scholarly journals A Smartphone-Based Decision Support Tool for Predicting Patients at Risk of Chemotherapy-Induced Nausea and Vomiting: App Development using Decision Tree Induction (Preprint)

10.2196/27024 ◽  
2021 ◽  
Author(s):  
Abu Saleh Mohammad Mosa ◽  
Md Kamruz Zaman Rana ◽  
Humayera Islam ◽  
AKM Mosharraf Hossain ◽  
Illhoi Yoo
Keyword(s):  
At Risk ◽  
Decision Support ◽  
Decision Tree ◽  
Decision Support Tool ◽  
Nausea And Vomiting ◽  
Support Tool ◽  
Decision Tree Induction ◽  
App Development ◽  
Patients At Risk

scholarly journals Development, implementation, and evaluation of a clinical decision support tool to improve naloxone coprescription within military health system pharmacies

2021 ◽  
Author(s):  
Alexander Rittel ◽  
Krista Highland ◽  
Mark S Maneval ◽  
Archie Bockhorst ◽  
Agustin Moreno ◽  
...  
Keyword(s):  
At Risk ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Opioid Overdose ◽  
Military Health System ◽  
Military Health ◽  
Support Tool ◽  
Patients At Risk

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To describe the development, implementation, and evaluation of a pharmacy clinical decision support tool designed to increase naloxone coprescription among people at risk for opioid overdose in a large healthcare system. Summary The Military Health System Opioid Registry and underlying presentation layer were used to develop a clinical decision support capability to improve naloxone coprescription at the pharmacy point of care. Pharmacy personnel use a patient identification card barcode scanner or manually enter a patient’s identification number to quickly visualize information on a patient’s risk for opioid overdose and medical history related to pain and, when appropriate, receive a recommendation to coprescribe naloxone. The tool was made available to military treatment facility pharmacy locations. An interactive dashboard was developed to support monitoring, utilization, and impact on naloxone coprescription to patients at risk for opioid overdose. Conclusion Initial implementation of the naloxone tool was slow from a lack of end-user awareness. Efforts to increase utilization were, in part, successful owing to a number of enterprise-wide educational initiatives. In early 2020, the naloxone tool was used in 15% of all opioid prescriptions dispensed at a military pharmacy. Data indicate that the frequency of naloxone coprescription to patients at risk for opioid overdose was significantly higher when the naloxone tool was used than when the tool was not used.

Benchmarking contractors’ financial performance: case study of Singapore

2020 ◽  
Vol 25 (2) ◽  
pp. 183-199 ◽  
Author(s):  
Zhe Zhang ◽  
Zhi Ye Koh ◽  
Florence Ling
Keyword(s):  
Decision Support ◽  
Decision Tree ◽  
Financial Performance ◽  
Decision Support Tool ◽  
International Standards ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Support Tool ◽  
Public Agency

Purpose This study aims to develop benchmarks of the financial performance of contractors and a decision support tool for evaluation, selection and appointment of contractors. The financial benchmarks allow contractors to know where they are relative to the best-performing contractors, and they can then take steps to improve their own performance. The decision support tool helps clients to decide which contractor should be awarded the project. Design/methodology/approach Financial data between 2013 and 2015 of 44 Singapore-based contractors were acquired from a Singaporean public agency. Benchmarks for Z-score and financial ratios were developed. A decision tree for evaluating contractors was constructed. Findings This study found that between 57% and 64% of contractors stayed in the financially healthy zone from 2013 to 2015. Ratios related to financial liabilities are relatively bad compared with international standards. Research limitations/implications The limitation is that the data is obtained from a cross-sectional survey of contractors’ financial performance in Singapore over a three-year period. Regarding the finding that ratios relating to financial liabilities are weak, the implication is that contractors need to reduce their financial liabilities to achieve a good solvency profile. Contractors may use the benchmarks to check their financial performances relative to that of their competitors. To reduce financial risks, project clients may use these benchmarks to examine contractors’ financial performance. Originality/value This study provides benchmarks for contractors and clients to examine the financial performance of contractors in Singapore. A decision tree is provided to aid clients in making decisions on which contractors to appoint.

A decision support tool to determine cost-to-benefit of a family-centered in-home program for at-risk adolescents

2016 ◽  
Vol 56 ◽  
pp. 43-49 ◽  
Author(s):  
Fernando A. Wilson ◽  
Ozgur M. Araz ◽  
Ronald W. Thompson ◽  
Jay L. Ringle ◽  
W. Alex Mason ◽  
...  
Keyword(s):  
At Risk ◽  
Decision Support ◽  
Decision Support Tool ◽  
Support Tool ◽  
Home Program ◽  
At Risk Adolescents ◽  
Family Centered

scholarly journals Decision support for the selection of reference sites using <sup>137</sup>Cs as a soil erosion tracer

SOIL ◽  
2017 ◽  
Vol 3 (3) ◽  
pp. 113-122 ◽  
Author(s):  
Laura Arata ◽  
Katrin Meusburger ◽  
Alexandra Bürge ◽  
Markus Zehringer ◽  
Michael E. Ketterer ◽  
...  
Keyword(s):  
Decision Support ◽  
Soil Erosion ◽  
Decision Tree ◽  
Decision Support Tool ◽  
Small Scale ◽  
Reference Sites ◽  
Chernobyl Fallout ◽  
Support Tool ◽  
Alpine Valley ◽  
Selection Of

Abstract. The classical approach of using 137Cs as a soil erosion tracer is based on the comparison between stable reference sites and sites affected by soil redistribution processes; it enables the derivation of soil erosion and deposition rates. The method is associated with potentially large sources of uncertainty with major parts of this uncertainty being associated with the selection of the reference sites. We propose a decision support tool to Check the Suitability of reference Sites (CheSS). Commonly, the variation among 137Cs inventories of spatial replicate reference samples is taken as the sole criterion to decide on the suitability of a reference inventory. Here we propose an extension of this procedure using a repeated sampling approach, in which the reference sites are resampled after a certain time period. Suitable reference sites are expected to present no significant temporal variation in their decay-corrected 137Cs depth profiles. Possible causes of variation are assessed by a decision tree. More specifically, the decision tree tests for (i) uncertainty connected to small-scale variability in 137Cs due to its heterogeneous initial fallout (such as in areas affected by the Chernobyl fallout), (ii) signs of erosion or deposition processes and (iii) artefacts due to the collection, preparation and measurement of the samples; (iv) finally, if none of the above can be assigned, this variation might be attributed to turbation processes (e.g. bioturbation, cryoturbation and mechanical turbation, such as avalanches or rockfalls). CheSS was exemplarily applied in one Swiss alpine valley where the apparent temporal variability called into question the suitability of the selected reference sites. In general we suggest the application of CheSS as a first step towards a comprehensible approach to test for the suitability of reference sites.

scholarly journals Incorporating Guideline Adherence and Practice Implementation Issues into the Design of Decision Support for Beta-Blocker Titration for Heart Failure

2018 ◽  
Vol 09 (02) ◽  
pp. 478-489 ◽  
Author(s):  
Michael Smith ◽  
Charnetta Brown ◽  
Salim Virani ◽  
Charlene Weir ◽  
Laura Petersen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Decision Support ◽  
Ejection Fraction ◽  
Decision Support Tool ◽  
Cognitive Demands ◽  
Support Tool ◽  
Usability Assessment ◽  
Clinical Reminder ◽  
Patients At Risk ◽  
Β Blocker

Background The recognition of and response to undertreatment of heart failure (HF) patients can be complicated. A clinical reminder can facilitate use of guideline-concordant β-blocker titration for HF patients with depressed ejection fraction. However, the design must consider the cognitive demands on the providers and the context of the work. Objective This study's purpose is to develop requirements for a clinical decision support tool (a clinical reminder) by analyzing the cognitive demands of the task along with the factors in the Cabana framework of physician adherence to guidelines, the health information technology (HIT) sociotechnical framework, and the Promoting Action on Research Implementation in Health Services (PARIHS) framework of health services implementation. It utilizes a tool that extracts information from medical records (including ejection fraction in free text reports) to identify qualifying patients at risk of undertreatment. Methods We conducted interviews with 17 primary care providers, 5 PharmDs, and 5 Registered Nurses across three Veterans Health Administration outpatient clinics. The interviews were based on cognitive task analysis (CTA) methods and enhanced through the inclusion of the Cabana, HIT sociotechnical, and PARIHS frameworks. The analysis of the interview data led to the development of requirements and a prototype design for a clinical reminder. We conducted a small pilot usability assessment of the clinical reminder using realistic clinical scenarios. Results We identified organizational challenges (such as time pressures and underuse of pharmacists), knowledge issues regarding the guideline, and information needs regarding patient history and treatment status. We based the design of the clinical reminder on how to best address these challenges. The usability assessment indicated the tool could help the decision and titration processes. Conclusion Through the use of CTA methods enhanced with adherence, sociotechnical, and implementation frameworks, we designed a decision support tool that considers important challenges in the decision and execution of β-blocker titration for qualifying HF patients at risk of undertreatment.

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