A systematic review with attempted network meta-analysis of asthma therapy recommended for five to eighteen year olds in GINA steps three and four

Background: The recommendations for the treatment of moderate persistent asthma in the Global Initiative for Asthma (GINA) guidelines for paediatric asthma are mainly based on scientific evidence extrapolated from studies in adults or on consensus. Furthermore, clinical decision-making would benefit from formal ranking of treatments in terms of effectiveness.Our objective is to assess all randomized trial-based evidence specifically pertaining to 5-18 year olds with moderate persistent asthma. Rank the different drug treatments of GINA guideline steps 3&4 in terms of effectiveness.Methods: Systematic review with network meta-analysis. After a comprehensive search in Central, Medline, Embase, CINAHL and the WHO search portal two reviewers selected RCTs performed in 4,129 children from 5-18 year old, with moderate persistent asthma comparing any GINA step 3&4 medication options. Further quality was assessed according the Cochrane Collaboration's tool and data-extracted included papers and built a network of the trials. Attempt at ranking treatments with formal statistical methods employing direct and indirect (e.g. through placebo) connections between all treatments.Results: 8,175 references were screened; 23 randomized trials (RCT), comparing head-to-head (n=17) or against placebo (n=10), met the inclusion criteria. Except for theophylline as add-on therapy in step 4, a closed network allowed all comparisons to be made, either directly or indirectly. Huge variation in, and incomplete reporting of, outcome measurements across RCTs precluded assessment of relative efficacies.Conclusion: Evidence-based ranking of effectiveness of drug treatments in GINA steps 3&4 is not possible yet. Existing initiatives for harmonization of outcome measurements in asthma trials need urgent implementation

Ordered Preference Elicitation Strategies for Supporting Multi-Objective Decision Making

In multi-objective decision planning and learning, much attention is paid to producing optimal solution sets that contain an optimal policy for every possible user preference profile. We argue that the step that follows, i.e, determining which policy to execute by maximising the user's intrinsic utility function over this (possibly infinite) set, is under-studied. This paper aims to fill this gap. We build on previous work on Gaussian processes and pairwise comparisons for preference modelling, extend it to the multi-objective decision support scenario, and propose new ordered preference elicitation strategies based on ranking and clustering. Our main contribution is an in-depth evaluation of these strategies using computer and human-based experiments. We show that our proposed elicitation strategies outperform the currently used pairwise methods, and found that users prefer ranking most. Our experiments further show that utilising monotonicity information in GPs by using a linear prior mean at the start and virtual comparisons to the nadir and ideal points, increases performance. We demonstrate our decision support framework in a real-world study on traffic regulation, conducted with the city of Amsterdam.Comment: AAMAS 2018, Source code at https://github.com/lmzintgraf/gp_pref_elici

A methodology for the selection of new technologies in the aviation industry

The purpose of this report is to present a technology selection methodology to quantify both tangible and intangible benefits of certain technology alternatives within a fuzzy environment. Specifically, it describes an application of the theory of fuzzy sets to hierarchical structural analysis and economic evaluations for utilisation in the industry. The report proposes a complete methodology to accurately select new technologies. A computer based prototype model has been developed to handle the more complex fuzzy calculations. Decision-makers are only required to express their opinions on comparative importance of various factors in linguistic terms rather than exact numerical values. These linguistic variable scales, such as ‘very high’, ‘high’, ‘medium’, ‘low’ and ‘very low’, are then converted into fuzzy numbers, since it becomes more meaningful to quantify a subjective measurement into a range rather than in an exact value. By aggregating the hierarchy, the preferential weight of each alternative technology is found, which is called fuzzy appropriate index. The fuzzy appropriate indices of different technologies are then ranked and preferential ranking orders of technologies are found. From the economic evaluation perspective, a fuzzy cash flow analysis is employed. This deals quantitatively with imprecision or uncertainties, as the cash flows are modelled as triangular fuzzy numbers which represent ‘the most likely possible value’, ‘the most pessimistic value’ and ‘the most optimistic value’. By using this methodology, the ambiguities involved in the assessment data can be effectively represented and processed to assure a more convincing and effective decision- making process when selecting new technologies in which to invest. The prototype model was validated with a case study within the aviation industry that ensured it was properly configured to meet the

Hashing as Tie-Aware Learning to Rank

Hashing, or learning binary embeddings of data, is frequently used in nearest neighbor retrieval. In this paper, we develop learning to rank formulations for hashing, aimed at directly optimizing ranking-based evaluation metrics such as Average Precision (AP) and Normalized Discounted Cumulative Gain (NDCG). We first observe that the integer-valued Hamming distance often leads to tied rankings, and propose to use tie-aware versions of AP and NDCG to evaluate hashing for retrieval. Then, to optimize tie-aware ranking metrics, we derive their continuous relaxations, and perform gradient-based optimization with deep neural networks. Our results establish the new state-of-the-art for image retrieval by Hamming ranking in common benchmarks.Comment: 15 pages, 3 figures. IEEE Conference on Computer Vision and Pattern Recognition (CVPR), 201

A Methodology for the Selection of Multi-Criteria Decision Analysis Methods in Real Estate and Land Management Processes

Real estate and land management are characterised by a complex, elaborate combination of technical, regulatory and governmental factors. In Europe, Public Administrators must address the complex decision-making problems that need to be resolved, while also acting in consideration of the expectations of the different stakeholders involved in settlement transformation. In complex situations (e.g., with different aspects to be considered and multilevel actors involved), decision-making processes are often used to solve multidisciplinary and multidimensional analyses, which support the choices of those who are making the decision. Multi-Criteria Decision Analysis (MCDA) methods are included among the examination and evaluation techniques considered useful by the European Community. Such analyses and techniques are performed using methods, which aim to reach a synthesis of the various forms of input data needed to define decision-making problems of a similar complexity. Thus, one or more of the conclusions reached allow for informed, well thought-out, strategic decisions. According to the technical literature on MCDA, numerous methods are applicable in different decision-making situations, however, advice for selecting the most appropriate for the specific field of application and problem have not been thoroughly investigated. In land and real estate management, numerous queries regarding evaluations often arise. In brief, the objective of this paper is to outline a procedure with which to select the method best suited to the specific queries of evaluation, which commonly arise while addressing decision-making problems. In particular issues of land and real estate management, representing the so-called “settlement sector”. The procedure will follow a theoretical-methodological approach by formulating a taxonomy of the endogenous and exogenous variables of the multi-criteria analysis method