Reducing Decisional Conflict and Enhancing Satisfaction with Information among Women Considering Breast Reconstruction following Mastectomy: Results from the BRECONDA Randomized Controlled Trial

Background: Deciding whether or not to have breast reconstruction following breast cancer diagnosis is a complex decision process. This randomized controlled trial assessed the impact of an online decision aid [Breast RECONstruction Decision Aid (BRECONDA)] on breast reconstruction decision-making. Methods: Women (n = 222) diagnosed with breast cancer or ductal carcinoma in situ, and eligible for reconstruction following mastectomy, completed an online baseline questionnaire. They were then assigned randomly to receive either standard online information about breast reconstruction (control) or standard information plus access to BRECONDA (intervention). Participants then completed questionnaires at 1 and 6 months after randomization. The primary outcome was participants' decisional conflict 1 month after exposure to the intervention. Secondary outcomes included decisional conflict at 6 months, satisfaction with information at 1 and 6 months, and 6-month decisional regret. Results: Linear mixed-model analyses revealed that 1-month decisional conflict was significantly lower in the intervention group (27.18) compared with the control group (35.5). This difference was also sustained at the 6-month follow-up. Intervention participants reported greater satisfaction with information at 1- and 6-month follow-up, and there was a nonsignificant trend for lower decisional regret in the intervention group at 6-month follow-up. Intervention participants' ratings for BRECONDA demonstrated high user acceptability and overall satisfaction. Conclusions: Women who accessed BRECONDA benefited by experiencing significantly less decisional conflict and being more satisfied with information regarding the reconstruction decisional process than women receiving standard care alone. These findings support the efficacy of BRECONDA in helping women to arrive at their breast reconstruction decision

Web–based Group Decision Support Systems In Defence Technologies

Tez (Yüksek Lisans) -- İstanbul Teknik Üniversitesi, Fen Bilimleri Enstitüsü, 2006Thesis (M.Sc.) -- İstanbul Technical University, Institute of Science and Technology, 2006Bu çalışmada, İTÜ – Web GDSS adı altında bir Web tabanlı karar destek sisteminin yapısı ve tasarım detayları anlatılmıştır ve bir karar destek sistemi oluştururken karşılaşılan zorluklardan bahsedilmektedir. İTÜ - Web GDSS çok ölçütlü karar verme metotlarından biri olan Analitik Hiyerarşi Süreci modelini kullanmaktadır. İTÜ – Web GDSS Web tabanlı bir grup karar destek sistemidir. Bu sistem, kullanıcılara bir hedef doğrultusunda kendi kararlarını almalarına yardımcı olmaktadır. İTÜ – Web GDSS, grup kararını da desteklemekte olup kullanıcılara kendi kararlarının yanı sıra grup kararlarını gözlemleyebilmelerini sağlamaktadır. İTÜ – Web GDSS bir yazılım aracıdır ve AHS modelini karar alma sürecinde kullanmaktadır. AHS yöntemi kullanılarak bir problem modellenir, alternatifler göreceli önemlerine göre değerlendirilir, bilgi organize edilir ve değerlendirme hükümleri yapılır. İTÜ – Web GDSS Web de kullanılabilir olup küresel olarak erişime açıktır. Web teknolojilerinin avantajlarını kullanmaktadır. Web kaynaklarına bağlantı kurmak ve çeşitli platform özellikleri sisteme önemli özelliklerinden bazılarıdır. Karar destek sistemlerini kullanan grupların performansları son 20 yıldır çokça tartışılan bir konudur. Bu yüzden, grup karar destek sistemi kullanan takım üyelerinin tatmini gibi öznel değişkenlere biraz daha odaklanmaya ihtiyaç duyulmaktadır. Deneysel bir çalışma yapılarak İTÜ – Web GDSS’in kullanıcı tatmini rapor halinde hazırlanmıştır. Bu çalışmada, grup kararı alırken çeşitli kullanıcı tatmin öğelerine odaklanılmıştır: sistemden tatmin, süreçten tatmin, karardan tatmin, karar destek sisteminden tatmin.In this research, the architecture and detailed design of a Web-based GDSS, called İTÜ – Web GDSS are discussed to address the challenges of building a Web-based GDSS. İTÜ - Web GDSS, which uses Analytical Hierarchy Process model in decision process that is for multi-attribute decision making, is a Web-based Group Decision Support System. İTÜ - Web GDSS supports users to decide on their own specified goal. It also provides users to observe their own decision and group decision. İTÜ – Web GDSS is a software tool, which implements the AHP. It uses the AHP methodology to model any problem, evaluate relative desirability of alternatives, and organize information and judgments used in decision making. İTÜ – Web GDSS is deployed on the World Wide Web (WWW) and can be accessed globally. It takes advantages of WWW with wide ability, Web resource integration and cross-platform capabilities. Performance of groups using group decision support systems has been an issue debated over the last two decade. Yet, there is need for more focused on subjective variables such as the satisfaction of team members with the experience of using a GDSS. An empirical study is reported to assess the user satisfaction of İTÜ – Web GDSS in supporting distributed group. This research focuses on different types of user satisfaction in GDSS based group decision making: system satisfaction, process satisfaction, outcome, and GDSS satisfaction.Yüksek LisansM.Sc

Evaluation of e-learning web sites using fuzzy axiomatic design based approach

High quality web site has been generally recognized as a critical enabler to conduct online business. Numerous studies exist in the literature to measure the business performance in relation to web site quality. In this paper, an axiomatic design based approach for fuzzy group decision making is adopted to evaluate the quality of e-learning web sites. Another multi-criteria decision making technique, namely fuzzy TOPSIS, is applied in order to validate the outcome. The methodology proposed in this paper has the advantage of incorporating requirements and enabling reductions in the problem size, as compared to fuzzy TOPSIS. A case study focusing on Turkish e-learning websites is presented, and based on the empirical findings, managerial implications and recommendations for future research are offered

How and Why Decision Models Influence Marketing Resource Allocations

We study how and why model-based Decision Support Systems (DSSs) influence managerial decision making, in the context of marketing budgeting and resource allocation. We consider several questions: (1) What does it mean for a DSS to be "good?"; (2) What is the relationship between an anchor or reference condition, DSS-supported recommendation and decision quality? (3) How does a DSS influence the decision process, and how does the process influence outcomes? (4) Is the effect of the DSS on the decision process and outcome robust, or context specific? We test hypotheses about the effects of DSSs in a controlled experiment with two award winning DSSs and find that, (1) DSSs improve users' objective decision outcomes (an index of likely realized revenue or profit); (2) DSS users often do not report enhanced subjective perceptions of outcomes; (3) DSSs, that provide feedback in the form of specific recommendations and their associated projected benefits had a stronger effect both on the decision making process and on the outcomes.Our results suggest that although managers actually achieve improved outcomes from DSS use, they may not perceive that the DSS has improved the outcomes. Therefore, there may be limited interest in managerial uses of DSSs, unless they are designed to: (1) encourage discussion (e.g., by providing explanations and support for the recommendations), (2) provide feedback to users on likely marketplace results, and (3) help reduce the perceived complexity of the problem so that managers will consider more alternatives and invest more cognitive effort in searching for improved outcomes.marketing models;resource allocation;DSS;decision process;decision quality

Research and Applications of the Processes of Performance Appraisal: A Bibliography of Recent Literature, 1981-1989

[Excerpt] There have been several recent reviews of different subtopics within the general performance appraisal literature. The reader of these reviews will find, however, that the accompanying citations may be of limited utility for one or more reasons. For example, the reference sections of these reviews are usually composed of citations which support a specific theory or practical approach to the evaluation of human performance. Consequently, the citation lists for these reviews are, as they must be, highly selective and do not include works that may have only a peripheral relationship to a given reviewer\u27s target concerns. Another problem is that the citations are out of date. That is, review articles frequently contain many citations that are fifteen or more years old. The generation of new studies and knowledge in this field occurs very rapidly. This creates a need for additional reference information solely devoted to identifying the wealth of new research, ideas, and writing that is changing the field

Towards a better understanding of the e-health user: comparing USE IT and Requirements study for an Electronic Patient Record.

This paper compares a traditional requirements study with 22 interviews for the design of an electronic patient record (EPR) and a USE IT analysis with 17 interviews trying to understand the end- user of an EPR. Developing, implementing and using information technology in organizations is a complex social activity. It is often characterized by ill-defined problems or vague goals, conflicts and disruptions that result from organizational change. Successfully implementing information systems in healthcare organizations appears to be a difficult task. Information Technology is regarded as an enabler of change in healthcare organizations but (information) technology adoption decisions in healthcare are complex, because of the uncertainty of benefits and the rate of change of technology. (Job) Relevance is recognized as an important determinant for IS success but still does not find its way into a systems design process

Pest activity prognosis in rice fields using fuzzy expert system approach

Logik kabur merupakan satu bentuk perwakilan pengetahuan bagi konsep yang tak dapat ditakrifkan secara tepat tetapi bergantung kepada konteks penggunaannya. Sistem Pakar adalah program komputer yang menggunakan pengetahuan manusia untuk menyelesaikan masalah khusus yang memerlukan kepintaran manusia. Oleh kerana pengetahuan yang terlibat dalam pengurusan serangga adalah tidak lengkap dan kabur, maka logik kabur diintegrasikan ke dalam sistem pakar untuk mengendalikan penaksiran anggaran. Sistem Pakar dan Logik Kabur mempunyai kelebihannya tersendiri dan gabungan kedua-dua teknologi yang membentuk sistem pakar-kabur dapat meningkatkan keupayaan sistem (Herrmann, 1996). Berdasarkan keupayaan logik kabur dan sistem pakar, peramalan aktiviti serangga di sawah padi menggunakan pendekatan pakar-kabur telah dibangunkan untuk menyediakan maklumat kepada petani dan penyelidik melalui Internet. Oleh kerana beras merupakan makanan ruji rakyat Malaysia dan Kedah merupakan kawasan utama penanaman padi di Malaysia, kajian ini memfokuskan kepada aktiviti serangga di sawah padi. Dalam MyPEST, jenis serangga yang mengakibatkan kerosakan pada tanaman padi ditentukan oleh sistem pakar, manakala Logik Kabur digunakan untuk meramalkan tahap aktiviti serangga. Ixii penting supaya rawatan awal dapat dilakukan sebelum kerosakan bertambah buruk. Sistem MyPEST membantu pengguna dengan mengendalikan rundingan pakar yang dikawalselia oleh sistem pakar dan logik kabur untuk peramalan dan menguruskan ketidakpastian data menggunakan pembolehubah lingistik. Sistem berasaskan web ini juga membantu petani dan institusi pertanian untuk menguruskan ladang dengan cekap dan dapat meningkatkan kualiti serta kuantiti beras yang dihasilkan. Dalam kajian ini, proses peramalan menggunakan lebih daripada satu attribut telah dikaji. Dapatan kajian menunjukkan sekiranya lebih daripada satu atribut terlibat, graf keputusan 3-dimensi yang kurang tegar dihasilkan. Penentuan jenis serangga adalah dalam fasa pertama MyPEST dan diikuti oleh peramalan aktiviti serangga yang dikenalpasti. Sistem ini telah disemak oleh pakar serangga di MARDi dan disahkan membawa manfaat kepada penyelidik di MARDI, MADA dan DOA khususnya dan petani secara keseluruhan

Development and preliminary evaluation of a clinical guidance programme for the decision about prophylactic oophorectomy in women undergoing a hysterectomy

Objectives: To develop a decision analysis based and computerised clinical guidance programme (CGP) that provides patient specific guidance on the decision whether or not to undergo a prophylactic oophorectomy to reduce the risk of subsequent ovarian cancer and to undertake a preliminary pilot and evaluation. Subjects: Women who had already agreed to have a hysterectomy who otherwise had no ovarian pathology. Setting: Oophorectomy decision consultation at the outpatient or pre-admission clinic. Methods: A CGP was developed with advice from gynaecologists and patient groups, incorporating a set of Markov models within a decision analytical framework to evaluate the benefits of undergoing a prophylactic oophorectomy or not on the basis of quality adjusted life expectancy, life expectancy, and for varying durations of hormone replacement therapy. Sensitivity analysis and preliminary testing of the CGP were undertaken to compare its overall performance with established guidelines and practice. A small convenience sample of women invited to use the CGP were interviewed, the interviews were taped and transcribed, and a thematic analysis was undertaken. Results: The run time of the programme was 20 minutes, depending on the use of opt outs to default values. The CGP functioned well in preliminary testing. Women were able to use the programme and expressed overall satisfaction with it. Some had reservations about the computerised format and some were surprised at the specificity of the guidance given. Conclusions: A CGP can be developed for a complex healthcare decision. It can give evidence-based health guidance which can be adjusted to account for individual risk factors and reflects a patient’s own values and preferences concerning health outcomes. Future decision aids and support systems need to be developed and evaluated in a way which takes account of the variation in patients’ preferences for inclusion in the decision making process