Patterns of Decision Making in Kidney Allocation Problems

2001 ◽  
Vol 23 (2) ◽  
Author(s):  
Marlies Ahlert

AbstractExperts in the field of organ transplantation had to rank order a set of 32 patients according to their priority in receiving a donated kidney. The patients were described by the five characteristics that are incorporated in the kidney allocation algorithm applied by Eurotransplant. The priority rankings as defined by the experts were analyzed and patterns of dedsion making identified in the rankings investigated in this study. All patterns could be explained by some type of lexicographical ranking. The larger group of experts preordered tissue compatibility or, more technically speaking, the criterion of HLA match, while the complementary group applied the criterion of the length of waiting time first. Analyzing the finer decision structures of expert rankings and com paring the method of pattern exploration with a conjoint measurement analysis led to two follow-up questions: First, how can the value judgments of the experts be described adequately? Second, which type of aggregated ordering derived from the individual rankings represents them ‘best’?

Babel ◽  
2006 ◽  
Vol 52 (1) ◽  
pp. 39-65 ◽  
Author(s):  
Rasoul al-Khafaji

Abstract The paper is an attempt, guided by the principles of Descriptive Translation Studies, to ‘detect’ and ‘describe’ the various types of shifts, in the area of lexical repetition, which have occurred in an Arabic–English translation. The study also tries to ‘explain’ the underlying factors which may have prompted the various decision-making processes behind these translation shifts. It is postulated that any translation product represents an intertext which carries the ‘finger-prints’ of the norms of its SL and culture. Moreover, translation as a retextualizing process is bound to be directed by the norms of the TL and its culture. The two poles of SL ‘adequacy’ norms and TL ‘acceptability’ norms have thus been at the background during the description, taxonomy, and explanation of the various types of shifts in lexical repetition detected in the study corpus. Different instances of shifts have been found to fall under three main categories: (a) Shifts which avoid or minimize lexical repetition; (b) Shifts which announce repetition by retaining it, though with some modifications; and (c) Shifts which emphasize lexical repetition by expanding it. Most shifts, it has been found, belong to the first category. A lengthy discussion of the possible causes which could have motivated the translator to perform these various shifts has come to the conclusion that the textual and cultural norms of the TL seem to play the major role in the operation. In order to ascertain that the above conclusion is not attributable to the ‘hegemony’ of the TL (English), nor to the individual translator or to the type of text being analyzed, a number of follow-up studies is proposed at the end. Résumé Guidé par les principes des études de traduction descriptive, l’article est une tentative de « détecter » et de « décrire » les différents types de changements dans le domaine de la répétition lexicale, qui se sont présentées dans une traduction arabe-anglais. L’étude cherche également à « expliquer » les facteurs sous-jacents qui peuvent avoir provoqué les différents processus de prise de décision derrière ces changements de la traduction. On pose comme principe que tout produit d’une traduction représente un intertexte, qui porte les «empreintes digitales » des normes de sa langue-source et de sa culture. De plus, la traduction, en tant que processus de retextualisation, est nécessairement guidé par les normes de la langue-cible et de sa culture. Par conséquent, les deux pôles des normes « de justesse » de la langue-source et des normes «d’admissibilité » de la langue-cible se trouvaient à l’arrière-plan, pendant la description, la taxonomie et l’explication des différents types de changements de la répétition lexicale, détectées dans le corpus de l’étude. On a remarqué que les différents exemples de changements s’inscrivaient dans trois catégories principales : (a) les changements qui évitent ou minimisent la répétition lexicale ; (b) les changements qui annoncent une répétition en la conservant ; et (c) les changements qui soulignent la répétition lexicale en la développant. On a découvert que la plupart des changements appartiennent à la première catégorie. Une longue discussion sur les causes possibles, qui peuvent avoir poussé le traducteur à effectuer ces divers changements, a abouti à la conclusion que les normes textuelles et culturelles de la langue-cible semblent jouer un rôle majeur dans l’opération. Un certain nombre d’études complémentaires sont proposées, afin de vérifier que la conclusion ci-dessus n’est imputable ni à « l’hégémonie » de la langue-cible (anglais), ni au traducteur individuel, ni au type de texte analysé.


2017 ◽  
Vol 5 (4) ◽  
pp. 495
Author(s):  
Mette Kjer Kaltoft ◽  
Jesper Bo Nielsen ◽  
Jack Dowie

Background: Most existing multi-critierial instruments measuring the person-as-patient’s experience (PREMs like ‘decision quality’) or outcome (e.g., PROMs like ‘quality of life’) are designed for use as inputs into group level decision and guidelines. Regrettably, they elicit only the ratings of the individual respondent. They therefore lack person-centered preference-sensitivity in that the measure for the individual patient does not also reflect that patient’s relative weighting of the multiple items/criteria/indicators that constitute it. Some instruments may use weightings that are preference-based, but the preferences are almost always the average ‘tariff’ derived in a separate study, not those of the individual concerned. The aggregated results from such instruments cannot reflect the heterogeneous and potentially changing preferences of the patient population and in this sense are not the appropriate ‘living’ metrics.Personalisation: A preference-sensitive person-centered instrument reflects these weightings and is ‘dually-personalised’. Six possible degrees of personalisation are identified, varying in the ability of the individual respondent to customize the instrument. The appropriate level depends on the context and goals of the measurement. Higher levels of personalisation, such as those allowing the individual to generate the items, are unlikely to be of use in routine clinical practice, where dual and triple personalisation are the most practical. (In triple personalisation the respondent selects their criteria from a menu.)Constructs: Whether single or some higher degree of personalisation is appropriate depends on the nature of the construct. Formative constructs producing indexes, such as most PROMs/PREMS, do not exist independently of the instrument claiming to measure them. The multiple components of these instruments, such as pain and mobility, ‘cause’ the construct and are not caused by it. Measures of formative constructs should always be (at least) dually-personalised. In contrast, reflective constructs (such as Appendicitis), exist independently of measurement and the scale measure they produce should never be dually-personalised; the component cues are properly integrated by belief/evidential coefficients, not value judgments.Validation and Measurement models: Currently, most PROMs and PREMs are being treated as reflective indexes and are only singly-personalised. In breach of the COSMIN guidelines they are often ‘validated’ by criteria such as internal consistency and structural validity, using techniques such as Rasch or Item Response Theory, that are appropriate only for reflective scales. The output from applying a conjoint measurement model to a preference-sensitive construct (such as quality of life) is an appropriate input only in single-criterion decision-making, where the measured construct is the sole maximand. It is not appropriate in multi-criteria decision-making, because it has not involved the necessary separation of criterion weighting from option performance rating. Conclusion: Person-centered care will advance only when it is accepted that the central constructs are formative indexes and measurement of them needs to be individually preference-sensitive, not just group preference-based and therefore at least dually-personalised.


2015 ◽  
Vol 24 (3) ◽  
pp. 74-85
Author(s):  
Sandra M. Grether

Individuals with Rett syndrome (RS) present with a complex profile. They benefit from a multidisciplinary approach for diagnosis, treatment, and follow-up. In our clinic, the Communication Matrix © (Rowland, 1990/1996/2004) is used to collect data about the communication skills and modalities used by those with RS across the lifespan. Preliminary analysis of this data supports the expected changes in communication behaviors as the individual with RS ages and motor deficits have a greater impact.


Author(s):  
Olga Olegovna Eremenko ◽  
Lyubov Borisovna Aminul ◽  
Elena Vitalievna Chertina

The subject of the research is the process of making managerial decisions for innovative IT projects investing. The paper focuses on the new approach to decision making on investing innovative IT projects using expert survey in a fuzzy reasoning system. As input information, expert estimates of projects have been aggregated into six indicators having a linguistic description of the individual characteristics of the project type "high", "medium", and "low". The task of decision making investing has been formalized and the term-set of the output variable Des has been defined: to invest 50-75% of the project cost; to invest 20-50% of the project cost; to invest 10-20% of the project cost; to send the project for revision; to turn down investing project. The fuzzy product model of making investment management decisions has been developed; it adequately describes the process of investment management. The expediency of using constructed production model on a practical example is shown.


2020 ◽  
Vol 16 (7) ◽  
pp. 1202-1222
Author(s):  
M.V. Grechko ◽  
L.A. Kobina ◽  
S.A. Goncharenko

Subject. The article focuses on the decision-making mechanism used by economic agents given the existing social constraints. Objectives. We devise applied toolkit to study how socio-economic constraints transform the decision-making mechanism used by economic agents. Methods. The study involves means of the expert survey, the method that streamlines economic knowledge. Results. Social constraints are illustrated to influence the decision-making mechanism used by economic agents, assuming that the individual mind relies on specific mechanisms to make judgments and decisions. Generally, the mechanisms are very useful, however they may generate serious errors during the decision-making process. Given the social constraints, economic agents were found to follow four mental models to make their decisions in case of the full or partial uncertainty, i.e. the representative relevance, accessibility, relations, heuristics (modeling). Conclusions and Relevance. The scientific ideas herein show that the inner architecture of a choice an individual makes determines his or her decisions. The decisions often depend on the contextual environment that gives external signals perceived by the individual while evaluating alternative ways. The findings can possibly be used as a mechanism to manage the consumer choice.


Author(s):  
Liza Handayani ◽  
Muhammad Syahrizal ◽  
Kennedi Tampubolon

The head of the environment is an extension of the head of the village head in assisting or providing services to the community both in the administration of administration in the village and to other problems. It is natural for a kepling to be appreciated for their performance during their special tenure in the kecamatan field area. Previously, the selection of a dipling in a sub-district was very inefficient and seemed unfair for this exemplary selection to use a system to produce an accurate value, and no intentional element. To overcome the process of selecting an exemplary kepling that experiences these obstacles by using an application called a Decision Support System. Decision Support System (SPK) is a system that can solve a problem, and this system is also assisted with several methods, namely the Rank Order Centroid (ROC) method that can assign weight values to each of the criteria based on their priority level. And to do the ranking or determine an exemplary set using the Additive Ratio Assessment (ARAS) method, this method provides decision making that takes decisions based on ranking or the highest value.Keywords: Head of Medan Area Subdistrict, SPK, Centroid Rank Order, Additive Ratio Assessment (ARAS).


2020 ◽  
Author(s):  
Janet Michel

BACKGROUND Background: Online forward triage tools (OFTT) or symptom checkers are being widely used during this COVID-19 pandemic. The effects and utility of such tools however, have not been widely assessed. OBJECTIVE Objective: To assess the effects (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, exploring patient perspectives as well as eliciting recommendations for tool improvement. METHODS Methods: We employed a mixed-method sequential explanatory study design. Quantitative data of all users of the OFTT between March 2nd, 2020 and May 12th, 2020 were collected. A follow-up survey of people who consented to participation was conducted. Secondly, qualitative data was collected through key informant interviews (n=19) to explain the quantitative findings, as well as explore tool utility, user experience and elicit recommendations. RESULTS Results: An estimate of the effects, (quantitatively) and the utility (qualitatively) of a COVID-19 OFTT in a pandemic context, and recommendations for tool improvement. In the study period, 6,272 users consulted our OFTT; 560 participants consented to a follow-up survey and provided a valid e-mail address. 176 (31.4%) participants returned a complete follow-up questionnaire. 85.2% followed the recommendations given. 41.5% reported that their fear was allayed after using tool and 41.1% would have contacted the GP or visited a hospital had the tool not existed. Qualitatively, seven overarching themes emerged namely i) accessibility of tool, ii) user-friendliness of tool, iii) utility of tool as an information source, iv) utility of tool in allaying fear and anxiety, v) utility of tool in decision making (test or not to test), vi) utility of tool in reducing the potential for onward transmissions (preventing cross infection) and vii) utility of tool in reducing health system burden. CONCLUSIONS Conclusion: Our findings demonstrated that a COVID-19 OFTT does not only reduce the health system burden, but can also serve as an information source, reduce anxiety and fear, reduce cross infections and facilitate decision making (to test or not to test). Further studies are needed to assess the transferability of these COVID-19 OFTT findings to other contexts as the second wave sweeps across Europe.


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