Integration of decision support systems to improve decision support performance

Decision support system (DSS) is a well-established research and development area. Traditional isolated, stand-alone DSS has been recently facing new challenges. In order to improve the performance of DSS to meet the challenges, research has been actively carried out to develop integrated decision support systems (IDSS). This paper reviews the current research efforts with regard to the development of IDSS. The focus of the paper is on the integration aspect for IDSS through multiple perspectives, and the technologies that support this integration. More than 100 papers and software systems are discussed. Current research efforts and the development status of IDSS are explained, compared and classified. In addition, future trends and challenges in integration are outlined. The paper concludes that by addressing integration, better support will be provided to decision makers, with the expectation of both better decisions and improved decision making processes

Patient Choice for Older People in English NHS Primary Care: Theory and Practice

In the English National Health Service (NHS), patients are now expected to choose the time and place of treatment and even choose the actual treatment. However, the theory on which patient choice is based and the implementation of patient choice are controversial. There is evidence to indicate that attitudes and abilities to make choices are relatively sophisticated and not as straightforward as policy developments suggest. In addition, and surprisingly, there is little research on whethermaking individual choices about care is regarded as a priority by the largest NHS patient group and the single largest group for most GPs—older people.This conceptual paper examines the theory of patient choice concerning accessing and engaging with healthcare provision and reviews existing evidence on older people and patient choice in primary care

State of New York Public Employment Relations Board Decisions from June 12, 2002

6_12_2002_PERB_BD_DecisionsOCR.pdf: 364 downloads, before Oct. 1, 2020

Smallpox and Bioterrorism: Why the Plan to Protect the Nation Is Stalled and What to Do

The Iraq war is over, no weapons of mass destruction (WMD) have yet been found, and the president's smallpox plan, though sound, is running out of steam. Instead of being well on the way to protecting the nation's civilian population by vaccinating up to 10 million health, emergency, and public safety workers, we are stalled at 37,971 vaccinated civilians while the military has successfully and safely vaccinated more than 450,000 people. Moreover, whether or not WMD are found in Iraq, it is only one of a number of nations on the list of suspects. Of all biological weapons, smallpox has the greatest potential for doing widespread harm. Given that the risk of death or serious harm to anyone from any form of terrorism is very low, we should live our daily lives normally, not in fear. However, to do that we need to be sure that our government is taking effective steps to reduce the chances of terrorism and, when it occurs, to minimize its consequences. Even though there is enough vaccine for everyone, we are ill prepared to rapidly contain smallpox after a bioterrorist release. Although Centers for Disease Control and Prevention (CDC) guidelines have recently improved, they continue to overstate the risk of side effects of the vaccine and erroneously suggest that, after an attack, the techniques used decades ago to eradicate smallpox will work well today. Medicine and public health are very risk-averse professions in our risk-averse culture. We have not yet realized the complexity and difficulty of vaccinating millions of Americans rapidly after an attack. Nor have we come to grips with the need to make rapid, possibly draconian, post-attack decisions based on limited data of uncertain quality. That type of decisionmaking runs counter to the culture of public health. The Bush administration needs to revitalize our preparations for a smallpox bioterrorist event

Capturing Scientific Knowledge on Medical Risk Factors

In this paper, we describe a model for representing scientific knowledge of risk factors in medicine in an explicit format which enables its use for automated reasoning. The resulting model supports linking the conclusions of up-to-date clinical research with data relating to individual patients. This model, which we have implemented as an ontology-based system using Linked Data, enables the capture of risk factor knowledge and serves as a translational research tool to apply that knowledge to assist with patient treatment, lifestyle, and education. Knowledge captured using this model can be disseminated for other intelligent systems to use for a variety of purposes, for example, to explore the state of the available medical knowledge