Evidence-based Assessment

Author(s):  
John Hunsley ◽  
Eric J. Mash

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.

Author(s):  
John Hunsley ◽  
Eric J. Mash

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.


PEDIATRICS ◽  
1956 ◽  
Vol 17 (6) ◽  
pp. 897-924
Author(s):  
Lytt I. Gardner

THE IDENTIFICATION and measurement of adrenocortical steroids in body fluids over the past 2 decades have made possible an extensive exploration of adrenal function. This review is restricted to adrenocortical metabolism in the fetus, infant and child. No attempt will be made to cover all of this rapidly developing area of endeavor. Certain aspects have been treated in other review articles, to which the reader is referred. The reviews by Moore on fetal endorinology, Klein on neonatal adrenal physiology, Lieberman and Teich and Roberts and Szego on steroid biochemistry, White and Wettstein and Anner on adrenal cortical hormones, Ingle on cortisone and Gaunt, Renzi and Chart on aldosterone are especially useful. The books by Wilkins and by Talbot and colleagues contain helpful treatments of this area. Due to the prolific nature of even the review literature, it is necessary to make a rather arbitrary selection of material. NEWER METHODOLOGY Within recent years a number of methods have been developed for the estimation of hormones in urine and plasma. Several techniques for the chromatographic separation of the 17-ketosteroids in urine have been described. Of particular value in the diagnosis of virilizing adrenal tumor has been the development of colorimetric methods for the estimation of dehydroepiandrosterone in urine. Some progress has been made in the estimation of corticosteroids in the urine. Techniques for the measurement of 11-oxygenated neutral 17-ketosteroids, pregnanetriol and pregnanediol in the urine of patients with congenital adrenal hyperplasia have been described. There has been a blossoming of methods for estimating steroids in plasma. Several varieties of techniques are now available for the measurement of corticosteroids and 17-ketosteroids in plasma.


Author(s):  
Mark Liponis ◽  
Bettina Martin

The past two decades have seen great progress in recognizing the importance of inflammation in medicine. Increased focus on inflammation in both prevention and treatment has improved outcomes and quality of life in chronic diseases. Science has improved our understanding of inflammation’s many causes and effects on health, and many advances have been made in the availability of targeted therapeutic options for treating inflammation. This chapter gives an overview of recognizing the many causes of inflammation, its many targeted treatments strategies, and the questions that still surround it. It discusses several integrative approaches to reducing inflammation, including exercise, diet, and different strategies for managing sleep, mood, and stress, such as meditation and massage.


2009 ◽  
Vol 25 (S1) ◽  
pp. 102-107 ◽  
Author(s):  
Marjukka Mäkelä ◽  
Risto P. Roine

Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency, with special responsibility in providing assessments to underpin national policies in screening. External evaluations enhanced the rapid growth. In the Finnish environment, decision making on health technologies is extremely decentralized, so Finohta has developed some practical tools for implementing HTA findings. The Managed Uptake of Medical Methods program links the hospital districts to agree on introduction of technologies. The Ohtanen database provides Finnish-language summaries of major assessments made in other countries.


AGROFOR ◽  
2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Bojan ĐURIN ◽  
Anita PTIČEK SIROČIĆ ◽  
Nikola SAKAČ ◽  
Marko ŠRAJBEK

Selection of a particular agricultural crop for the food production is a complexproblem. This is usually conditioned not only by the financial claims, but also otherrequirements should be taken into the account, i.e. environmental criteria,sustainability, etc. Fuzzy Logicis one of the many appropriate tools/procedures forsolving such task(s).Such a procedure will be implemented within decision-makingalgorithm for the selection of an appropriate agricultural crop. The paper deals withthe implementation of the mentioned tool/procedure for selection and ranking ofthe particular sort of crops, regarding different decision-making structures. Withinthis, there is an intention to reduce all possible biases and subjectivities tominimum by using Fuzzy Logic. This will be applied with input parameters, whichare extracted and correlated with real requirements and conditions regarding actualneeds of the market and farmers. Along with the offered agricultural crops andpossibility of their selection, final ranking and selection of the most appropriatecrop can be supported for different possible scenarios (dry or wet period of theyear, accents on the financial, environmental of other criteria, available financialresources, market availability, etc.). Presented methodology will contribute to thefinal goal, which is systematic agricultural planting and sustainability of the foodproduction.


Author(s):  
Muhammad Isa Daud ◽  
Mufty Mufty

Making the right decision is very important in a management, wrong decision making can be fatal for both companies and individuals Through the Education Office the government seeks to allocate funds to provide scholarships to students who are economically unable to finance their education and provide scholarships to students who have achievements. In order for the implementation of scholarships to be achieved, it must be in accordance with the principle of 3T, namely On target, Right amount and On time. The provision of tuition fee assistance in the form of scholarships is also given to students in universities. Scholarships are given to students who excel and are underprivileged. The selection of scholarship recipients so far is not maximal because of the assessment that seems to favor one student so that students who really deserve it become unable to get. In this research using Weighted Products method to conduct the assessment process and the process implemented into a system, it is expected that with the system of decision-makers can choose students who really deserve. The results showed that Mahasiswa 4 was selected as a scholarship student with a score of 0.237


Author(s):  
Peta Masters ◽  
Mor Vered

Every model involves assumptions. While some are standard to all models that simulate intelligent decision-making (e.g., discrete/continuous, static/dynamic), goal recognition is well known also to involve choices about the observed agent: is it aware of being observed? cooperative or adversarial? In this paper, we examine not only these but the many other assumptions made in the context of model-based goal recognition. By exploring their meaning, the relationships between them and the confusions that can arise, we demonstrate their importance, shed light on the way trends emerge in AI, and suggest a novel means for researchers to uncover suitable avenues for future work.


2019 ◽  
Author(s):  
Ryan Kirkpatrick ◽  
Brandon Turner ◽  
Per B. Sederberg

The dynamics of decision-making have been widely studied over the past several decades through the lens of an overarching theory called sequential sampling theory (SST). Within SST, choices are represented as accumulators, each of which races toward a decision boundary by drawing stochastic samples of evidence through time. Although progress has been made in understanding how decisionsare made within the SST framework, considerable debate centers on whether the accumulators exhibit dependency during the evidence accumulation process; namely whether accumulators are independent, fully dependent, or partially dependent. To evaluate which type of dependency is the most plausible representation of human decision-making, we applied a novel twist on two classic perceptual tasks; namely, in addition to the classic paradigm (i.e., the unequal-evidence conditions), we used stimuli that provided different magnitudes of equal-evidence (i.e., the equal-evidence conditions). In equal-evidence conditions, response times systematically decreased with increases in the magnitude of evidence, whereas in unequal evidence conditions, response times systematically increased as the difference in evidence between the two alternatives decreased. We designed a spectrum of models that ranged from independent accumulation to fully dependent accumulation, while also examining the effects of within-trial and between-trial variability. We then fit the set of models to our two experiments and found that models instantiating the principles of partial dependency provided the best fit to the data. Our results further suggest that mechanisms inducing partial dependency, such as lateral inhibition, are beneficial for understanding complex decision-making dynamics, even when the task is relatively simple.


2016 ◽  
Vol 140 (12) ◽  
pp. 1345-1363 ◽  
Author(s):  
Angela N. Bartley ◽  
Mary Kay Washington ◽  
Christina B. Ventura ◽  
Nofisat Ismaila ◽  
Carol Colasacco ◽  
...  

Context.— ERBB2 (erb-b2 receptor tyrosine kinase 2 or HER2) is currently the only biomarker established for selection of a specific therapy for patients with advanced gastroesophageal adenocarcinoma (GEA). However, there are no comprehensive guidelines for the assessment of HER2 in patients with GEA. Objectives.— To establish an evidence-based guideline for HER2 testing in patients with GEA, to formalize the algorithms for methods to improve the accuracy of HER2 testing while addressing which patients and tumor specimens are appropriate, and to provide guidance on clinical decision making. Design.— The College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology convened an expert panel to conduct a systematic review of the literature to develop an evidence-based guideline with recommendations for optimal HER2 testing in patients with GEA. Results.— The panel is proposing 11 recommendations with strong agreement from the open-comment participants. Recommendations.— The panel recommends that tumor specimen(s) from all patients with advanced GEA, who are candidates for HER2-targeted therapy, should be assessed for HER2 status before the initiation of HER2-targeted therapy. Clinicians should offer combination chemotherapy and a HER2-targeted agent as initial therapy for all patients with HER2-positive advanced GEA. For pathologists, guidance is provided for morphologic selection of neoplastic tissue, testing algorithms, scoring methods, interpretation and reporting of results, and laboratory quality assurance. Conclusions.— This guideline provides specific recommendations for assessment of HER2 in patients with advanced GEA while addressing pertinent technical issues and clinical implications of the results.


2018 ◽  
Vol 211 ◽  
pp. 12003
Author(s):  
Paula Couto ◽  
Filipa Salvado ◽  
Maria João Falcão Silva

The socio-economic objectives of transport projects are generally related to the improvement of travel conditions for goods and passengers as well as the improvement of the quality of the environment and the wellbeing of the served population. Railways infrastructure projects are always complex because of the many variables involved. In railway rehabilitation, in particular, social, economic and environmental variables take on considerable importance. These variables contribute strongly to the selection of the intervention project to be performed. Historically, multicriteria evaluation methods were developed to select the best alternative from a set of competing options. Multicriteria Analysis is applied for comparison of alternative projects, allowing taking into account different criteria simultaneously. It presents a framework in which all the stakeholders can participate actively in the process of decision making and in the explicit resolution of problems. The paper intends to frame the multicriteria analysis with the purpose of its implementation in railway investment projects concerning rehabilitation interventions. In this sense, its importance and potential will be highlighted for several stakeholders in the decision-making process, as well as the objectives and criteria definition for a practical implementation.


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