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Decision Support (decision + support)
Kinds of Decision Support Terms modified by Decision Support Selected AbstractsADAPTATION KNOWLEDGE ACQUISITION: A CASE STUDY FOR CASE-BASED DECISION SUPPORT IN ONCOLOGYCOMPUTATIONAL INTELLIGENCE, Issue 3-4 2006Mathieu D'Aquin Kasimir is a case-based decision support system in the domain of breast cancer treatment. For this system, a problem is given by the description of a patient and a solution is a set of therapeutic decisions. Given a target problem, Kasimir provides several suggestions of solutions, based on several justified adaptations of source cases. Such adaptation processes are based on adaptation knowledge. The acquisition of this kind of knowledge from experts is presented in this paper. It is shown how the decomposition of adaptation processes by introduction of intermediate problems can highlight simple and generalizable adaptation steps. Moreover, some adaptation knowledge units that are generalized from those acquired for Kasimir are presented. This knowledge can be instantiated in other case-based decision support systems, in particular in medicine. [source] DECISION SUPPORT FOR INAPPROPRIATE PRESCRIBINGJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2010Kouta Ito MD No abstract is available for this article. [source] DECISION SUPPORT FOR ALLOCATION OF WATERSHED POLLUTION LOAD USING GREY FUZZY MULTIOBJECTIVE PROGRAMMING,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 3 2006Ho-Wen Chen ABSTRACT: This paper uses the grey fuzzy multiobjective programming to aid in decision making for the allocation of waste load in a river system under versatile uncertainties and risks. It differs from previous studies by considering a multicriteria objective function with combined grey and fuzzy messages under a cost benefit analysis framework. Such analysis technically integrates the prior information of water quality models, water quality standards, wastewater treatment costs, and potential benefits gained via in-stream water quality improvement. While fuzzy sets are characterized based on semantic and cognitive vagueness in decision making, grey numbers can delineate measurement errors in data collection. By employing three distinct set theoretic fuzzy operators, the synergy of grey and fuzzy implications may smoothly characterize the prescribed management complexity. With the aid of genetic algorithm in the solution procedure, the modeling outputs contribute to the development of an effective waste load allocation and reduction scheme for tributaries in this subwatershed located in the lower Tseng-Wen River Basin, South Taiwan. Research findings indicate that the inclusion of three fuzzy set theoretic operators in decision analysis may delineate different tradeoffs in decision making due to varying changes, transformations, and movements of waste load in association with land use pattern within the watershed. [source] Integration of Different Data Bodies for Humanitarian Decision Support: An Example from Mine ActionDISASTERS, Issue 4 2003Aldo A. Benini Geographic information systems (GIS) are increasingly used for integrating data from different sources and substantive areas, including in humanitarian action. The challenges of integration are particularly well illustrated by humanitarian mine action. The informational requirements of mine action are expensive, with socio,economic impact surveys costing over US$1.5 million per country, and are feeding a continuous debate on the merits of considering more factors or ,keeping it simple'. National census offices could, in theory, contribute relevant data, but in practice surveys have rarely overcome institutional obstacles to external data acquisition. A positive exception occurred in Lebanon, where the landmine impact survey had access to agricultural census data. The challenges, costs and benefits of this data integration exercise are analysed in a detailed case study. The benefits are considerable, but so are the costs, particularly the hidden ones. The Lebanon experience prompts some wider reflections. In the humanitarian community, data integration has been fostered not only by the diffusion of GIS technology, but also by institutional changes such as the creation of UN-led Humanitarian Information Centres. There is a question whether the analytic capacity is in step with aggressive data acquisition. Humanitarian action may yet have to build the kind of strong analytic tradition that public health and poverty alleviation have accomplished. [source] Decision Support for Location Problems in Town PlanningINTERNATIONAL TRANSACTIONS IN OPERATIONAL RESEARCH, Issue 3 2002Renate Patz Urban development and town planning need an adequate decision-making process. European cities, in particular, are compact. Urban elements and functions are in a constant state of change. Moreover, the large number of historic buildings and areas means a sensitive and responsible approach must be taken. The aim of this paper is to consider special location problems in town planning. We formulate multi-criteria location problems, derive optimality conditions and present a geometric algorithm and an interactive procedure including a proximal point algorithm for solving multi-criteria location problems. In this paper, we use location theory as a possible method to help determine the location of a children's playground in a newly-built district of Halle, Germany. [source] Computerized Physician Order Entry with Clinical Decision Support in the Long-Term Care Setting: Insights from the Baycrest Centre for Geriatric CareJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Paula A. Rochon MD Although computerized physician order entry (CPOE) has been successfully implemented in many acute care hospitals, few descriptions of its use in the long-term care (LTC) setting are available. This report describes the experiences of one LTC facility in developing and implementing a CPOE system with clinical decision support (CDS). Even when a facility has the necessary resources and "institutional will," many challenges are associated with the implementation of this application. The system was designed to meet the needs of healthcare providers in the LTC setting, in particular by informing prescribing decisions, reducing the frequency of prescribing and monitoring errors, and reducing adverse drug event rates. Based on experience adopting this technology early, 10 insights are offered that it is hoped will assist others who are considering the implementation of CPOE systems with CDS in the LTC setting. [source] Introduction to Water Use From Arctic Lakes: Identification, Impacts, and Decision Support,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 2 2008Paul K. Sibley No abstract is available for this article. [source] Conceptual Models for Creating Useful Decision SupportNEW DIRECTIONS FOR INSTITUTIONAL RESEARCH, Issue 112 2001Richard D. Howard Using Senge's rationale for the creation of mental models, this chapter presents a series of conceptual models that provide guidance for the creation of effective decision support. [source] Decision support for network operation in an open power marketEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 4 2007Geir Warland Abstract The Norwegian system operator plans to change from (N-1) to a more flexible cost-based security criterion. The approach is illustrated using a simple example and then compared with alternative decision paradigms. The comparison shows how different paradigms may change ranking of operating alternatives and that the new cost-based criterion still tends to favor alternatives close to (N-1), provided application of a penalty factor giving additional and significant weight on interruption costs. Copyright © 2007 John Wiley & Sons, Ltd. [source] Decision support for simulating the car park activity in an urban areaJOURNAL OF ADVANCED TRANSPORTATION, Issue 2 2009Jean-Marie Boussier Abstract Complexity of car park activity is reproduced from a concurrent execution of behaviour of various drivers. This paper presents a step in the development of a multimodal traffic simulator based on multi-agent paradigm and designed as a decision aid tool as well as a video game. The user-player has the opportunity to test different scenarios. We propose an approach for designing the decision-making rules and the learning mechanism for a car driver agent. For that, a panel of methods such as stated preference modelling, Design Of Experiments and data fusion is used. Initial behavioural models, based on similar preferences, are developed for specified categories. Each agent will adapt its behaviour after executing its learning process. Our approach can be used in order to optimize needs of road network users and those of people in charge of traffic regulation. A demonstrator has been developed to test parking policies in an urban area as well as changes of car park characteristics. [source] Early and reliable detection of herpes simplex virus type 1 and varicella zoster virus DNAs in oral fluid of patients with idiopathic peripheral facial nerve palsy: Decision support regarding antiviral treatment?JOURNAL OF MEDICAL VIROLOGY, Issue 9 2010Andreas Lackner Abstract Idiopathic peripheral facial nerve palsy has been associated with the reactivation of herpes simplex virus type 1 (HSV-1) or varicella zoster virus (VZV). In recent studies, detection rates were found to vary strongly which may be caused by the use of different oral fluid collection devices in combination with molecular assays lacking standardization. In this single-center pilot study, liquid phase-based and absorption-based oral fluid collection was compared. Samples were collected with both systems from 10 patients with acute idiopathic peripheral facial nerve palsy, 10 with herpes labialis or with Ramsay Hunt syndrome, and 10 healthy controls. Commercially available IVD/CE-labeled molecular assays based on fully automated DNA extraction and real-time PCR were employed. With the liquid phase-based oral fluid collection system, three patients with idiopathic peripheral facial nerve palsy tested positive for HSV-1 DNA and another two tested positive for VZV DNA. All patients with herpes labialis tested positive for HSV-1 DNA and all patients with Ramsay Hunt syndrome tested positive for VZV DNA. With the absorption-based oral fluid collection system, detections rates and viral loads were found to be significantly lower when compared to those obtained with the liquid phase-based collection system. Collection of oral fluid with a liquid phase-based system and the use of automated and standardized molecular methods allow early and reliable detection of HSV-1 and VZV DNAs in patients with acute idiopathic peripheral facial nerve palsy and may provide a valuable decision support regarding start of antiviral treatment at the first clinical visit. J. Med. Virol. 82:1582,1585, 2010. © 2010 Wiley-Liss, Inc. [source] Preference-Based Constrained Optimization with CP-NetsCOMPUTATIONAL INTELLIGENCE, Issue 2 2004Craig Boutilier Many artificial intelligence (AI) tasks, such as product configuration, decision support, and the construction of autonomous agents, involve a process of constrained optimization, that is, optimization of behavior or choices subject to given constraints. In this paper we present an approach for constrained optimization based on a set of hard constraints and a preference ordering represented using a CP-network,a graphical model for representing qualitative preference information. This approach offers both pragmatic and computational advantages. First, it provides a convenient and intuitive tool for specifying the problem, and in particular, the decision maker's preferences. Second, it admits an algorithm for finding the most preferred feasible (Pareto-optimal) outcomes that has the following anytime property: the set of preferred feasible outcomes are enumerated without backtracking. In particular, the first feasible solution generated by this algorithm is Pareto optimal. [source] Research Priorities for Surge CapacityACADEMIC EMERGENCY MEDICINE, Issue 11 2006Richard E. Rothman MD The 2006 Academic Emergency Medicine Consensus Conference discussed key concepts within the field of surge capacity. Within the breakout session on research priorities, experts in disaster medicine and other related fields used a structured nominal-group process to delineate five critical areas of research. Of the 14 potential areas of discovery identified by the group, the top five were the following: 1) defining criteria and methods for decision making regarding allocation of scarce resources, 2) determining effective triage protocols, 3) determining key decision makers for surge-capacity planning and means to evaluate response efficacy (e.g., incident command), 4) developing effective communication and information-sharing strategies (situational awareness) for public-health decision support, and 5) developing methods and evaluations for meeting workforce needs. Five working groups were formed to consider the above areas and to devise sample research questions that were refined further by the entire group of participants. [source] Multi-scale system reliability analysis of lifeline networks under earthquake hazardsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 3 2010Junho Song Abstract Recent earthquake events evidenced that damage of structural components in a lifeline network may cause prolonged disruption of lifeline services, which eventually results in significant socio-economic losses in the affected area. Despite recent advances in network reliability analysis, the complexity of the problem and various uncertainties still make it a challenging task to evaluate the post-hazard performance and connectivity of lifeline networks efficiently and accurately. In order to overcome such challenges and take advantage of merits of multi-scale analysis, this paper develops a multi-scale system reliability analysis method by integrating a network decomposition approach with the matrix-based system reliability (MSR) method. In addition to facilitating system reliability analysis of large-size networks, the multi-scale approach enables optimizing the level of computational effort on subsystems; identifying the relative importance of components and subsystems at multiple scales; and providing a collaborative risk management framework. The MSR method is uniformly applied for system reliability analyses at both the lower-scale (for link failure) and the higher-scale (for system connectivity) to obtain the probability of general system events, various conditional probabilities, component importance measures, statistical correlation between subsystem failures and parameter sensitivities. The proposed multi-scale analysis method is demonstrated by its application to a gas distribution network in Shelby County of Tennessee. A parametric study is performed to determine the number of segments during the lower-scale MSR analysis of each pipeline based on the strength of the spatial correlation of seismic intensity. It is shown that the spatial correlation should be considered at both scales for accurate reliability evaluation. The proposed multi-scale analysis approach provides an effective framework of risk assessment and decision support for lifeline networks under earthquake hazards. Copyright © 2009 John Wiley & Sons, Ltd. [source] Framing participation with multicriterion evaluations to support the management of complex environmental issuesENVIRONMENTAL POLICY AND GOVERNANCE, Issue 2 2010Katrine Soma Abstract A repeated statement observed in the literature is that stakeholder participation can contribute to improve complex environmental management decisions. However, transparent and legitimate decision-making processes cannot be ensured without suitable involvement strategies and information treatments throughout the processes. The main goal in this study is to frame participatory processes with multicriterion evaluations to increase transparency of the decision support. The developed approach applies clearly defined roles of interest groups, experts and citizens, as well as alternatives presented on maps, criteria arranged in a hierarchy of decision elements and weights obtained by conducting deliberative processes with citizens. The approach is applied in a case study at municipal level in Norway to support coastal zone management decisions. Relevant interests and social values are systematically represented by the multicriterion evaluation framework utilized in the approach presented. Copyright © 2010 John Wiley & Sons, Ltd and ERP Environment. [source] Implementing life cycle assessment in product developmentENVIRONMENTAL PROGRESS & SUSTAINABLE ENERGY, Issue 4 2003Gurbakhash Singh Bhander The overall aim of this paper is to provide an understanding of the environmental issues involved in the early stages of product development, and the capacity of Life Cycle Assessment (LCA) techniques to address these issues. The paper aims to outline the problems for the designer in evaluating the environmental benignity of a product from the outset, and to provide a framework for decision support based on the performance evaluation at different stages of the design process. The barriers that prevent product developers from using LCA are presented, as well as opportunities for introducing environmental criteria in the design process by meeting the designer's information requirements at the different life cycle stages. This can lead to an in-depth understanding of the attitudes of product developers towards the subject area, and an understanding of possible future directions for product development. This paper introduces an Environmentally Conscious Design method, and presents trade-offs between design degrees of freedom and environmental solutions. Life cycle design frameworks and strategies are also addressed. The paper collects experiences and ideas around the state-of-the-art in eco-design, from literature and personal experience, and provides eco-design life cycle assessment strategies. The end result of this presentation is to define the requirements for performance measurement techniques, and the environment needed to support life cycle evaluation throughout the evaluation of early stages of a product system. [source] Extracting new patterns for cardiovascular disease prognosisEXPERT SYSTEMS, Issue 5 2009Luis Mena Abstract: Cardiovascular diseases constitute one of the main causes of mortality in the world, and machine learning has become a powerful tool for analysing medical data in the last few years. In this paper we present an interdisciplinary work based on an ambulatory blood pressure study and the development of a new classification algorithm named REMED. We focused on the discovery of new patterns for abnormal blood pressure variability as a possible cardiovascular risk factor. We compared our results with other classification algorithms based on Bayesian methods, decision trees, and rule induction techniques. In the comparison, REMED showed similar accuracy to these algorithms but it has the advantage of being superior in its capacity to classify sick people correctly. Therefore, our method could represent an innovative approach that might be useful in medical decision support for cardiovascular disease prognosis. [source] Financial decision support using neural networks and support vector machinesEXPERT SYSTEMS, Issue 4 2008Chih-Fong Tsai Abstract: Bankruptcy prediction and credit scoring are the two important problems facing financial decision support. The multilayer perceptron (MLP) network has shown its applicability to these problems and its performance is usually superior to those of other traditional statistical models. Support vector machines (SVMs) are the core machine learning techniques and have been used to compare with MLP as the benchmark. However, the performance of SVMs is not fully understood in the literature because an insufficient number of data sets is considered and different kernel functions are used to train the SVMs. In this paper, four public data sets are used. In particular, three different sizes of training and testing data in each of the four data sets are considered (i.e. 3:7, 1:1 and 7:3) in order to examine and fully understand the performance of SVMs. For SVM model construction, the linear, radial basis function and polynomial kernel functions are used to construct the SVMs. Using MLP as the benchmark, the SVM classifier only performs better in one of the four data sets. On the other hand, the prediction results of the MLP and SVM classifiers are not significantly different for the three different sizes of training and testing data. [source] Sequential Monte Carlo methods for multi-aircraft trajectory prediction in air traffic managementINTERNATIONAL JOURNAL OF ADAPTIVE CONTROL AND SIGNAL PROCESSING, Issue 10 2010I. Lymperopoulos Abstract Accurate prediction of aircraft trajectories is an important part of decision support and automated tools in air traffic management. We demonstrate that by combining information from multiple aircraft at different locations and time instants, one can provide improved trajectory prediction (TP) accuracy. To perform multi-aircraft TP, we have at our disposal abundant data. We show how this multi-aircraft sensor fusion problem can be formulated as a high-dimensional state estimation problem. The high dimensionality of the problem and nonlinearities in aircraft dynamics and control prohibit the use of common filtering methods. We demonstrate the inefficiency of several sequential Monte Carlo algorithms on feasibility studies involving multiple aircraft. We then develop a novel particle filtering algorithm to exploit the structure of the problem and solve it in realistic scale situations. In all studies we assume that aircraft fly level (possibly at different altitudes) with known, constant, aircraft-dependent airspeeds and estimate the wind forecast errors based only on ground radar measurements. Current work concentrates on extending the algorithms to non-level flights, the joint estimation of wind forecast errors and the airspeed and mass of the different aircraft and the simultaneous fusion of airborne and ground radar measurements. Copyright © 2010 John Wiley & Sons, Ltd. [source] Fuzzy decision support for the control of detergent productionINTERNATIONAL JOURNAL OF ADAPTIVE CONTROL AND SIGNAL PROCESSING, Issue 8 2001Magne Setnes This paper describes a fuzzy decision support system (DSS) for the control of a detergent production process. The application has been carried out at a real-world, large-scale industrial production plant in the Netherlands, where a large variety of powder-based detergents for industrial users are produced in a spray drying process. The system consists of several fuzzy rule bases that model the control actions of experienced process operators in response to different quality deviations of the product. A hierarchical architecture of the fuzzy system is introduced to cope with the complexity. A fuzzy supervisor is used to deal with process constraints and to activate the applicable rule bases when control actions are needed. In this way, a system is obtained that enables the control of the process within stricter quality bounds than those applied by human operators alone. During in-production evaluation, the average improvement in the quality parameters for all product classes was above 30 percent. Copyright © 2001 John Wiley & Sons, Ltd. [source] Modelling daily precipitation features in the Volta Basin of West AfricaINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 7 2009P. Laux Abstract The combination of a conventional Markov chain model (zero and first order) and a gamma distribution model are found to be applicable to derive meaningful agricultural features from precipitation in the Volta Basin (West Africa). Since the analysis of the monthly or annual precipitation amount does not provide any adequate information on rainfall timing and sufficiency of crop water requirement, rainfall modelling was performed on a daily time scale for 29 rainfall stations. The modelled rainfall features follow distinct spatial patterns, which will be presented as maps of(1) rainfall occurrence probabilities and (2) recommendations of optimal planting dates. In addition, the effective drought index (EDI) working on daily time scales is calculated in order to assess drought properties of five different rainfall regions within the Volta Basin. Apart from the common way of separately modelling the duration and intensity due to their different distributions, a copula approach is chosen in this study to construct a bivariate drought distribution. Application of the measures derived to agricultural decision support will be discussed briefly. Copyright © 2009 Royal Meteorological Society [source] Bipolar preference modeling and aggregation in decision supportINTERNATIONAL JOURNAL OF INTELLIGENT SYSTEMS, Issue 9 2008Meltem Öztürk The article discusses the use of positive and negative reasons when preferences about alternative options have to be considered. Besides explaining the intuitive and formal situations where such a bipolar reasoning is used, the article shows how it is possible to generalize the concordance/discordance principle in preference aggregation and apply it to the problem of aggregating preferences expressed under intervals. © 2008 Wiley Periodicals, Inc. [source] The impact of pharmacy computerised clinical decision support on prescribing, clinical and patient outcomes: a systematic review of the literatureINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2010Jane Robertson Abstract Objectives Computerised clinical decision support systems (CDSSs) are being used increasingly to support evidence-based decision-making by health care professionals. This systematic review evaluated the impact of CDSSs targeting pharmacists on physician prescribing, clinical and patient outcomes. We compared the impact of CDSSs addressing safety concerns (drug interactions, contraindications, dose monitoring and adjustment) and those focusing on medicines use in line with guideline recommendations (hereafter referred to as Quality Use of Medicines, or QUM). We also examined the influence of clinical setting (institutional versus ambulatory care), system- or user-initiation of CDSS, prescribing versus clinical outcomes reported and use of multi-faceted versus single interventions on system effectiveness. Methods We searched Medline, Embase, CINAHL and PsycINFO (1990,2009) for methodologically adequate studies (experiments and strong quasi-experiments) comparing a CDSS with usual pharmacy care. Individual study results are reported as positive trends or statistically significant results in the direction of the intentions of the CDSS being tested. Studies are aggregated and compared as the proportions of studies showing the effectiveness of the CDSS on the majority (, 50%) of outcomes reported in the individual study. Key findings Of 21 eligible studies, 11 addressed safety and 10 QUM issues. CDSSs addressing safety issues were more effective than CDSSs focusing on QUM (10/11 versus 4/10 studies reporting statistically significant improvements in favour of CDSSs on , 50% of all outcomes reported; P= 0.01). A number of QUM studies noted the limited contact between pharmacists and physicians relating to QUM treatment recommendations. More studies demonstrated CDSS benefits on prescribing outcomes than clinical outcomes (10/10 versus 0/3 studies; P= 0.002). There were too few studies to assess the impact of system- versus user-initiated CDSS, the influence of setting or multi-faceted interventions on CDSS effectiveness. Conclusions Our study demonstrated greater effectiveness of safety-focused compared with QUM-focused CDSSs. Medicine safety issues are traditional areas of pharmacy activity. Without good communication between pharmacists and physicians, the full benefits of QUM-focused CDSSs may not be realised. Developments in pharmacy-based CDSSs need to consider these inter-professional relationships as well as computer-system enhancements. [source] Computerized Physician Order Entry with Clinical Decision Support in the Long-Term Care Setting: Insights from the Baycrest Centre for Geriatric CareJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Paula A. Rochon MD Although computerized physician order entry (CPOE) has been successfully implemented in many acute care hospitals, few descriptions of its use in the long-term care (LTC) setting are available. This report describes the experiences of one LTC facility in developing and implementing a CPOE system with clinical decision support (CDS). Even when a facility has the necessary resources and "institutional will," many challenges are associated with the implementation of this application. The system was designed to meet the needs of healthcare providers in the LTC setting, in particular by informing prescribing decisions, reducing the frequency of prescribing and monitoring errors, and reducing adverse drug event rates. Based on experience adopting this technology early, 10 insights are offered that it is hoped will assist others who are considering the implementation of CPOE systems with CDS in the LTC setting. [source] Tuning and control of dimensional consistency in molded productsADVANCES IN POLYMER TECHNOLOGY, Issue 3 2004David Kazmer Abstract Design and manufacturing of molded products are subject to uncontrolled variation (noise) and unknown performance behavior and/or requirements (uncertainty). The validity of current Six Sigma approaches for tolerancing and process optimization for multiple part dimensions is explored. Response surfaces for part weight and two part dimensions are developed as a function of multiple process variables for a rectangular part molded of isotactic polypropylene, i-PP. The process capabilities with respect to dimensional consistency and part weight are assessed using standard practices and Monte Carlo analysis. With respect to tuning of manufacturing processes, multicriteria optimization is necessary to ensure the selection of process set-points resulting in an acceptable likelihood of satisfying multiple dimensional specifications. The Extensive Simplex Method is shown to provide reasonable decision support for process optimization based on a linear process model derived from a main effects design of experiments. With respect to on-line quality control of dimensional consistency, part weight was validated as a good estimator of part dimensions, though requiring validation on an application by application basis. © 2004 Wiley Periodicals, Inc. Adv Polym Techn 23: 163,175, 2004; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/adv.20007 [source] The role of research for integrated management of invasive species, invaded landscapes and communitiesJOURNAL OF APPLIED ECOLOGY, Issue 2 2008Yvonne M. Buckley Summary 1Invaded landscapes and ecosystems are composed of multiple interacting networks and feed-back loops, sometimes leading to unexpected effects of management actions. In order to plan management for invaded systems we need to explicitly consider management goals before putting actions in place. Actions taken must be justified in terms of their amelioration of impacts of invaders, contribution to the management goals and the costs incurred. 2This Special Profile brings together papers on the management of invasive plants, transgenes, animals and diseases, leading to conclusions with clear policy and management relevance and contributing to some of the hottest current topics in invasion ecology: unexpected impacts of invaders, restoration of invasion resistance, distribution mapping, spatial epidemiology, escape of transgenes, community interactions and complex effects of management. 3As papers in this Special Profile demonstrate, management for amelioration of the impacts of invasive species will include a wide range of manipulations, not just of the invader itself but of both abiotic and biotic components of the system. In fact, several papers in this Special Profile show that indirect management of the community may be more effective than removal of the invader alone. 4As little information is generally available at the beginning of a management programme, an adaptive approach should be taken and the management objectives/goals revised throughout the management process. New methods are emerging for adaptive management; an example is presented in this Special Profile where a Bayesian model used for assessing eradication goals can be updated throughout the management process leading to refinement of management. 5Synthesis and applications. Applied research should be directed at providing decision support for managers throughout the management process and can be used to provide predictive tools for risk assessment of new invaders. The science of invasion ecology has much to contribute to the new challenge of natural or enhanced movement of organisms in relation to climate change. Methods and information from invasion ecology can be used to assess management goals, management actions and the risks of potential translocations before they are put in place. [source] Computerized physician order entry (CPOE) system: expectations and experiences of usersJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2010Jasperien E. Van Doormaal PharmD Abstract Objectives, To explore physicians' and nurses' expectations before and experiences after the implementation of a computerized physician order entry (CPOE) system in order to give suggestions for future optimization of the system as well as the implementation process. Method, On four internal medicine wards of two Dutch hospitals, 18 physicians and 42 nurses were interviewed to measure expectations and experiences with the CPOE system. Using semi-structured questionnaires, expectations and experiences of physicians and nurses with the CPOE system were measured with statements on a 5-point Likert scale (1 = completely disagree, 5 = completely agree). The percentage respondents agreeing (score of 4 or 5) was calculated. Chi-squared tests were used to compare the expectations versus experiences of physicians and nurses and to assess the differences between physicians and nurses. Results, In general, both physicians and nurses were positive about CPOE before and after the implementation of this system. Physicians and nurses did not differ in their views towards CPOE except for the overview of patients' medication use that was not clear according to the nurses. Both professions were satisfied with the implementation process. CPOE could be improved especially with respect to technical aspects (including the medication overview) and decision support on drug,drug interactions. Conclusion, Overall we conclude that physicians and nurses are positive about CPOE and the process of its implementation and do accept these systems. However, these systems should be further improved to fit into clinical practice. [source] Clinician attitudes towards prescribing and implications for interventions in a multi-specialty group practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2008Robert J. Fortuna MD Abstract Background, Prescribing decisions are subject to a myriad of external forces, including patient requests for advertised medications. Although numerous factors influence prescribing, resources to support unbiased evidence-based prescribing are not widely available. Methods, To guide future interventions, we surveyed clinicians about influences on prescribing, awareness of pharmaceutical costs and attitudes towards computerized decision support. A 21-item survey was sent to 604 prescribing clinicians in a large multi-specialty group practice that employs a robust electronic medical record. Results, Surveys were returned from 405 clinicians (67%). Most respondents (87%) felt that direct-to-consumer (DTC) advertising prompts patients to request inappropriate medications, and more than one in five clinicians (22%) reported difficulty declining patients' requests for advertised medications. Providers with more clinical sessions per week reported greater difficulty. Although 93% of clinicians felt they have access to the information needed to guide prescribing, only about half (54%) reported they are aware of how much patients pay for prescription medications. Clinicians' awareness of medication costs varied considerably by specialty, with behavioural health clinicians being the most aware. The majority of providers (79%) stated that computerized prescribing alerts are a clinically useful source of information. Conclusions, Although the majority of clinicians reported that DTC advertising leads many patients to request medications that are inappropriate for their condition, a sizable proportion of clinicians reported difficulty declining these requests, and many are unaware of medication costs. Interventions to support prescribing decisions should provide the busiest clinicians with up-to-date, specialty-specific evidence and cost information. [source] Early and reliable detection of herpes simplex virus type 1 and varicella zoster virus DNAs in oral fluid of patients with idiopathic peripheral facial nerve palsy: Decision support regarding antiviral treatment?JOURNAL OF MEDICAL VIROLOGY, Issue 9 2010Andreas Lackner Abstract Idiopathic peripheral facial nerve palsy has been associated with the reactivation of herpes simplex virus type 1 (HSV-1) or varicella zoster virus (VZV). In recent studies, detection rates were found to vary strongly which may be caused by the use of different oral fluid collection devices in combination with molecular assays lacking standardization. In this single-center pilot study, liquid phase-based and absorption-based oral fluid collection was compared. Samples were collected with both systems from 10 patients with acute idiopathic peripheral facial nerve palsy, 10 with herpes labialis or with Ramsay Hunt syndrome, and 10 healthy controls. Commercially available IVD/CE-labeled molecular assays based on fully automated DNA extraction and real-time PCR were employed. With the liquid phase-based oral fluid collection system, three patients with idiopathic peripheral facial nerve palsy tested positive for HSV-1 DNA and another two tested positive for VZV DNA. All patients with herpes labialis tested positive for HSV-1 DNA and all patients with Ramsay Hunt syndrome tested positive for VZV DNA. With the absorption-based oral fluid collection system, detections rates and viral loads were found to be significantly lower when compared to those obtained with the liquid phase-based collection system. Collection of oral fluid with a liquid phase-based system and the use of automated and standardized molecular methods allow early and reliable detection of HSV-1 and VZV DNAs in patients with acute idiopathic peripheral facial nerve palsy and may provide a valuable decision support regarding start of antiviral treatment at the first clinical visit. J. Med. Virol. 82:1582,1585, 2010. © 2010 Wiley-Liss, Inc. [source] Combining scenario planning and multi-criteria decision analysis in practiceJOURNAL OF MULTI CRITERIA DECISION ANALYSIS, Issue 1-3 2006Gilberto Montibeller Abstract The integrated use of scenario planning and multi-criteria decision analysis (MCDA) has been advocated as a powerful combination for providing decision support in strategic decisions. Scenario planning helps decision makers in devising strategies and thinking about possible future scenarios; while MCDA can support an in-depth performance evaluation of each strategy, as well as in the design of more robust and better options. One of the frameworks proposed recently, by Goodwin & Wright, suggests the use of scenario planning with multi-attribute value theory, a mathematically simple, yet extensively researched and widely employed multi-criteria method. However, so far, such framework has been presented only using hypothetical problems. In this paper, we describe two case studies where this approach was used to support real-world strategic decisions. We discuss the challenges and limitations we encountered in applying it and suggest some possible improvements that could be made to such framework. Copyright © 2007 John Wiley & Sons, Ltd. [source] | ||||||||||||||||||||||||||||