

The identification of plausible causes for water body status deterioration will be much easier if it can build on available, reliable, extensive and comprehensive biogeochemical monitoring data (preferably aggregated in a database). A plausible identification of such causes is a prerequisite for well-informed decisions on which mitigation or remediation measures to take. In this chapter, first a rationale for an extended monitoring programme is provided; it is then compared to the one required by the Water Framework Directive (WFD). This proposal includes a list of relevant parameters that are needed for an integrated, a priori status assessment. Secondly, a few sophisticated statistical tools are described that subsequently allow for the estiation of the magnitude of impairment as well as the likely relative importance of different stressors in a multiple stressed environment. The advantages and restrictions of these rather complicated analytical methods are discussed. Finally, the use of Decision Support Systems (DSS) is advocated with regard to the specific WFD implementation requirements.

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. ^

Building a decision support system with a knowledge modeling tool

Knowledge modeling tools are software tools that follow a modeling approach to help developers in building a knowledge-based system. The purpose of this article is to show the advantages of using this type of tools in the development of complex knowledge-based decision support systems. In order to do so, the article describes the development of a system called SAIDA in the domain of hydrology with the help of the KSM modeling tool. SAIDA operates on real-time receiving data recorded by sensors (rainfall, water levels, flows, etc.). It follows a multi-agent architecture to interpret the data, predict the future behavior and recommend control actions. The system includes an advanced knowledge based architecture with multiple symbolic representation. KSM was especially useful to design and implement the complex knowledge based architecture in an efficient way.

TITIM GIS-tool: A GIS-based decision support system for measuring the territorial impact of transport infrastructures

To achieve sustainability in the area of transport we need to view the decision-making process as a whole and consider all the most important socio-economic and environmental aspects involved. Improvements in transport infrastructures have a positive impact on regional development and significant repercussions on the economy, as well as affecting a large number of ecological processes. This article presents a DSS to assess the territorial effects of new linear transport infrastructures based on the use of GIS. The TITIM ? Transport Infrastructure Territorial Impact Measurement ? GIS tool allows these effects to be calculated by evaluating the improvement in accessibility, loss of landscape connectivity, and the impact on other local territorial variables such as landscape quality, biodiversity and land-use quality. The TITIM GIS tool assesses these variables automatically, simply by entering the required inputs, and thus avoiding the manual reiteration and execution of these multiple processes. TITIM allows researchers to use their own GIS databases as inputs, in contrast with other tools that use official or predefined maps. The TITIM GIS-tool is tested by application to six HSR projects in the Spanish Strategic Transport and Infrastructure Plan 2005?2020 (PEIT). The tool creates all 65 possible combinations of these projects, which will be the real test scenarios. For each one, the tool calculates the accessibility improvement, the landscape connectivity loss, and the impact on the landscape, biodiversity and land-use quality. The results reveal which of the HSR projects causes the greatest benefit to the transport system, any potential synergies that exist, and help define a priority for implementing the infrastructures in the plan

A methodology for implementing a decision support system:a small company case study

The importance of non-technical factors in the design and implementation of information systems has been increasingly recognised by both researchers and practitioners, and recent literature highlights the need for new tools and techniques with an organisational, rather than technical, focus. The gap between what is technically possible and what is generally practised, is particularly wide in the sales and marketing field. This research describes the design and implementation of a decision support system (DSS) for marketing planning and control in a small, but complex company and examines the nature of the difficulties encountered. An intermediary with functional, rather than technical, expertise is used as a strategy for overcoming these by taking control of the whole of the systems design and implementation cycle. Given the practical nature of the research, an action research approach is adopted with the researcher undertaking this role. This approach provides a detailed case study of what actually happens during the DSS development cycle, allowing the influence of organisational factors to be captured. The findings of the research show how the main focus of the intermediary's role needs to be adapted over the systems development cycle; from coordination and liaison in the pre-design and design stages, to systems champion during the first part of the implementation stage, and finally to catalyst to ensure that the DSS is integrated into the decision-making process. Two practical marketing exercises are undertaken which illustrate the nature of the gap between the provision of information and its use. The lack of a formal approach to planning and control is shown to have a significant effect on the way the DSS is used and the role of the intermediary is extended successfully to accommodate this factor. This leads to the conclusion that for the DSS to play a fully effective role, small firms may need to introduce more structure into their marketing planning, and that the role of the intermediary, or Information Coordinator, should include the responsibility for introducing new techniques and ideas to aid with this.

Knowledge engineering for mental-health risk assessment and decision support

Mental-health risk assessment practice in the UK is mainly paper-based, with little standardisation in the tools that are used across the Services. The tools that are available tend to rely on minimal sets of items and unsophisticated scoring methods to identify at-risk individuals. This means the reasoning by which an outcome has been determined remains uncertain. Consequently, there is little provision for: including the patient as an active party in the assessment process, identifying underlying causes of risk, and eecting shared decision-making. This thesis develops a tool-chain for the formulation and deployment of a computerised clinical decision support system for mental-health risk assessment. The resultant tool, GRiST, will be based on consensual domain expert knowledge that will be validated as part of the research, and will incorporate a proven psychological model of classication for risk computation. GRiST will have an ambitious remit of being a platform that can be used over the Internet, by both the clinician and the layperson, in multiple settings, and in the assessment of patients with varying demographics. Flexibility will therefore be a guiding principle in the development of the platform, to the extent that GRiST will present an assessment environment that is tailored to the circumstances in which it nds itself. XML and XSLT will be the key technologies that help deliver this exibility.

Defining an OWL ontology that could be used to integrate mental-health risk information within a decision support system

In the field of mental health risk assessment, there is no standardisation between the data used in different systems. As a first step towards the possible interchange of data between assessment tools, an ontology has been constructed for a particular one, GRiST (Galatean Risk Screening Tool). We briefly introduce GRiST and its data structures, then describe the ontology and the benefits that have already been realised from the construction process. For example, the ontology has been used to check the consistency of the various trees used in the model. We then consider potential uses in integration of data from other sources. © 2009 IEEE.

Psychological cue use and implications for a clinical decision support system

Effective clinical decision making depends upon identifying possible outcomes for a patient, selecting relevant cues, and processing the cues to arrive at accurate judgements of each outcome's probability of occurrence. These activities can be considered as classification tasks. This paper describes a new model of psychological classification that explains how people use cues to determine class or outcome likelihoods. It proposes that clinicians respond to conditional probabilities of outcomes given cues and that these probabilities compete with each other for influence on classification. The model explains why people appear to respond to base rates inappropriately, thereby overestimating the occurrence of rare categories, and a clinical example is provided for predicting suicide risk. The model makes an effective representation for expert clinical judgements and its psychological validity enables it to generate explanations in a form that is comprehensible to clinicians. It is a strong candidate for incorporation within a decision support system for mental-health risk assessment, where it can link with statistical and pattern recognition tools applied to a database of patients. The symbiotic combination of empirical evidence and clinical expertise can provide an important web-based resource for risk assessment, including multi-disciplinary education and training. © 2002 Informa UK Ltd All rights reserved.

The Fuzzy-Neuro Classifier for Decision Support

This paper aims at development of procedures and algorithms for application of artificial intelligence tools to acquire process and analyze various types of knowledge. The proposed environment integrates techniques of knowledge and decision process modeling such as neural networks and fuzzy logic-based reasoning methods. The problem of an identification of complex processes with the use of neuro-fuzzy systems is solved. The proposed classifier has been successfully applied for building one decision support systems for solving managerial problem.

Support tools for paediatric inpatient prescribers:a review

Prescribing support for paediatrics is diverse and includes both standard texts and electronic tools. Evidence concerning who should be supported and by what method is limited. This review aims to collate the current information available on prescribing support in paediatrics. Many tools designed to support prescribers are technology based. For example, electronic prescribing and smart phone applications. There is a focus on prescriber education both at undergraduate and postgraduate level. In the UK, the majority of inpatient prescribing is done by junior medical staff. It is important to ensure they are competent on qualification and supported in this role. A UK national prescribing assessment is being trialled to test for competence on graduation and there are also tools available to test paediatric prescribing after qualification. No information is available on the tools and resources UK prescribers currently use to support their decision making. One US study reported a decrease in the availability of paediatric prescribing information in a popular reference text. There is limited evidence to show that decisionsupport tools improve patient outcomes, however, there is growing confirmation that electronic prescribing reduces medication errors. There have been reports of new error types, such as selection errors, occurring with the use of electronic prescribing. Another concern with computerised decision-support systems is deciding what alerts should be presented to the prescriber and when/how often in order to avoid alert fatigue. There is little published concerning paediatric alerts perhaps as a consequence of commercial systems often not including paediatric specific support.

A Real-time Decision Support System Prototype for Management of a Power Block

This paper describes the basic tools for a real-time decision support system of a semiotic type on the example of the prototype for management and monitoring of a nuclear power block implemented on the basis of the tool complex G2+GDA using cognitive graphics and parallel processing. This work was supported by RFBR (project 02-07-90042).

Reasoning by Structural Analogy Taking into Account the Context for Intelligent Decision Support Systems

Development of methods and tools for modeling human reasoning (common sense reasoning) by analogy in intelligent decision support systems is considered. Special attention is drawn to modeling reasoning by structural analogy taking the context into account. The possibility of estimating the obtained analogies taking into account the context is studied. This work was supported by RFBR.

Representing human expertise by the OWL web ontology language to support knowledge engineering in decision support systems

Clinical decision support systems (CDSSs) often base their knowledge and advice on human expertise. Knowledge representation needs to be in a format that can be easily understood by human users as well as supporting ongoing knowledge engineering, including evolution and consistency of knowledge. This paper reports on the development of an ontology specification for managing knowledge engineering in a CDSS for assessing and managing risks associated with mental-health problems. The Galatean Risk and Safety Tool, GRiST, represents mental-health expertise in the form of a psychological model of classification. The hierarchical structure was directly represented in the machine using an XML document. Functionality of the model and knowledge management were controlled using attributes in the XML nodes, with an accompanying paper manual for specifying how end-user tools should behave when interfacing with the XML. This paper explains the advantages of using the web-ontology language, OWL, as the specification, details some of the issues and problems encountered in translating the psychological model to OWL, and shows how OWL benefits knowledge engineering. The conclusions are that OWL can have an important role in managing complex knowledge domains for systems based on human expertise without impeding the end-users' understanding of the knowledge base. The generic classification model underpinning GRiST makes it applicable to many decision domains and the accompanying OWL specification facilitates its implementation.

Decision support based on genomics:integration of data-and knowledge-driven reasoning

The breadth and depth of available clinico-genomic information, present an enormous opportunity for improving our ability to study disease mechanisms and meet the individualised medicine needs. A difficulty occurs when the results are to be transferred 'from bench to bedside'. Diversity of methods is one of the causes, but the most critical one relates to our inability to share and jointly exploit data and tools. This paper presents a perspective on current state-of-the-art in the analysis of clinico-genomic data and its relevance to medical decision support. It is an attempt to investigate the issues related to data and knowledge integration. Copyright © 2010 Inderscience Enterprises Ltd.

A simulation-based decision support system for evaluating operating policies in an emergency room facility

Increased pressure to control costs and increased competition has prompted health care managers to look for tools to effectively operate their institutions. This research sought a framework for the development of a Simulation-Based Decision Support System (SB-DSS) to evaluate operating policies. A prototype of this SB-DSS was developed. It incorporates a simulation model that uses real or simulated data. ER decisions have been categorized and, for each one, an implementation plan has been devised. Several issues of integrating heterogeneous tools have been addressed. The prototype revealed that simulation can truly be used in this environment in a timely fashion because the simulation model has been complemented with a series of decision-making routines. These routines use a hierarchical approach to organize the various scenarios under which the model may run and to partially reconfigure the ARENA model at run time. Hence, the SB-DSS tailors its responses to each node in the hierarchy.