In 2005, the International Patient Decision Aids Standards Collaboration identified twelve quality dimensions to guide assessment of patient decision aids. One dimension-the delivery of patient decision aids on the Internet-is relevant when the Internet is used to provide some or all components of a patient decision aid. Building on the original background chapter, this paper provides an updated definition for this dimension, outlines a theoretical rationale, describes current evidence, and discusses emerging research areas. An international, multidisciplinary panel of authors examined the relevant theoretical literature and empirical evidence through 2012. The updated definition distinguishes Internet-delivery of patient decision aids from online health information and clinical practice guidelines. Theories in cognitive psychology, decision psychology, communication, and education support the value of Internet features for providing interactive information and deliberative support. Dissemination and
Decision curve analysis is a suitable method for evaluating alternative diagnostic and prognostic strategies that has advantages over other commonly used measures and techniques.
Clinical decision analysis: Incorporating the evidence with patient preferences Ilyas S Aleem1, Hamza Jalal2, Idris S Aleem3, Adeel A Sheikh1, Mohit Bhandari11Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; 2The University of Calgary, Calgary, Alberta, Canada; 3Carleton University, Ottawa, Ontario, CanadaAbstract: Decision analysis has become an increasingly popular decision-making tool with a multitude of clinical applications. Incorporating patient and expert preferences with available literature, it allows users to apply evidence-based medicine to make informed decisions when confronted with difficult clinical scenarios. A decision tree depicts potential alternatives and outcomes involved with a given decision. Probabilities and utilities are used to quantify the various options and help determine the best course of action. Sensitivity analysis allows users to explore the uncertainty of data on expected clinical outcomes. The decision maker can
Patient decision aids are increasingly regarded as important components of clinical practice that enable shared decision making (SDM) and evidence based patient choice. Despite broad acceptance of their value, there remains little evidence of their successful implementation in primary care settings. Health care practitioners from five general practice surgeries in northern England participated in focus group sessions around the themes of patient decision aids, patient and practitioner preferences and SDM. Participants included general practitioners (n = 19), practice nurses (n = 5) and auxiliary staff (n = 3). Transcripts were analysed using a framework approach. We report a) practitioners discussion of the current impetus towards sharing decisions and their perspectives on barriers to SDM, and b) the implementation of patient decision aids in practice and impediments such as lack of an evidence base and time available in consultations. We demonstrate two orientations to sharing decisions: practitioner
Part I: An Introduction to Business Decision Analysis:. 1. What is Business Decision Analysis?.. 2. Model-Building in Business Decision Analysis.. 3. The Components of a Mathematical Model.. 4. Deterministic and Stochastic Models.. 5. Single-attribute and Multi-attribute Problems.. 6. Sensitivity Analysis and Model Building.. Part II: Decision Analysis:.. 7. Decision Trees and Payoff Matrices.. 8. Decision-Making under Conditions of Uncertainty.. 9. Decision-Making under Conditions of Risk.. 10. Multi-Stage Decision Problems.. 11. Revising Probabilities.. 12. Extensions.. Part III: Linear Programming:.. 13. Formulating a Linear Programming Problem.. 14. Solving Linear Programming Problems Using a Graphical Method.. 15. Sensitivity Analysis of Solutions.. 16. Computer Solution of Linear Programming Problems.. 17. The Transportation Problem.. 18. The Assignment Problem.. 19. Linear Programming - Limitations and Extensions.. Part IV: Regression Analysis:.. 20. Functional Relationships.. 21. ...
A UCSF PI-initiated study which includes comprehensive decision support intervention incorporating clinical, lifestyle, tumor genomic, and germline gene variant data.. The web and coaching intervention will: 1) summarize key clinical, lifestyle, and biomarker data elements, 2) communicate relative and absolute risks of upgrading/upstaging based on each of these elements, individually and in aggregate, and 3) provide tailored educational information for informed decision making on treatment options . A key aspect of the intervention will be provision of tiered coaching to the men prior to their physician visits to help them enter information accurately into the system, understand the results of the prediction model, document their questions for their physicians, and prepare them to make better-informed treatment decisions. UCSF research team will develop the decision support intervention in phases, initially using only CAPRA (validated clinical risk score), BMI (body mass index), and smoking data ...
Decision analysis (DA) is the discipline comprising the philosophy, theory, methodology, and professional practice necessary to address important decisions in a formal manner. Decision analysis includes many procedures, methods, and tools for identifying, clearly representing, and formally assessing important aspects of a decision, for prescribing a recommended course of action by applying the maximum expected utility action axiom to a well-formed representation of the decision, and for translating the formal representation of a decision and its corresponding recommendation into insight for the decision maker and other stakeholders. Graphical representation of decision analysis problems commonly use framing tools, influence diagrams and decision trees. Such tools are used to represent the alternatives available to the decision maker, the uncertainty they involve, and evaluation measures representing how well objectives would be achieved in the final outcome. Uncertainties are represented through ...
This graph shows the total number of publications written about "Decision Support Techniques" by people in this website by year, and whether "Decision Support Techniques" was a major or minor topic of these publications ...
BACKGROUND: Several models are currently available for predicting the malignancy of pancreatic intraductal papillary mucinous neoplasm (IPMN), namely, the Pancreatic Surgery Consortium (PSC), the Japan Pancreas Society (JPS), the Johns Hopkins Hospital (JHH), and the Japan-Korea (JPN-KOR) models. However, a head-to-head comparison that shows which model is more accurate for this individualized prediction is lacking. AIM: To perform a head-to-head comparison of the four models for predicting the malignancy of pancreatic IPMN. METHODS: A total of 181 patients with IPMN who had undergone surgical resection were identified from a prospectively maintained database. The characteristics of IPMN in patients were recorded from endoscopic ultrasound imaging data and report archives. The performance of all four models was examined using Harrells concordance index (C-index), calibration plots, decision curve analyses, and diagnostic tests. RESULTS: Of the 181 included patients, 94 were categorized as ...
Multi-Criteria Decision Analysis (MCDA) is the area of the Decision Sciences that focus on structuring, analyzing, modeling, solving, and recommending a solution to decision problems in the presence of multiple criteria. One important issue in MCDA has to do with Robustness Analysis in discrete MCDA. Although there is not a single definition accepted by the scientific community, we can conveniently refer to robustness as the ability of a solution to cope with uncertainties. Different sources of uncertainty interact in a decision problem, some reflecting more or less arbitrary choices of the decision analyst and others concerning external uncertainties. In this sense, it has been proposed that the robustness concern needs to be explicit in a problem such that the robustness analysis is driven by a specific aim. A new robustness analysis framework is proposed where robustness of a solution in a decision aiding process is measured by the distance from that solution to an expected outcome, chosen by ...
The SAMe-TT2R2 score is a clinical prediction rule to aid decision making between a non-VKA oral anticoagulant (NOAC) and a vitamin K antagonist (VKA)
Markus Kraus and Thomas Czypionka contributed to the article Strengthening the evidence-base of integrated care for people with mulit-morbidity in Europe using Multi-Criteria Decision Analysis (MCDA) published in the BMC Health Services Research Journal. The paper discusses the evaluation of integrated care programmes for individuals with multi-morbidity, through the use of Multi-Criteria Decision Analyses (MCDA). Read the full article online. ...
Researchers have developed a simple clinical decision rule that may help doctors identify patients with headache in the emergency department who have subarachnoid hemorrhage (bleeding in a certain area of the brain), according to a study in the September 25 issue of JAMA.
Impact of a clinical decision rule on hospital triage of patients with suspected acute cardiac ischemia in the emergency department Academic Article ...
Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet
Many important decisions must be made without full information. For example, a woman may need to make a treatment decision regarding breast cancer without full knowledge of important uncertainties, such as how well she might respond to treatment. In the financial domain, in the wake of the housing crisis, the government may need to monitor the credit market and decide whether to intervene. A key input in this case would be a model to describe the chance that one person (or company) will default given that others have defaulted. However, such a model requires addressing the lack of knowledge regarding the correlation between groups or individuals. How to model and make decisions in cases where only partial information is available is a significant challenge. In the past, researchers have made arbitrary assumptions regarding the missing information. In this research, we developed a modeling procedure that can be used to analyze many possible scenarios subject to strict conditions. Specifically, we ...
Your patient walks into your clinic with neck pain that radiates into their arm...now what? How do you know what it is, what you should do, and if they are going to respond well to conservative therapy? With the help of several research studies we thankfully have the answer to some of these questions. Wainner…
Hörster, Laura; Schlenk, Richard F.; Stadler, Michael; Gabriel, Maria; Thol, Felicitas; Schildmann, Jan; Vollmann, Jochen; Rochau, Ursula; Sroczynski, Gaby; Wasem, Jürgen; Ganser, Arnold; Port, Matthias; Neumann, Anja (2017): Cost-effectiveness of methods in personalized medicine. Results of a decision-analytic model in patients with acute myeloid leukemia with normal karyotype. In: Leukemia Research, Vol. 62: pp. 84-90 ...
A population-based cohort study revealed cancer incidence was 24 percent greater in people who underwent CT imaging at least one year prior to diagnosis, according to research published online May 22 in BMJ. The researchers called for increased awareness of the risks and benefits of CT imaging among providers and increased utilization of decision tools.
The tri-fold Clinical Prediction Card is a great reminder of several commonly-used prediction rules for the emergency department.
This decision aid was developed by Aleena Wojcieszek, a Psychology Honours student I supervised in 2009. In an alternate allocation controlled trial, we found that exposure to this tool increased young peoples knowledge of fertility decline over the lifespan and of the effectiveness of in vitro fertilisation. Exposure also decreased peoples desired age at commencement and completion of childbearing. This trial was published here. ...
The halting problem is a decision problem about properties of computer programs on a fixed Turing-complete model of computation. The problem is to determine, given a program and an input to the program, whether the program will eventually halt when run with that input. In this abstract framework, there are no resource limitations of memory or time on the programs execution; it can take arbitrarily long, and use arbitrarily much storage space, before halting. The question is simply whether the given program will ever halt on a particular input.. For example, in pseudocode, the program. does not halt; rather, it goes on forever in an infinite loop. On the other hand, the program. halts very soon.. The halting problem is famous because it was one of the first problems proven algorithmically undecidable. This means there is no algorithm which can be applied to any arbitrary program and input to decide whether the program stops when run with that input.. Full article ▸. ...
When building a new analytical model, rushing headlong into construction is not a good idea. Careful planning and design will result in analytics you can trust.
When building a new analytical model, rushing headlong into construction is not a good idea. Careful planning and design will result in analytics you can trust.
Given the following sample information, test the hypothesis that the treatment means are equal at the .05 significance level. a. State the null hypothesis and the alternative hypothesis. b. What is the decision rule? c. Compute.
On completion of your course, you will receive two qualifications:. Business Decision Analysis Diploma. Business Decision Analysis Diploma issued by My Distance Learning College, entitling you to use the letters SAC Dip after your name.. NCFE Level 4 Business Decision Analysis Award. This Course leads to an NCFE Level 4 Award Certificate for successful learners. That means that it is independently accredited at a level of learning equivalent to level 4 on the National Qualifications Framework (NQF) for England, Wales and Northern Ireland (in which case GCSEs are at levels 1 and 2 and A Levels are at level 3). In accrediting the program at level 4, NCFE attests that its learning outcomes are at an equivalent level to a level 4 national qualification. This award has been designed by My Distance Learning College to meet specific learners or employers requirements. Accreditation by NCFE is a guarantee of quality. It means that this learning program has been scrutinized and approved by an ...
One of the most important uses of benefit-risk assessment pertains to approval of new medicines by regulatory authorities and the subsequent review of these products during their life-cycle when new safety and/or efficacy data becomes available. At present, there exist no validated, well-accepted models for benefit-risk assessment that have the appropriate degree of sophistication, and as a consequence no models are widely used by regulatory authorities or industry. The aim of the study was therefore to develop a new model for benefit-risk assessment of medicines using multi-criteria decision analysis (MCDA). ...
TY - JOUR. T1 - Inform. T2 - Integrated decision support in intensive care. AU - Hunter, James. AU - Chambrin, Marie-Christine. AU - Collinson, Paul. AU - Hedlund, Anders. AU - Groth, Torgny. AU - Kalli, Seppo. AU - Kari, Aarno. AU - Lenoudias, George. AU - Ravaux, Pierre. AU - Ross, Donnie. PY - 1990. Y1 - 1990. N2 - Many medical decision support systems that have been developed in the past have failed to enter routine clinical practice. Often this is because the developers have failed to analyse in sufficient detail the precise user requirements, because they have produced a system which takes too narrow a view of the patient, or because the decision support facilities have not been sufficiently well integrated into the routine clinical data handling activities. In this paper we discuss how the AIM-INFORM project is setting out to deal with these issues, in the context of the provision of decision support in the intensive care unit.. AB - Many medical decision support systems that have been ...
Approves additional funding for the Phase 2 period for the proposals listed in Table 1 in the amounts indicated for each proposal, with the clear understanding that the amounts approved are upper ceilings rather than final funding amounts, and based on an understanding that the Secretariat shall pursue on-going implementation arrangements for each proposal consistent with the recommendations set forth in its Grant Score Card. Approval is also subject to paragraph 3.c. of the Comprehensive Funding Policy (GF/B20/DP9)[1] ...
Unisense FertiliTech, world leader in time-lapse technology for IVF will present a new tool to improve embryo evaluation in IVF. The KIDScore™ decision support tool is an exclusive feature of the EmbryoScope™ time-lapse system and is based on analysis of…
Approves additional funding for the Phase 2 period for the proposals listed in Table 1 in the amounts indicated for each proposal, with the clear understanding that the amounts approved are upper ceilings rather than final funding amounts, and based on an understanding that the Secretariat shall pursue on-going implementation arrangements for each proposal consistent with the recommendations set forth in its Grant Score Card. Approval is also subject to paragraph 3.c. of the Comprehensive Funding Policy (GF/B20/DP9)[1] ...
Carbon Trust Biomass decision support tool - find the most cost effective biomass system size & integration strategy based on site heating requirements.
books.google.comhttps://books.google.com/books/about/Cost_benefit_and_multi_criteria_analysis.html?id=SPUlAQAAMAAJ&utm_source=gb-gplus-shareCost-benefit and multi-criteria analysis for inland waterways infrastructure ...
Objectives. Using a decision-analytic model, we sought to examine the cost-effectiveness of three strategies for cardioversion of patients admitted to the hospital with atrial fibrillation. Background. Transesophageal echocardiographic TEE - guided cardioversion has been proposed as a method for early cardioversion of patients with atrial...
An infinite-state Markov decision model is considered for the control of a simple immigration process, which represents a pest population, by an intermittent predator. It is assumed that the predator may leave the habitat before capturing all the pests. The cost rate caused by the pests is an increasing function of their population size, while the cost rate of the controlling action is constant. A sequence of suitable finite-state Markov decision models is constructed such that the optimal average-cost policies in the sequence converge to the optimal average-cost policy in the original model. There is strong numerical evidence that the optimal policy introduces the predator if and only if the pest population is greater than or equal to some critical size.. • An exact solution to a Kolmogorov-type model for two interacting ...
The Complete Risk and Decision Analysis Toolkit Wouldnt you like to know the chances of making money on your next venture? Or which of many decision options is most likely to yield the best payoff? How about the best sequential drilling strategy? Or how much to invest in various projects in order to maximize the return on your project portfolio? Everyone would like answers to these types of questions. Armed with that kind of information, you could take a lot of guesswork out of big decisions and plan strategies with confidence. With the DecisionTools Suite, you can answer these questions and more - right in your Excel spreadsheet. The DecisionTools Suite is an integrated set of programs for risk analysis and decision making under uncertainty that runs in Microsoft Excel. The DecisionTools Suite includes @RISK, which adds risk analysis to Excel using Monte Carlo simulation, PrecisonTree for visual decision tree analysis, TopRank for what-if analysis, NeuralTools and StatTools for data analysis, and
TY - JOUR. T1 - Development and validation of a clinical prediction rule for breast cancer. T2 - British Journal of General Practice. AU - McCowan,Colin. AU - Fahey,Tom. AU - Little,Paul. PY - 2011/6. Y1 - 2011/6. U2 - 10.3399/bjgp11X572670. DO - 10.3399/bjgp11X572670. M3 - Letter. VL - 61. SP - 382. EP - 382. JO - British Journal of General Practice. JF - British Journal of General Practice. SN - 0960-1643. IS - 587. ER - ...
Abstract: This talk presents suffcient conditions for the existence of stationary optimal policies for average-cost Markov Decision Processes with Borel state and action sets and with weakly continuous transition probabilities. The one-step cost functions may be unbounded, and the action sets may be noncompact. The main contributions of this paper are: (i) general sufficient conditions for the existence of stationary discount-optimal and average-cost optimal policies and descriptions of properties of value functions and sets of optimal actions, (ii) a sufficient condition for the average-cost optimality of a stationary policy in the form of optimality inequalities, and (iii) approximations of average-cost optimal actions by discount-optimal actions ...
03/14/19 - We consider the recently proposed reinforcement learning (RL) framework of Contextual Markov Decision Processes (CMDP), where the ...
TY - JOUR. T1 - A Decision Analytic Method for Scoring Performance on Computer-Based Patient Simulations. AU - Downs, Stephen. AU - Friedman, Charles P.. AU - Marasigan, Farah. AU - Gartner, Gary. PY - 1997. Y1 - 1997. N2 - As computer based clinical case simulations become increasingly popular for training and evaluating clinicians, approaches are needed to evaluate a trainees or examinees solution of the simulated cases. We developed a decision analytic approach to scoring performance on computerized patient case simulations. We developed decision models for computerized patient case simulations in four specific domains in the field of infectious disease. The decision models were represented as influence diagrams. A single decision node represents the possible diagnoses the user may make. One chance node represents a probability distribution over the set of competing diagnoses in the simulations. The value node contains the utilities associated with all possible combinations of diagnosis and ...
The stochastic models of systems with reverse logistics usually assume that the quantity of products returned is independent of sales. This hypothesis is obviously not true and can lead to suboptimal production policies. In this paper a new sales-dependent returns model is described. In this model, the returns depend on the useful life of the products sold and on the probability of an end-of-life product being returned. A Markov decision problem is formulated in order to obtain the optimal manufacturing policy. A numerical example is provided to illustrate the use of the defined model. An approximated Markov decision model is defined where the optimal policy is easily obtained. The optimal policies of the original and the approximated models are compared ...
A Mashup Application to Support Complex Decision Making for Retail Consumers: 10.4018/jisss.2010100103: Purchase processes often require complex decision making and consumers frequently use Web information sources to support these decisions. However, increasing
This useful handbook provides a concise compilation of the evidence supporting diagnostic testing and clinical decision rules in emergency care.
This page contains the abstract A Theoretical Model For The Development Of A Diagnosis-based Clinical Decision Rule For The Management Of Patients With Spinal Pain http://www.chiro.org/LINKS/ABSTRACTS/A_Theoretical_Model_For_The_Development.shtml
BMC Health Services Research http://www.biomedcentral.com/bmchealthservres/content (Accessed 9 December 2017) Research article Cost-effectiveness of Human Papilloma Virus (HPV) vaccination in Nigeria: a decision analysis using pragmatic parameter estimates for cost and programme coverage Authors: Obinna I. Ekwunife and Stefan K. Lhachimi Citation: BMC Health Services Research 2017 17:815 Published on: 8 December 2017 Abstract Background World…
Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet
Location: Tabriz University of Medical Sciences. The workshop is free. However registration is required.. This workshop will be highly interactive. Workshop instructors will describe core concepts of shared decision making using a seminar format and group based activities to ensure transmission of the needed information, they will also provide hands‐on for participants for improving quality of learning. For example, participants will have the opportunity to evaluate a sample decision support intervention using standard internationally recognized criteria.. Background: Shared decision making (SDM) is a collaborative process that allows patients and clinicians to make this difficult decision together, taking into account the best evidence available as well as the patients values and preferences. Patients who participate in decisions about their health have better experiences, better outcomes and get better value for money. However, for clinicians to engage patients in SDM, they need new skills ...
This article outlined the process of the development and alpha testing of a PtDA in an iterative process on the complex primary treatment decision for women with early stage breast cancer. The iterated process in ongoing data collection and alternating the PtDA has proved to be a well-chosen way to involve end users and to improve the PtDA [27]. In this study professionals and patients exerted significant influence on the PtDAs content, structure and lay-out. Patients had highly valuable views, sometimes conflicting between patients but also with professionals, about the presentation of relevant risks and values, for which we succeeded to find a common denominator that was still comprehensible for lower-educated patients. We spent much time in trying to achieve consensus between the patients and professionals on the content and format of the PtDA. The research team and the professionals involved in the development discussed the impact of all of the comments after each test round. If there were ...
Project Risk Management, Project Decision Analysis, Project Risk Analysis, Event Chain Methodology, Psychology of Project Management
An interactive decision dashboard format developed by researchers with the University of Rochester (N.Y.) School of Medicine & Dentistry can be adapted to create a clinically realistic prototype patient decision aid, according to an article published this week inBMC Medical Informatics and Decision Making. Such findings, the researchers say, represent the potential of interactive decision dashboards for fostering informed decision making.