883 resultados para clinical decision support systems
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This paper presents a decision support methodology for electricity market players’ bilateral contract negotiations. The proposed model is based on the application of game theory, using artificial intelligence to enhance decision support method’s adaptive features. This model is integrated in AiD-EM (Adaptive Decision Support for Electricity Markets Negotiations), a multi-agent system that provides electricity market players with strategic behavior capabilities to improve their outcomes from energy contracts’ negotiations. Although a diversity of tools that enable the study and simulation of electricity markets has emerged during the past few years, these are mostly directed to the analysis of market models and power systems’ technical constraints, making them suitable tools to support decisions of market operators and regulators. However, the equally important support of market negotiating players’ decisions is being highly neglected. The proposed model contributes to overcome the existing gap concerning effective and realistic decision support for electricity market negotiating entities. The proposed method is validated by realistic electricity market simulations using real data from the Iberian market operator—MIBEL. Results show that the proposed adaptive decision support features enable electricity market players to improve their outcomes from bilateral contracts’ negotiations.
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Football is considered nowadays one of the most popular sports. In the betting world, it has acquired an outstanding position, which moves millions of euros during the period of a single football match. The lack of profitability of football betting users has been stressed as a problem. This lack gave origin to this research proposal, which it is going to analyse the possibility of existing a way to support the users to increase their profits on their bets. Data mining models were induced with the purpose of supporting the gamblers to increase their profits in the medium/long term. Being conscience that the models can fail, the results achieved by four of the seven targets in the models are encouraging and suggest that the system can help to increase the profits. All defined targets have two possible classes to predict, for example, if there are more or less than 7.5 corners in a single game. The data mining models of the targets, more or less than 7.5 corners, 8.5 corners, 1.5 goals and 3.5 goals achieved the pre-defined thresholds. The models were implemented in a prototype, which it is a pervasive decision support system. This system was developed with the purpose to be an interface for any user, both for an expert user as to a user who has no knowledge in football games.
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Drug delivery is one of the most common clinical routines in hospitals, and is critical to patients' health and recovery. It includes a decision making process in which a medical doctor decides the amount (dose) and frequency (dose interval) on the basis of a set of available patients' feature data and the doctor's clinical experience (a priori adaptation). This process can be computerized in order to make the prescription procedure in a fast, objective, inexpensive, non-invasive and accurate way. This paper proposes a Drug Administration Decision Support System (DADSS) to help clinicians/patients with the initial dose computing. The system is based on a Support Vector Machine (SVM) algorithm for estimation of the potential drug concentration in the blood of a patient, from which a best combination of dose and dose interval is selected at the level of a DSS. The addition of the RANdom SAmple Consensus (RANSAC) technique enhances the prediction accuracy by selecting inliers for SVM modeling. Experiments are performed for the drug imatinib case study which shows more than 40% improvement in the prediction accuracy compared with previous works. An important extension to the patient features' data is also proposed in this paper.
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Introduction Preventing drug incompatibilities has a high impact onthe safety of drug therapy. Although there are no internationalguidelines to manage drug incompatibilities, different decision-supporttools such as handbooks, cross-tables and databases are available.In a previous study, two decision-support tools have been pre-selectedby pharmacists as fitting nurses' needs on the wards1. The objective ofthis study was to have these both tools evaluated by nurses todetermine which would be the most suitable for their daily practice.Materials & Methods Evaluated tools were:1. Cross-table of drug pairs (http://files.chuv.ch/internet-docs/pha/medicaments/pha_phatab_compatibilitessip.pdf)2. Colour-table (a colour for each drug according to the pH: red =acid; blue = basic; yellow = neutral; black = to be infused alone)2Tools were assessed by 48 nurses in 5 units (PICU, adult andgeriatric intensive care, surgery, onco-hematology) using a standardizedform1. The scientific accuracy of the tools was evaluated bydetermining the compatibility of five drugs pairs (rate of correctanswers according to the Trissel's Handbook on Injectable Drugs,chi-square test). Their ergonomics, design, reliability and applicabilitywere estimated using visual analogue scales (VAS 0-10; 0 =null, 10 = excellent). Results are expressed as the median and interquartilerange (IQR) for 25% and 75% (Wilcoxon rank sum test).Results The rate of correct answers was above 90% for both tools(cross-table 96.2% vs colour-table 92.5%, p[0.05).The ergonomics and the applicability were higher for the crosstable[7.1 (IQR25 4.0, IQR75 8.0) vs 5.0 (IQR25 2.7, IQR75 7.0), p =0.025 resp. 8.3 (IQR25 7.4, IQR75 9.2) vs 7.6 (IQR25 5.9, IQR75 8.8)p = 0.047].The design of the colour-table was judged better [4.6 (IQR25 2.9,IQR75 7.1) vs 7.1 (IQR25 5.4, IQR75 8.4) p = 0.002].No difference was observed in terms of reliability [7.3 (IQR25 6.5,IQR75 8.4) vs 6.7 (IQR25 5.0, IQR758.6) p[0.05].The cross-table was globally preferred by 65% of the nurses (27%colour-table, 8% undetermined) and 68% would like to have thisdecision-support tool available for their daily practice.Discussion & Conclusion Both tools showed the same accuracy toassess drug compatibility. In terms of ergonomics and applicabilitythe cross-table was better than the colour-table, and was preferred bythe nurses for their daily practice. The cross-table will be implementedin our hospital as decision-support tool to help nurses tomanage drug incompatibilities.
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Sustainable resource use is one of the most important environmental issues of our times. It is closely related to discussions on the 'peaking' of various natural resources serving as energy sources, agricultural nutrients, or metals indispensable in high-technology applications. Although the peaking theory remains controversial, it is commonly recognized that a more sustainable use of resources would alleviate negative environmental impacts related to resource use. In this thesis, sustainable resource use is analysed from a practical standpoint, through several different case studies. Four of these case studies relate to resource metabolism in the Canton of Geneva in Switzerland: the aim was to model the evolution of chosen resource stocks and flows in the coming decades. The studied resources were copper (a bulk metal), phosphorus (a vital agricultural nutrient), and wood (a renewable resource). In addition, the case of lithium (a critical metal) was analysed briefly in a qualitative manner and in an electric mobility perspective. In addition to the Geneva case studies, this thesis includes a case study on the sustainability of space life support systems. Space life support systems are systems whose aim is to provide the crew of a spacecraft with the necessary metabolic consumables over the course of a mission. Sustainability was again analysed from a resource use perspective. In this case study, the functioning of two different types of life support systems, ARES and BIORAT, were evaluated and compared; these systems represent, respectively, physico-chemical and biological life support systems. Space life support systems could in fact be used as a kind of 'laboratory of sustainability' given that they represent closed and relatively simple systems compared to complex and open terrestrial systems such as the Canton of Geneva. The chosen analysis method used in the Geneva case studies was dynamic material flow analysis: dynamic material flow models were constructed for the resources copper, phosphorus, and wood. Besides a baseline scenario, various alternative scenarios (notably involving increased recycling) were also examined. In the case of space life support systems, the methodology of material flow analysis was also employed, but as the data available on the dynamic behaviour of the systems was insufficient, only static simulations could be performed. The results of the case studies in the Canton of Geneva show the following: were resource use to follow population growth, resource consumption would be multiplied by nearly 1.2 by 2030 and by 1.5 by 2080. A complete transition to electric mobility would be expected to only slightly (+5%) increase the copper consumption per capita while the lithium demand in cars would increase 350 fold. For example, phosphorus imports could be decreased by recycling sewage sludge or human urine; however, the health and environmental impacts of these options have yet to be studied. Increasing the wood production in the Canton would not significantly decrease the dependence on wood imports as the Canton's production represents only 5% of total consumption. In the comparison of space life support systems ARES and BIORAT, BIORAT outperforms ARES in resource use but not in energy use. However, as the systems are dimensioned very differently, it remains questionable whether they can be compared outright. In conclusion, the use of dynamic material flow analysis can provide useful information for policy makers and strategic decision-making; however, uncertainty in reference data greatly influences the precision of the results. Space life support systems constitute an extreme case of resource-using systems; nevertheless, it is not clear how their example could be of immediate use to terrestrial systems.
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Our objective was to determine the test and treatment thresholds for common acute primary care conditions. We presented 200 clinicians with a series of web-based clinical vignettes, describing patients with possible influenza, acute coronary syndrome (ACS), pneumonia, deep vein thrombosis (DVT) and urinary tract infection (UTI). We randomly varied the probability of disease and asked whether the clinician wanted to rule out disease, order tests or rule in disease. By randomly varying the probability, we obtained clinical decisions across a broad range of disease probabilities that we used to create threshold curves. For influenza, the test (4.5% vs 32%, p<0.001) and treatment (55% vs 68%, p=0.11) thresholds were lower for US compared with Swiss physicians. US physicians had somewhat higher test (3.8% vs 0.7%, p=0.107) and treatment (76% vs 58%, p=0.005) thresholds for ACS than Swiss physicians. For both groups, the range between test and treatment thresholds was greater for ACS than for influenza (which is sensible, given the consequences of incorrect diagnosis). For pneumonia, US physicians had a trend towards higher test thresholds and lower treatment thresholds (48% vs 64%, p=0.076) than Swiss physicians. The DVT and UTI scenarios did not provide easily interpretable data, perhaps due to poor wording of the vignettes. We have developed a novel approach for determining decision thresholds. We found important differences in thresholds for US and Swiss physicians that may be a function of differences in healthcare systems. Our results can also guide development of clinical decision rules and guidelines.
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A growing concern for organisations is how they should deal with increasing amounts of collected data. With fierce competition and smaller margins, organisations that are able to fully realize the potential in the data they collect can gain an advantage over the competitors. It is almost impossible to avoid imprecision when processing large amounts of data. Still, many of the available information systems are not capable of handling imprecise data, even though it can offer various advantages. Expert knowledge stored as linguistic expressions is a good example of imprecise but valuable data, i.e. data that is hard to exactly pinpoint to a definitive value. There is an obvious concern among organisations on how this problem should be handled; finding new methods for processing and storing imprecise data are therefore a key issue. Additionally, it is equally important to show that tacit knowledge and imprecise data can be used with success, which encourages organisations to analyse their imprecise data. The objective of the research conducted was therefore to explore how fuzzy ontologies could facilitate the exploitation and mobilisation of tacit knowledge and imprecise data in organisational and operational decision making processes. The thesis introduces both practical and theoretical advances on how fuzzy logic, ontologies (fuzzy ontologies) and OWA operators can be utilized for different decision making problems. It is demonstrated how a fuzzy ontology can model tacit knowledge which was collected from wine connoisseurs. The approach can be generalised and applied also to other practically important problems, such as intrusion detection. Additionally, a fuzzy ontology is applied in a novel consensus model for group decision making. By combining the fuzzy ontology with Semantic Web affiliated techniques novel applications have been designed. These applications show how the mobilisation of knowledge can successfully utilize also imprecise data. An important part of decision making processes is undeniably aggregation, which in combination with a fuzzy ontology provides a promising basis for demonstrating the benefits that one can retrieve from handling imprecise data. The new aggregation operators defined in the thesis often provide new possibilities to handle imprecision and expert opinions. This is demonstrated through both theoretical examples and practical implementations. This thesis shows the benefits of utilizing all the available data one possess, including imprecise data. By combining the concept of fuzzy ontology with the Semantic Web movement, it aspires to show the corporate world and industry the benefits of embracing fuzzy ontologies and imprecision.
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Accurate data of the natural conditions and agricultural systems with a good spatial resolution are a key factor to tackle food insecurity in developing countries. A broad variety of approaches exists to achieve precise data and information about agriculture. One system, especially developed for smallholder agriculture in East Africa, is the Farm Management Handbook of Kenya. It was first published in 1982/83 and fully revised in 2012, now containing 7 volumes. The handbooks contain detailed information on climate, soils, suitable crops and soil care based on scientific research results of the last 30 years. The density of facts leads to time consuming extraction of all necessary information. In this study we analyse the user needs and necessary components of a system for decision support for smallholder farming in Kenya based on a geographical information system (GIS). Required data sources were identified, as well as essential functions of the system. We analysed the results of our survey conducted in 2012 and early 2013 among agricultural officers. The monitoring of user needs and the problem of non-adaptability of an agricultural information system on the level of extension officers in Kenya are the central objectives. The outcomes of the survey suggest the establishment of a decision support tool based on already available open source GIS components. The system should include functionalities to show general information for a specific location and should provide precise recommendations about suitable crops and management options to support agricultural guidance on farm level.
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La tesis propone un marco de trabajo para el soporte de la toma de decisiones adecuado para soportar la ejecución distribuida de acciones cooperativas en entornos multi-agente dinámicos y complejos. Soporte para la toma de decisiones es un proceso que intenta mejorar la ejecución de la toma de decisiones en escenarios cooperativos. Este proceso ocurre continuamente en la vida diaria. Los humanos, por ejemplo, deben tomar decisiones acerca de que ropa usar, que comida comer, etc. En este sentido, un agente es definido como cualquier cosa que está situada en un entorno y que actúa, basado en su observación, su interpretación y su conocimiento acerca de su situación en tal entorno para lograr una acción en particular.Por lo tanto, para tomar decisiones, los agentes deben considerar el conocimiento que les permita ser consientes en que acciones pueden o no ejecutar. Aquí, tal proceso toma en cuenta tres parámetros de información con la intención de personificar a un agente en un entorno típicamente físico. Así, el mencionado conjunto de información es conocido como ejes de decisión, los cuales deben ser tomados por los agentes para decidir si pueden ejecutar correctamente una tarea propuesta por otro agente o humano. Los agentes, por lo tanto, pueden hacer mejores decisiones considerando y representando apropiadamente tal información. Los ejes de decisión, principalmente basados en: las condiciones ambientales, el conocimiento físico y el valor de confianza del agente, provee a los sistemas multi-agente un confiable razonamiento para alcanzar un factible y exitoso rendimiento cooperativo.Actualmente, muchos investigadores tienden a generar nuevos avances en la tecnología agente para incrementar la inteligencia, autonomía, comunicación y auto-adaptación en escenarios agentes típicamente abierto y distribuidos. En este sentido, esta investigación intenta contribuir en el desarrollo de un nuevo método que impacte tanto en las decisiones individuales como colectivas de los sistemas multi-agente. Por lo tanto, el marco de trabajo propuesto ha sido utilizado para implementar las acciones concretas involucradas en el campo de pruebas del fútbol robótico. Este campo emula los juegos de fútbol real, donde los agentes deben coordinarse, interactuar y cooperar entre ellos para solucionar tareas complejas dentro de un escenario dinámicamente cambiante y competitivo, tanto para manejar el diseño de los requerimientos involucrados en las tareas como para demostrar su efectividad en trabajos colectivos. Es así que los resultados obtenidos tanto en el simulador como en el campo real de experimentación, muestran que el marco de trabajo para el soporte de decisiones propuesto para agentes situados es capaz de mejorar la interacción y la comunicación, reflejando en un adecuad y confiable trabajo en equipo dentro de entornos impredecibles, dinámicos y competitivos. Además, los experimentos y resultados también muestran que la información seleccionada para generar los ejes de decisión para situar a los agentes, es útil cuando tales agentes deben ejecutar una acción o hacer un compromiso en cada momento con la intención de cumplir exitosamente un objetivo colectivo. Finalmente, algunas conclusiones enfatizando las ventajas y utilidades del trabajo propuesto en la mejora del rendimiento colectivo de los sistemas multi-agente en situaciones tales como tareas coordinadas y asignación de tareas son presentadas.
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In domain of intelligent buildings, saving energy in buildings and increasing preferences of occupants are two important factors. These factors are the important keys for evaluating the performance of work environment. In recent years, many researchers combine these areas to create the system that can change from original to the modern work environment called intelligent work environment. Due to advance of agent technology, it has received increasing attention in the area of intelligent pervasive environments. In this paper, we review several issues in intelligent buildings, with respect to the implementation of control system for intelligent buildings via multi-agent systems. Furthermore, we present the MASBO (Multi-Agent System for Building cOntrol) that has been implemented for controlling the building facilities to reach the balancing between energy efficiency and occupant’s comfort. In addition to enhance the MASBO system, the collaboration through negotiation among agents is presented.
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Background: This study was carried out as part of a European Union funded project (PharmDIS-e+), to develop and evaluate software aimed at assisting physicians with drug dosing. A drug that causes particular problems with drug dosing in primary care is digoxin because of its narrow therapeutic range and low therapeutic index. Objectives: To determine (i) accuracy of the PharmDIS-e+ software for predicting serum digoxin levels in patients who are taking this drug regularly; (ii) whether there are statistically significant differences between predicted digoxin levels and those measured by a laboratory and (iii) whether there are differences between doses prescribed by general practitioners and those suggested by the program. Methods: We needed 45 patients to have 95% Power to reject the null hypothesis that the mean serum digoxin concentration was within 10% of the mean predicted digoxin concentration. Patients were recruited from two general practices and had been taking digoxin for at least 4 months. Exclusion criteria were dementia, low adherence to digoxin and use of other medications known to interact to a clinically important extent with digoxin. Results: Forty-five patients were recruited. There was a correlation of 0·65 between measured and predicted digoxin concentrations (P < 0·001). The mean difference was 0·12 μg/L (SD 0·26; 95% CI 0·04, 0·19, P = 0·005). Forty-seven per cent of the patients were prescribed the same dose as recommended by the software, 44% were prescribed a higher dose and 9% a lower dose than recommended. Conclusion: PharmDIS-e+ software was able to predict serum digoxin levels with acceptable accuracy in most patients.
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Mycoplasma gallisepticum (MG) is a bacterium that causes respiratory disease in chickens, leading to reduced egg production. A dynamic simulation model was developed that can be used to assess the costs and benefits of control using antimicrobials or vaccination in caged or free range systems. The intended users are veterinarians and egg producers. A user interface is provided for input of flock specific parameters. The economic consequence of an MG outbreak is expressed as a reduction in expected egg output. The model predicts that either vaccination or microbial treatment can approximately halve potential losses from MG in some circumstances. Sensitivity analysis is used to test assumptions about infection rate and timing of an outbreak. Feedback from veterinarians points to the value of the model as a discussion tool with producers.
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A decision support system (DSS) was implemented based on a fuzzy logic inference system (FIS) to provide assistance in dose alteration of Duodopa infusion in patients with advanced Parkinson’s disease, using data from motor state assessments and dosage. Three-tier architecture with an object oriented approach was used. The DSS has a web enabled graphical user interface that presents alerts indicating non optimal dosage and states, new recommendations, namely typical advice with typical dose and statistical measurements. One data set was used for design and tuning of the FIS and another data set was used for evaluating performance compared with actual given dose. Overall goodness-of-fit for the new patients (design data) was 0.65 and for the ongoing patients (evaluation data) 0.98. User evaluation is now ongoing. The system could work as an assistant to clinical staff for Duodopa treatment in advanced Parkinson’s disease.
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The communication between user and software is a basic stage in any Interaction System project. In interactive systems, this communication is established by the means of a graphical interface, whose objective is to supply a visual representation of the main entities and functions present in the Virtual Environment. New ways of interacting in computational systems have been minimizing the gap in the relationship between man and computer, and therefore enhancing its usability. The objective of this paper, therefore, is to present a proposal for a non-conventional user interface library called ARISupport, which supplies ARToolKit applications developers with an opportunity to create simple GUI interfaces, and provides some of the functionality used in Augmented Reality systems. © Springer-Verlag Berlin Heidelberg 2005.