Decision Support and Expert Systems in Public Health

Author(s):  
William A. Yasnoff ◽  
Perry L. Miller
2021 ◽  
Vol 13 (9) ◽  
pp. 4640
Author(s):  
Seung-Yeoun Choi ◽  
Sean-Hay Kim

New functions and requirements of high performance building (HPB) being added and several regulations and certification conditions being reinforced steadily make it harder for designers to decide HPB designs alone. Although many designers wish to rely on HPB consultants for advice, not all projects can afford consultants. We expect that, in the near future, computer aids such as design expert systems can help designers by providing the role of HPB consultants. The effectiveness and success or failure of the solution offered by the expert system must be affected by the quality, systemic structure, resilience, and applicability of expert knowledge. This study aims to set the problem definition and category required for existing HPB designs, and to find the knowledge acquisition and representation methods that are the most suitable to the design expert system based on the literature review. The HPB design literature from the past 10 years revealed that the greatest features of knowledge acquisition and representation are the increasing proportion of computer-based data analytics using machine learning algorithms, whereas rules, frames, and cognitive maps that are derived from heuristics are conventional representation formalisms of traditional expert systems. Moreover, data analytics are applied to not only literally raw data from observations and measurement, but also discrete processed data as the results of simulations or composite rules in order to derive latent rule, hidden pattern, and trends. Furthermore, there is a clear trend that designers prefer the method that decision support tools propose a solution directly as optimizer does. This is due to the lack of resources and time for designers to execute performance evaluation and analysis of alternatives by themselves, even if they have sufficient experience on the HPB. However, because the risk and responsibility for the final design should be taken by designers solely, they are afraid of convenient black box decision making provided by machines. If the process of using the primary knowledge in which frame to reach the solution and how the solution is derived are transparently open to the designers, the solution made by the design expert system will be able to obtain more trust from designers. This transparent decision support process would comply with the requirement specified in a recent design study that designers prefer flexible design environments that give more creative control and freedom over design options, when compared to an automated optimization approach.


2009 ◽  
Vol 18 (01) ◽  
pp. 84-95 ◽  
Author(s):  
A. Y. S. Lau ◽  
G. Tsafnat ◽  
V. Sintchenko ◽  
F. Magrabi ◽  
E. Coiera

Summary Objectives To review the recent research literature in clinical decision support systems (CDSS). Methods A review of recent literature was undertaken, focussing on CDSS evaluation, consumers and public health, the impact of translational bioinformatics on CDSS design, and CDSS safety. Results In recent years, researchers have concentrated much less on the development of decision technologies, and have focussed more on the impact of CDSS in the clinical world. Recent work highlights that traditional process measures of CDSS effectiveness, such as document relevance are poor proxy measures for decision outcomes. Measuring the dynamics of decision making, for example via decision velocity, may produce a more accurate picture of effectiveness. Another trend is the broadening of user base for CDSS beyond front line clinicians. Consumers are now a major focus for biomedical informatics, as are public health officials, tasked with detecting and managing disease outbreaks at a health system, rather than individual patient level. Bioinformatics is also changing the nature of CDSS. Apart from personalisation of therapy recommendations, translational bioinformatics is creating new challenges in the interpretation of the meaning of genetic data. Finally, there is much recent interest in the safety and effectiveness of computerised physicianorderentry (CPOE) systems, given that prescribing and administration errors are a significant cause of morbidity and mortality. Of note, there is still much controversy surrounding the contention that poorly designed, implemented or used CDSS may actually lead to harm. Conclusions CDSS research remains an active and evolving area of research, as CDSS penetrate more widely beyond their traditional domain into consumer decision support, and as decisions become more complex, for example by involving sequence level genetic data.


1992 ◽  
Vol 4 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Peter Smith ◽  
Eric Fletcher ◽  
Michael Thorne ◽  
William Walker ◽  
Kevin Maughan ◽  
...  

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