Applications of qualitative multi-attribute decision models in health care

Hierarchical decision models are a general decision support methodology aimed at the classification or evaluation of options that occur in decision-making processes. They are also important for the analysis, simulation and explanation of options. Decision models are typically developed through the decomposition of complex decision problems into smaller and less complex subproblems; the result of such decomposition is a hierarchical structure that consists of attributes and utility functions. This article presents an approach to the development and application of qualitative hierarchical decision models that is based on DEX, an expert system shell for multi-attribute decision support. The distinguishing characteristics of DEX are the use of qualitative (symbolic) attributes, and 'if-then' decision rules. Also, DEX provides a number of methods for the analysis of models and options, such as selective explanation and what-if analysis. We demonstrate the applicability and flexibility of the approach presenting four real-life applications of DEX in health care: assessment of breast cancer risk, assessment of basic living activities in community nursing, risk assessment in diabetic foot care, and technical analysis of radiogram errors. In particular, we highlight and justify the importance of knowledge presentation and option analysis methods for practical decision-making. We further show that, using a recently developed data mining method called HINT, such hierarchical decision models can be discovered from retrospective patient data.

Hierarchical multi-attribute decision models and their application in health care

Hierarchical decision models are developed through decomposition of complex decision problems into smaller and less complex subproblems. They are aimed at the classification or evaluation of options and can be used for analysis, simulation and explanation. This paper presents a set of methods for the construction and application of qualitative hierarchical decision models in health care. We present the results of four ongoing projects in oncology, radiology, community nursing and diabetic foot treatment.

Relating clinical and neurophysiological assessment of spasticity by machine learning

Spasticity following spinal cord injury (SCI) is most often assessed clinically using a five-point Ashworth score (AS). A more objective assessment of altered motor control may be achieved by using a comprehensive protocol based on a surface electromyographic (sEMG) activity recorded from thigh and leg muscles. However, the relationship between the clinical and neurophysiological assessments is still unknown. In this paper we employ three different classification methods to investigate this relationship. The experimental results indicate that, if the appropriate set of sEMG features is used, the neurophysiological assessment is related to clinical findings and can be used to predict the AS. A comprehensive sEMG assessment may be proven useful as an objective method of evaluating the effectiveness of various interventions and for follow-up of SCI patients.

Implementation problems of decision support system for nosocomial infection

Decision support system for nosocomial infection therapy Ptah can reduce antibiotic misuse with data about bacteria resistance and antibiotic ineffectiveness. Resistance vectors in time series show epidemiological problems with resistant bacterias, named house-bacteria. Most important implementation factors are integrated hospital information system and doctors, nurses and managers interested in problems of nosocomial infection.