Robust Distributed Fusion with Labeled Random Finite Sets

This paper considers the problem of the distributed fusion of multi-object posteriors in the labeled random finite set filtering framework, using Generalized Covariance Intersection (GCI) method. Our analysis shows that GCI fusion with labeled multi-object densities strongly relies on label consistencies between local multi-object posteriors at different sensor nodes, and hence suffers from a severe performance degradation when perfect label consistencies are violated. Moreover, we mathematically analyze this phenomenon from the perspective of Principle of Minimum Discrimination Information and the so called yes-object probability. Inspired by the analysis, we propose a novel and general solution for the distributed fusion with labeled multi-object densities that is robust to label inconsistencies between sensors. Specifically, the labeled multi-object posteriors are firstly marginalized to their unlabeled posteriors which are then fused using GCI method. We also introduce a principled method to construct the labeled fused density and produce tracks formally. Based on the developed theoretical framework, we present tractable algorithms for the family of generalized labeled multi-Bernoulli (GLMB) filters including $\delta$-GLMB, marginalized $\delta$-GLMB and labeled multi-Bernoulli filters. The robustness and efficiency of the proposed distributed fusion algorithm are demonstrated in challenging tracking scenarios via numerical experiments.Comment: 17pages, 23 figure

Clinical Determinants of Health Care Professionals’ Recommendation of Human Papillomavirus Vaccination

Background. A health care professional’s (HCP’s) recommendation is among the strongest and most consistent predictors of human papillomavirus (HPV) vaccination, but not all US parents receive recommendations for their age-eligible adolescents. This dissertation sought to understand how clinical determinants, such as HCP and visit characteristics, influence HPV vaccine recommendations. Methods. For Aim 1, I systematically reviewed 28 quantitative studies published in 2012-2022 to summarize variation in HPV vaccine recommendation quality by HCP characteristics. For Aim 2, I conducted an online experiment with a 2 x 2 x 2 between-subjects factorial design to examine how visit characteristics affect HCPs’ intention to use presumptive recommendations that assume parents want to vaccinate. Participating HCPs (n=2,527) read clinical vignettes that varied on patient age, prior parental vaccine refusal, and time pressure. I used analysis of variance and parallel mediation to assess the effect of these visit characteristics on intention via attitudes, subjective norms, and self-efficacy. For Aim 3, I thematically analyzed interviews with 24 HCPs to characterize the roles and practices of vaccine champions, who promote evidence-based vaccination practices, including recommendations, among their colleagues. Results. The systematic review found that relatively low proportions of HCPs used higher-quality recommendation practices (median: 61%, 30 measures). Higher-quality recommendations were more common among pediatric versus family medicine HCPs (8 of 11 studies) and among HCPs with higher HPV-related knowledge (4 of 7 studies). The experiment indicated that about two-thirds of HCPs (64%) intended to use presumptive recommendations. Intention was higher for visits with older children (b=0.23) and no prior vaccine refusal (b=0.39, both p<0.001), which was partially explained by HCPs’ attitudes and self-efficacy (b=0.04-0.28, all p<0.05). The interviews suggested that vaccine champions were providers and nursing staff with strong vaccine beliefs and knowledge. While champions actively provided education on vaccine administration, they needed additional time and staff support for implementing other strategies, such as vaccine communication training. Conclusion. Findings suggest substantial room to improve HPV vaccine recommendations for adolescents, including by strengthening HCPs’ HPV-related knowledge and perceptions of presumptive recommendations. Supporting vaccine champions to expand their role in communication training is a promising strategy for achieving this goal.Doctor of Philosoph