A state-of-the-art multi-criteria model for drug benefit-risk analysis

Drug benefit-risk analysis is based on firm clinical evidence related to various safety and efficacy outcomes, such as tolerability, treatment response, and adverse events. In this paper, we propose a new approach for constructing a supporting multi-criteria model that fully takes into account this evidence. Our approach is based on the Stochastic Multicriteria Acceptability Analysis (SMAA) methodology, which allows us to compute the typical value judgments that support a decision, to quantify uncertainty, and to compute a comprehensive benefit-risk profile. As an example, we constructed a multi-criteria model for the therapeutic group of second-generation antidepressants. We analyzed Fluoxetine, Paroxetine, Sertraline, and Venlafaxine according to relative efficacy and absolute rates of several common adverse drug reactions using meta-analytical data from the literature. Our model showed that there are clear trade-offs among the four drugs. Based on our experiences from this study, SMAA appears to be a suitable approach for quantifying trade-offs and decision uncertainty in drug benefit-risk analysis.

Temporal Case-Based Reasoning Model for Reservoir Spillway Gate Operation Recommendation

Emergency decision making process faces difficulty in making timely and right decision. Delay in decision making will result catastrophic events that will jeopardize the public safety and properties. Decision making in reservoir spillway gate operation is usually dynamic in nature, and requires expert experiences in order to deliver decision. In this research, a decision support system was proposed that can assist decision maker determining whether to open or close the spillway gate. In this thesis, the Temporal Case-Based Reasoning (TCBR) technique is implemented to model the dam technician knowledge, by utilizing experiences database (case-base), to solve future problems. This is an experimental study, where Knowledge Discovery in Databases (KDD) approach is integrated with General Methodology of Design Research (GMDR), where a prototype was developed to proof the proposed model. Timah Tasoh Dam operation data ranges from year 1998 to 2005 are used to serve as a case study in this model. The proposed model was found to be able to recommended decision with up to accuracy of 87.2 percent and 88.75 percent case similarity with previous cases

Applied and conceptual approaches to evidence-based practice in research and academic libraries

Evidence-based practice is an approach to professional practice that involves a structured process of collecting, interpreting and applying valid and reliable research and evidence to support decision-making and continuous service improvement in professional practice. This paper reports on emerging initiatives in evidence-based practice at the University of Southern Queensland (USQ) Library, a regional multi-campus university in Australia. It demonstrates how evidence-based practice forms part of our organisational strategy to engage with our community and society. The case study describes a new model of embedding evidence-based practice through a role explicitly dedicated to developing the library’s evidence base. While other libraries may have a person responsible for assessment, performance metrics or data analysis, the Coordinator (Evidence-Based Practice) has a broader mandate – to work with library staff to develop tools, skills and expertise in evidence-based practice. The paper will describe why this role was created and how the Coordinator is working to engage with library staff to understand their business and the evidence needed to support service improvement for the Library. By doing this, USQ Library is building the capacity to demonstrate value to stakeholders, gain a deeper understanding of clients’ needs and experiences, promote robust decision-making and improve service delivery. The paper also outlines an initiative led by the Coordinator (Evidence-Based Practice) to develop a conceptual model of evidence-based practice within academic libraries at the organisational, rather than individual level. Current models of evidence-based library and information practice apply predominantly to individuals. Informed by relevant literature and 16 semi-structured interviews with library professionals from Australian and New Zealand university libraries, three themes emerged to describe how evidence-based practice might be experienced at the organisational level. The lived experience at USQ Library and our research investigations suggest that being evidence-based provides benefits to an academic library’s culture, practice and impact

An Integrated Approach for the Building and the Selection of Multidisciplinary Teams in Health Care System

This chapter presents a support approach for the building and the selection of multidisciplinary teams. In the first part, we propose a new general model for multidisciplinary team building. The proposed model takes professional’s preferences into account when a team building process is required for any type of project. In the second part, we develop hybridization between a multicriterion decision method and a cognitive method for selection teams. The developed methodology is based on the experiences of the past operations in order to select the adequate team for a new operation. We test the effectiveness of the model using health care domains of different complexities and describe some practical experiences of using the model in the surgical team building process

Support System Model for Value based Group Decision on Roof System Selection

A group decision support system is required on a value-based decision because there are different concern caused by differing preferences, experiences, and background. It is to enable each decision-maker to evaluate and rank the solution alternatives before engaging into negotiation with other decision-makers. Stakeholder of multi-criteria decision making problems usually evaluates the alternative solution from different perspective, making it possible to have a dominant solution among the alternatives. Each stakeholder needs to identify the goals that can be optimized and those that can be compromised in order to reach an agreement with other stakeholders. This paper presents group decision model involving three decision-makers on the selection of suitable system for a building’s roof. The objective of the research is to find an agreement options model and coalition algorithms for multi person decision with two main preferences of value which are function and cost. The methodology combines value analysis method using Function Analysis System Technique (FAST); Life Cycle Cost analysis, group decision analysis method based on Analytical Hierarchy Process (AHP) in a satisfying options, and Game theory-based agent system to develop agreement option and coalition formation for the support system. The support system bridges theoretical gap between automated design in construction domain and automated negotiation in information technology domain by providing a structured methodology which can lead to systematic support system and automated negotiation. It will contribute to value management body of knowledge as an advanced method for creativity and analysis phase, since the practice of this knowledge is teamwork based. In the case of roof system selection, it reveals the start of the first negotiation round. Some of the solutions are not an option because no individual stakeholder or coalition of stakeholders desires to select it. The result indicates the alternative solution that will be the best-fit solution. In this problem, a space frame system is the ‘best-fit’ solution for the roof system

Joining the Advocacy Conversation: How Dance/Movement Therapy can Influence Shared Decision-Making Policy for Children Seeking Grief Support: A Literature Review

The intention if this capstone thesis is to bring awareness to the current state of children’s grief support services and how dance/movement therapy can be used to address the areas where growth is required. The capacity of dance/movement therapy to facilitate the cocreation of improved grief support services lies in its ability to be used as an advocacy tool for children to process and express their experiences with grief. In collaboration with the shared decision-making model, the information gained from dance/movement therapy exploration can help children communicate their experiences with grief to those who have the power to shift how current grief support services are implemented. By analyzing the available research using a literature review format, three major themes surfaced. These themes include understanding children’s unique experiences with grief, the need to create grief support services that respond appropriately to presenting needs and advocating for the implementation of those services. When children’s voices are considered in the advocacy conversations that affect them, services can be structured to more effectively accommodate their needs. Based on these findings a tailored grief support framework for children was created outlining how to integrate the key takeaways from this research

School Personnel and Leadership Collaboration Model for Ideal Work Contexts

This article describes the school personnel and leadership collaboration (SPLC) model, a shared-responsibility framework for faculty, staff, and administrators. Prior research consistently demonstrates the need for (a) administrative support for teachers and other school personnel and (b) collegial support among staff. The SPLC model represents an amalgamation of this research and, moreover, integrates personnel support for leadership. In the managerial sciences, leader–member exchange (LMX) is a well-known relationship-based leadership approach that focuses on a dyadic or two-way relationship between supervisors and their employees. Though managers are responsible for overseeing operations, personnel contribute ideas, participate in decision-making, and follow through with their responsibilities. LMX is associated with positive work experiences and job performance outcomes. In contrast, schools are often run with a top–down leadership approach that solicits little to no input from staff, leading to low morale, high attrition rates, and negative school climate. Thus, the SPLC model was inspired by LMX and emphasizes practices, such as shared decision-making, staff autonomy, and shared responsibilities. Detailed examples of ways schools may apply the SPLC model to their practices are included

A Game of Attribute Decomposition for Software Architecture Design

Attribute-driven software architecture design aims to provide decision support by taking into account the quality attributes of softwares. A central question in this process is: What architecture design best fulfills the desirable software requirements? To answer this question, a system designer needs to make tradeoffs among several potentially conflicting quality attributes. Such decisions are normally ad-hoc and rely heavily on experiences. We propose a mathematical approach to tackle this problem. Game theory naturally provides the basic language: Players represent requirements, and strategies involve setting up coalitions among the players. In this way we propose a novel model, called decomposition game, for attribute-driven design. We present its solution concept based on the notion of cohesion and expansion-freedom and prove that a solution always exists. We then investigate the computational complexity of obtaining a solution. The game model and the algorithms may serve as a general framework for providing useful guidance for software architecture design. We present our results through running examples and a case study on a real-life software project.Comment: 23 pages, 5 figures, a shorter version to appear at 12th International Colloquium on Theoretical Aspects of Computing (ICTAC 2015

Managing \u27shades of grey\u27: a focus group study exploring community-dwellers’ views on advance care planning in older people

Background: Community-dwelling consumers of healthcare are increasing, many aging with life-limiting conditions and deteriorating cognition. However, few have had advance care planning discussions or completed documentation to ensure future care preferences are acted upon. This study examines the awareness, attitudes, and experiences of advance care planning amongst older people and unrelated offspring/caregivers of older people residing in the community. Methods: Qualitative descriptive research, which included focus groups with older people (55+ years) and older people’s offspring/caregivers living in an Australian city and surrounding rural region. Data was analysed using an inductive and comparative approach. Sampling was both convenience and purposive. Participants responded to web-based, newsletter or email invitations from an agency, which aims to support healthcare consumers, a dementia support group, or community health centres in areas with high proportions of culturally and linguistically diverse community-dwellers. Results: Eight focus groups were attended by a homogenous sample of 15 older people and 27 offspring/ caregivers, with 43% born overseas. The overarching theme, ‘shades of grey’: struggles in transition, reflects challenges faced by older people and their offspring/caregivers as older people often erratically transition from independence and capacity to dependence and/or incapacity. Offspring/caregivers regularly struggled with older people’s fluctuating autonomy and dependency as older people endeavoured to remain at home, and with conceptualising “best times” to actualise advance care planning with substitute decision maker involvement. Advance care planning was supported and welcomed, x advance care planning literacy was evident. Difficulties planning for hypothetical health events and socio-cultural attitudes thwarting death-related discussions were emphasised. Occasional offspring/caregivers with previous substitute decision maker experience reported distress related to their decisions. Conclusions: Advance care planning programs traditionally assume participants are ‘planning ready’ to legally appoint a substitute decision maker (power of attorney) and record end-of-life treatment preferences in short time frames. This contrasts with how community dwelling older people and offspring/caregivers conceive future care decisions over time. Advance care planning programs need to include provision of information, which supports older people’s advance care planning understanding and management, and also supports offspring/caregivers’ development of strategies for broaching advance care planning with older people, and preparing for potential substitute decision maker roles. Development and integration of strategies to support older people’s decision making when in the ‘grey zone’, with fluctuating cognitive capacities, needs further consideration. Findings support an advance care planning model with conversations occurring at key points across a person’s lifespan