Fuzzy multicriteria decision support for budget allocation in the transport sector

This paper compares two ways of providing decision support for the allocation of a fixed financial budget among a set of competing highway investment proposals. The first, which is described only in outline, uses a broadly conventional, hierarchically structured linear additive multicriteria model. The technical focus of the paper, however, is on the second, an approach based in fuzzy multicriteria modelling. The thinking which led us to explore this approach is set out, together with the formal structure of the model. The results of a small case study are given and an assessment is made of how decision makers’ understanding of the investment options available can be enhanced by using the two models in tandem

Fuzzy multicriteria techniques: an application to transport planning

This paper deals with the problem of allocating a fixed budget between a set of competing investment proposals. Based on previous practical experience with problems of this type, an analysis using the fuzzy outranking approach promised to be potentially effective. A decision aid computer package has been developed and applied to a case study. It proved to be flexible and to give additional insights into the, structure of the set of alternatives

How to improve impact reporting for sustainability

Measuring real-world impact is vital for demonstrating the success of a project and one of the most direct ways to justify taxpayers’ contributions towards public funding. Impact reporting should identify and examine the potential positive and negative consequences of the continuing operations of a proposed project and suggest strategies to expand, further develop, mitigate, avoid or offset them. Designing a tool or methodology that will capture the impact of collaborative research and innovation projects related to sustainability requires input from technical experts but also from experts in the domains of survey design and communication. Without survey design insights and testing it can be very difficult to achieve unambiguous and accurate reporting of impacts. This paper proposes six key recommendations that should be considered for those monitoring projects when identifying metrics and designing a sustainability impact report. These recommendations stem from a series of in-depth interviews about sustainability and innovation impact reporting with research project co-ordinators in the process industries (e.g., cement, ceramics, chemicals, engineering, minerals and ores, non-ferrous metals, steel and water sectors). Our results show that factors such as ambiguous terminology, two-in-one questions, the stage of the project, over-hypothetical estimates, inadequate formats and alternatives and lack of guidelines can negatively influence the data collected in usual project monitoring activities and jeopardise the overall validity of the reporting. This work acts as a guideline for those monitoring to improve how they ask for impact data from projects, whether they are introducing new impact metrics or evaluating existing ones

Integration of robotic surgery into routine practice and impacts on communication, collaboration, and decision making: A realist process evaluation protocol

Background: Robotic surgery offers many potential benefits for patients. While an increasing number of healthcare providers are purchasing surgical robots, there are reports that the technology is failing to be introduced into routine practice. Additionally, in robotic surgery, the surgeon is physically separated from the patient and the rest of the team, with the potential to negatively impact teamwork in the operating theatre. The aim of this study is to ascertain: how and under what circumstances robotic surgery is effectively introduced into routine practice; and how and under what circumstances robotic surgery impacts teamwork, communication and decision making, and subsequent patient outcomes. Methods and design: We will undertake a process evaluation alongside a randomised controlled trial comparing laparoscopic and robotic surgery for the curative treatment of rectal cancer. Realist evaluation provides an overall framework for the study. The study will be in three phases. In Phase I, grey literature will be reviewed to identify stakeholders' theories concerning how robotic surgery becomes embedded into surgical practice and its impacts. These theories will be refined and added to through interviews conducted across English hospitals that are using robotic surgery for rectal cancer resection with staff at different levels of the organisation, along with a review of documentation associated with the introduction of robotic surgery. In Phase II, a multi-site case study will be conducted across four English hospitals to test and refine the candidate theories. Data will be collected using multiple methods: the structured observation tool OTAS (Observational Teamwork Assessment for Surgery); video recordings of operations; ethnographic observation; and interviews. In Phase III, interviews will be conducted at the four case sites with staff representing a range of surgical disciplines, to assess the extent to which the results of Phase II are generalisable and to refine the resulting theories to reflect the experience of a broader range of surgical disciplines. The study will provide (i) guidance to healthcare organisations on factors likely to facilitate successful implementation and integration of robotic surgery, and (ii) guidance on how to ensure effective communication and teamwork when undertaking robotic surgery

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec