A decision support system to facilitate management of patients with acute gastrointestinal bleeding

Objective: To develop a model to predict the bleeding source and identify the cohort amongst patients with acute gastrointestinal bleeding (GIB) who require urgent intervention, including endoscopy. Patients with acute GIB, an unpredictable event, are most commonly evaluated and managed by non-gastroenterologists. Rapid and consistently reliable risk stratification of patients with acute GIB for urgent endoscopy may potentially improve outcomes amongst such patients by targeting scarce health-care resources to those who need it the most. Design and methods: Using ICD-9 codes for acute GIB, 189 patients with acute GIB and all. available data variables required to develop and test models were identified from a hospital medical records database. Data on 122 patients was utilized for development of the model and on 67 patients utilized to perform comparative analysis of the models. Clinical data such as presenting signs and symptoms, demographic data, presence of co-morbidities, laboratory data and corresponding endoscopic diagnosis and outcomes were collected. Clinical data and endoscopic diagnosis collected for each patient was utilized to retrospectively ascertain optimal management for each patient. Clinical presentations and corresponding treatment was utilized as training examples. Eight mathematical models including artificial neural network (ANN), support vector machine (SVM), k-nearest neighbor, linear discriminant analysis (LDA), shrunken centroid (SC), random forest (RF), logistic regression, and boosting were trained and tested. The performance of these models was compared using standard statistical analysis and ROC curves. Results: Overall the random forest model best predicted the source, need for resuscitation, and disposition with accuracies of approximately 80% or higher (accuracy for endoscopy was greater than 75%). The area under ROC curve for RF was greater than 0.85, indicating excellent performance by the random forest model Conclusion: While most mathematical models are effective as a decision support system for evaluation and management of patients with acute GIB, in our testing, the RF model consistently demonstrated the best performance. Amongst patients presenting with acute GIB, mathematical models may facilitate the identification of the source of GIB, need for intervention and allow optimization of care and healthcare resource allocation; these however require further validation. (c) 2007 Elsevier B.V. All rights reserved.

A decision support process to compare Riparian revegetation options in Scheu Creek catchment in North Queensland

While riparian vegetation can play a major role in protecting land, water and natural habitat in catchments, there are high costs associated with tree planting and establishment and in diverting land from cropping. The distribution of costs and benefits of riparian revegetation creates conflicts in the objectives of various stakeholder groups. Multicriteria analysis provides an appropriate tool to evaluate alternative riparian revegetation options, and to accommodate the conflicting views of various stakeholder groups. This paper discusses an application of multicriteria analysis in an evaluation of riparian revegetation policy options for Scheu Creek, a small sub-catchment in the Johnstone River catchment in north Queensland, Australia. Clear differences are found in the rankings of revegetation options for different stakeholder groups with respect to environmental, social and economic impacts. Implementation of a revegetation option will involve considerable cost for landholders for the benefits of society. Queensland legislation does not provide a means to require farmers to implement riparian revegetation, hence the need for subsidies, tau incentives and moral suasion. (C) 2001 Academic Press.

A decision support system for selecting sanitation systems in developing countries

Due to the socio-economic inhomogeneity of communities in developing countries, the selection of sanitation systems is a complex task. To assist planners and communities in assessing the suitability of alternatives, the decision support system SANEX™ was developed. SANEX™ evaluates alternatives in two steps. First, Conjunctive Elimination, based on 20 mainly technical criteria, is used to screen feasible alternatives. Subsequently, a model derived from Multiattribute Utility Technique (MAUT) uses technical, socio-cultural and institutional criteria to compare the remaining alternatives with regard to their implementability and sustainability. This paper presents the SANEX™ algorithm, examples of its application in practice, and results obtained from field testing.

Agent-based simulation of electronic marketplaces with decision support

This paper presents a Multi-Agent Market simulator designed for analyzing agent market strategies based on a complete understanding of buyer and seller behaviors, preference models and pricing algorithms, considering user risk preferences and game theory for scenario analysis. The system includes agents that are capable of improving their performance with their own experience, by adapting to the market conditions, and capable of considering other agents reactions.

A decision-support system based on particle swarm optimization for multiperiod hedging in electricity markets

This paper proposes a particle swarm optimization (PSO) approach to support electricity producers for multiperiod optimal contract allocation. The producer risk preference is stated by a utility function (U) expressing the tradeoff between the expectation and variance of the return. Variance estimation and expected return are based on a forecasted scenario interval determined by a price range forecasting model developed by the authors. A certain confidence level is associated to each forecasted scenario interval. The proposed model makes use of contracts with physical (spot and forward) and financial (options) settlement. PSO performance was evaluated by comparing it with a genetic algorithm-based approach. This model can be used by producers in deregulated electricity markets but can easily be adapted to load serving entities and retailers. Moreover, it can easily be adapted to the use of other type of contracts.

Decision support system with incomplete and domain incoherent information management

Many of the most common human functions such as temporal and non-monotonic reasoning have not yet been fully mapped in developed systems, even though some theoretical breakthroughs have already been accomplished. This is mainly due to the inherent computational complexity of the theoretical approaches. In the particular area of fault diagnosis in power systems however, some systems which tried to solve the problem, have been deployed using methodologies such as production rule based expert systems, neural networks, recognition of chronicles, fuzzy expert systems, etc. SPARSE (from the Portuguese acronym, which means expert system for incident analysis and restoration support) was one of the developed systems and, in the sequence of its development, came the need to cope with incomplete and/or incorrect information as well as the traditional problems for power systems fault diagnosis based on SCADA (supervisory control and data acquisition) information retrieval, namely real-time operation, huge amounts of information, etc. This paper presents an architecture for a decision support system, which can solve the presented problems, using a symbiosis of the event calculus and the default reasoning rule based system paradigms, insuring soft real-time operation with incomplete, incorrect or domain incoherent information handling ability. A prototype implementation of this system is already at work in the control centre of the Portuguese Transmission Network.

Environmental Decision Support: a Multi-Agent Approach

The environmental management domain is vast and encompasses many identifiable activities: impact assessment, planning, project evaluation, etc. In particular, this paper focusses on the modelling of the project evaluation activity. The environmental decision support system under development aims to provide assistance to project developers in the selection of adequate locations, guaranteeing the compliance with the applicable regulations and the existing development plans as well as satisfying the specified project requirements. The inherent multidisciplinarity features of this activity lead to the adoption of the Multi-Agent paradigm, and, in particular, to the modelling of the involved agencies as a community of cooperative autonomous agents, where each agency contributes with its share of problem solving to the final system’s recommendation. To achieve this behaviour the many conclusions of the individual agencies have to be justifiably accommodated: not only they may differ, but can be interdependent, complementary, irreconcilable, or simply, independent. We propose different solutions (involving both local and global consistency) to support the adequate merge of the distinct perspectives that inevitably arise during this type of decision making.

Distributed Belief Revision and Environmental Decision Support

This article discusses the development of an Intelligent Distributed Environmental Decision Support System, built upon the association of a Multi-agent Belief Revision System with a Geographical Information System (GIS). The inherent multidisciplinary features of the involved expertises in the field of environmental management, the need to define clear policies that allow the synthesis of divergent perspectives, its systematic application, and the reduction of the costs and time that result from this integration, are the main reasons that motivate the proposal of this project. This paper is organised in two parts: in the first part we present and discuss the developed - Distributed Belief Revision Test-bed - DiBeRT; in the second part we analyse its application to the environmental decision support domain, with special emphasis on the interface with a GIS.

Distributed Belief Revision and Environmental Decision Support

This article discusses the development of an Intelligent Distributed Environmental Decision Support System, built upon the association of a Multi-agent Belief Revision System with a Geographical Information System (GIS). The inherent multidisciplinary features of the involved expertises in the field of environmental management, the need to define clear policies that allow the synthesis of divergent perspectives, its systematic application, and the reduction of the costs and time that result from this integration, are the main reasons that motivate the proposal of this project. This paper is organised in two parts: in the first part we present and discuss the developed ; in the second part we analyse its application to the environmental decision support domain, with special emphasis on the interface with a GIS.

Intelligent Distributed Environmental Decision Support System

This article discusses the development of an Intelligent Distributed Environmental Decision Support System, built upon the association of a Multi-agent Belief Revision System with a Geographical Information System (GIS). The inherent multidisciplinary features of the involved expertises in the field of environmental management, the need to define clear policies that allow the synthesis of divergent perspectives, its systematic application, and the reduction of the costs and time that result from this integration, are the main reasons that motivate the proposal of this project. This paper is organised in two parts: in the first part we present and discuss the developed Distributed Belief Revision Test-bed — DiBeRT; in the second part we analyse its application to the environmental decision support domain, with special emphasis on the interface with a GIS.

Environmental Decision Support: a Distributed Artificial Intelligence Approach

Decision making in any environmental domain is a complex and demanding activity, justifying the development of dedicated decision support systems. Every decision is confronted with a large variety and amount of constraints to satisfy as well as contradictory interests that must be sensibly accommodated. The first stage of a project evaluation is its submission to the relevant group of public (and private) agencies. The individual role of each agency is to verify, within its domain of competence, the fulfilment of the set of applicable regulations. The scope of the involved agencies is wide and ranges from evaluation abilities on the technical or economical domains to evaluation competences on the environmental or social areas. The second project evaluation stage involves the gathering of the recommendations of the individual agencies and their justified merge to produce the final conclusion. The incorporation and accommodation of the consulted agencies opinions is of extreme importance: opinions may not only differ, but can be interdependent, complementary, irreconcilable or, simply, independent. The definition of adequate methodologies to sensibly merge, whenever possible, the existing perspectives while preserving the overall legality of the system, will lead to the making of sound justified decisions. The proposed Environmental Decision Support System models the project evaluation activity and aims to assist developers in the selection of adequate locations for their projects, guaranteeing their compliance with the applicable regulations.

Decision Support Concerning Demand Response Programs Design and Use – A Conceptual Framework and Simulation Tool

Demand response can play a very relevant role in the context of power systems with an intensive use of distributed energy resources, from which renewable intermittent sources are a significant part. More active consumers participation can help improving the system reliability and decrease or defer the required investments. Demand response adequate use and management is even more important in competitive electricity markets. However, experience shows difficulties to make demand response be adequately used in this context, showing the need of research work in this area. The most important difficulties seem to be caused by inadequate business models and by inadequate demand response programs management. This paper contributes to developing methodologies and a computational infrastructure able to provide the involved players with adequate decision support on demand response programs and contracts design and use. The presented work uses DemSi, a demand response simulator that has been developed by the authors to simulate demand response actions and programs, which includes realistic power system simulation. It includes an optimization module for the application of demand response programs and contracts using deterministic and metaheuristic approaches. The proposed methodology is an important improvement in the simulator while providing adequate tools for demand response programs adoption by the involved players. A machine learning method based on clustering and classification techniques, resulting in a rule base concerning DR programs and contracts use, is also used. A case study concerning the use of demand response in an incident situation is presented.