Data driven and practice-based evidence : design and development of efficient and effective clinical decision support system

Decision-making is such an integral aspect in health care routine that the ability to make the right decisions at crucial moments can lead to patient health improvements. Evidence-based practice, the paradigm used to make those informed decisions, relies on the use of current best evidence from systematic research such as randomized controlled trials. Limitations of the outcomes from randomized controlled trials (RCT), such as “quantity” and “quality” of evidence generated, has lowered healthcare professionals’ confidence in using EBP. An alternate paradigm of Practice-Based Evidence has evolved with the key being evidence drawn from practice settings. Through the use of health information technology, electronic health records (EHR) capture relevant clinical practice “evidence”. A data-driven approach is proposed to capitalize on the benefits of EHR. The issues of data privacy, security and integrity are diminished by an information accountability concept. Data warehouse architecture completes the data-driven approach by integrating health data from multi-source systems, unique within the healthcare environment.

Australia's disabling income support system: Tracing the history of the disability pension from 1908 to today

This article is based on a historical-comparative policy and discourse analysis of the principles underpinning the Australian disability income support system. It determines that these principles rely on a conception of disability that sustains a system of coercion and paternalism that perpetuates disability and referred to as disablism. The article examines the construction of disability in Australian income support across four major historical epochs spanning the period 1908-2007. Contextualisation of the policy trajectory and discourses of the contemporary disability pension regime for the time period 2008-now is also provided. Two major themes were found to have interacted with the ideology of disablism. This article argues that a non-disabling provision based on social citizenship, rather than responsible or productive citizenship, counters the tendency for authoritarian and paternal approaches. [Abridged]

Countering disablism: An alternative universal income support system based on egalitarianism

The long-term vision of economic security and social participation for people with a disability held by disability activists and policy-makers has not been realised on a global scale. This is despite the implementation of various poverty alleviation initiatives by international and national governments. Indeed within advanced Western liberal democracies, the inequalities and poverty gaps have widened rather than closed. This article is based on findings from a historical-comparative policy and discourse analysis of disability income support system in Australia and the Basic Income model. The findings suggest that a model such as Basic Income, grounded in principles of social citizenship, goes some way to maintaining an adequate level of subsistence for people with a disability. The article concludes by presenting some challenges and a commitment to transforming income support policy.

Predicting wood value in Queensland Caribbean pine plantations using a decision support system

A decision support system has been developed in Queensland to evaluate how changes in silvicultural regimes affect wood quality, and specifically the graded recovery of structural timber. Models of tree growth, branch architecture and wood properties were developed from data collected in routine Caribbean pine plantations and specific silvicultural experiments. These models were incorporated in software that simulates the conversion of standing trees into logs, and the logs into boards, and generates detailed data on knot location and basic density distribution. The structural grade of each board was determined by simulating the machine stress-grading process, and the predicted graded recovery provided an indicator of wood value. The decision support system improves the basis of decision-making by simulating the performance of elite genetic material under specified silvicultural regimes and by predicting links between wood quality and general stand attributes such as stocking and length of rotation.

AQUAMAN: a web-based decision support system for irrigation scheduling in peanuts

Peanut (Arachis hypogaea L.) is an economically important legume crop in irrigated production areas of northern Australia. Although the potential pod yield of the crop in these areas is about 8 t ha(-1), most growers generally obtain around 5 t ha(-1), partly due to poor irrigation management. Better information and tools that are easy to use, accurate, and cost-effective are therefore needed to help local peanut growers improve irrigation management. This paper introduces a new web-based decision support system called AQUAMAN that was developed to assist Australian peanut growers schedule irrigations. It simulates the timing and depth of future irrigations by combining procedures from the food and agriculture organization (FAO) guidelines for irrigation scheduling (FAO-56) with those of the agricultural production systems simulator (APSIM) modeling framework. Here, we present a description of AQUAMAN and results of a series of activities (i.e., extension activities, case studies, and a survey) that were conducted to assess its level of acceptance among Australian peanut growers, obtain feedback for future improvements, and evaluate its performance. Application of the tool for scheduling irrigations of commercial peanut farms since its release in 2004-2005 has shown good acceptance by local peanuts growers and potential for significantly improving yield. Limited comparison with the farmer practice of matching the pan evaporation demand during rain-free periods in 2006-2007 and 2008-2009 suggested that AQUAMAN enabled irrigation water savings of up to 50% and the realization of enhanced water and irrigation use efficiencies.

Information Visualization in a Business Decision Support System

Information visualization is a process of constructing a visual presentation of abstract quantitative data. The characteristics of visual perception enable humans to recognize patterns, trends and anomalies inherent in the data with little effort in a visual display. Such properties of the data are likely to be missed in a purely text-based presentation. Visualizations are therefore widely used in contemporary business decision support systems. Visual user interfaces called dashboards are tools for reporting the status of a company and its business environment to facilitate business intelligence (BI) and performance management activities. In this study, we examine the research on the principles of human visual perception and information visualization as well as the application of visualization in a business decision support system. A review of current BI software products reveals that the visualizations included in them are often quite ineffective in communicating important information. Based on the principles of visual perception and information visualization, we summarize a set of design guidelines for creating effective visual reporting interfaces.

Development and evaluation of a spatial decision support system for malaria elimination in Bhutan

Background: Bhutan has reduced its malaria incidence significantly in the last 5 years, and is aiming for malaria elimination by 2016. To assist with the management of the Bhutanese malaria elimination programme a spatial decision support system (SDSS) was developed. The current study aims to describe SDSS development and evaluate SDSS utility and acceptability through informant interviews. Methods: The SDSS was developed based on the open-source Quantum geographical information system (QGIS) and piloted to support the distribution of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) in the two sub-districts of Samdrup Jongkhar District. It was subsequently used to support reactive case detection (RACD) in the two sub-districts of Samdrup Jongkhar and two additional sub-districts in Sarpang District. Interviews were conducted to ascertain perceptions on utility and acceptability of 11 informants using the SDSS, including programme and district managers, and field workers. Results: A total of 1502 households with a population of 7165 were enumerated in the four sub-districts, and a total of 3491 LLINs were distributed with one LLIN per 1.7 persons. A total of 279 households representing 728 residents were involved with RACD. Informants considered that the SDSS was an improvement on previous methods for organizing LLIN distribution, IRS and RACD, and could be easily integrated into routine malaria and other vector-borne disease surveillance systems. Informants identified some challenges at the programme and field level, including the need for more skilled personnel to manage the SDSS, and more training to improve the effectiveness of SDSS implementation and use of hardware. Conclusions: The SDSS was well accepted and informants expected its use to be extended to other malaria reporting districts and other vector-borne diseases. Challenges associated with efficient SDSS use included adequate skills and knowledge, access to training and support, and availability of hardware including computers and global positioning system receivers.

Solar energy decision support system

Energy plays a prominent role in human society. As a result of technological and industrial development,the demand for energy is rapidly increasing. Existing power sources that are mainly fossil fuel based are leaving an unacceptable legacy of waste and pollution apart from diminishing stock of fuels.Hence, the focus is now shifted to large-scale propagation of renewable energy. Renewable energy technologies are clean sources of energy that have a much lower environmental impact than conventional energy technologies. Solar energy is one such renewable energy. Most renewable energy comes either directly or indirectly from the sun. Estimation of solar energy potential of a region requires detailed solar radiation climatology, and it is necessary to collect extensive radiation data of high accuracy covering all climatic zones of the region. In this regard, a decision support system (DSS)would help in estimating solar energy potential considering the region’s energy requirement.This article explains the design and implementation of DSS for assessment of solar energy. The DSS with executive information systems and reporting tools helps to tap vast data resources and deliver information. The main hypothesis is that this tool can be used to form a core of practical methodology that will result in more resilient in time and can be used by decision-making bodies to assess various scenarios. It also offers means of entering, accessing, and interpreting the information for the purpose of sound decision making.

Spatial Decision Support System for Assessing Micro, Mini and Small Hydel Potential

This study describes the design and implementation of DSS for assessment of Mini, Micro and Small Schemes. The design links a set of modelling, manipulation, spatial analyses and display tools to a structured database that has the facility to store both observed and simulated data. The main hypothesis is that this tool can be used to form a core of practical methodology that will result in more resilient in less time and can be used by decision-making bodies to assess the impacts of various scenarios (e.g.: changes in land use pattern) and to review, cost and benefits of decisions to be made. It also offers means of entering, accessing and interpreting the information for the purpose of sound decision making. Thus, the overall objective of this DSS is the development of set of tools aimed at transforming data into information and aid decisions at different scales.

Livelihood analysis and development of a planning support for the poor in aquaculture and aquatic resource management. Workshop proceedings. 13-15 February 2001, Thai Nguyen, Vietnam

The workshop was organized to understand and describe the livelihoods of poor people who manage aquatic resources for planning support. The purpose was to support field workers to carry out livelihood analysis and how to use this information. (PDF contains 13 pages)