scholarly journals Enhancement of Decision Rules to Increase Generalizability and Performance of the Rule-Based System Assessing Risk for Pressure Ulcer

2013 ◽  
Vol 04 (02) ◽  
pp. 251-266 ◽  
Author(s):  
H. Kim ◽  
J. Choi
Keyword(s):  
Risk Assessment ◽  
Pressure Ulcer ◽  
Assessment Tool ◽  
Decision Rules ◽  
Survey Study ◽  
Rule Based ◽  
Rule Based System ◽  
Braden Scale ◽  
And Performance ◽  
Level Of Agreement

SummaryBackground: A rule-based system, the Braden Scale based Automated Risk Assessment Tool (BART), was developed to assess risk for pressure ulcer in a previous study. However, the BART illustrated two major areas in need of improvement, which were: 1) the enhancement of decision rules and 2) validation of generalizability to increase performance of BART.Objectives: To enhance decision rules and validate generalizability of the enhanced BART.Method: Two layers of decision rule enhancement were performed: 1) finding additional data items with the experts and 2) validating logics of decision rules utilizing a guideline modeling language. To refine the decision rules of the BART further, a survey study was conducted to ascertain the operational level of patient status description of the Braden Scale.The enhanced BART (BART2) was designed to assess levels of pressure ulcer risk of patients (N = 99) whose data were collected by the nurses. The patients’ level of pressure ulcer risk was assessed by the nurses using a Braden Scale, by an expert using a Braden Scale, and by the automatic BART2 electronic risk assessment. SPSS statistical software version 20 (IBM, 2011) was used to test the agreement between the three different risk assessments performed on each patient.Results: The level of agreement between the BART2 and the expert pressure ulcer assessments was “very good (0.83)”. The sensitivity and the specificity of the BART2 were 86.8% and 90.3% respectively.Conclusion: This study illustrated successful enhancement of decision rules and increased general-izability and performance of the BART2. Although the BART2 showed a “very good” level of agreement (kappa = 0.83) with an expert, the data reveal a need to improve the moisture parameter of the Braden Scale. Once the moisture parameter has been improved, BART2 will improve the quality of care, while accurately identifying the patients at risk for pressure ulcers.Citation: Choi J, Kim H. Enhancement of Decision Rules to Increase Generalizability and Performance of the Rule-Based System Assessing Risk for Pressure Ulcer. Appl Clin Inf 2013; 4: 251–266http://dx.doi.org/10.4338/ACI-2012-12-RA-0056

Not at risk — Nevertheless a pressure ulcer

Open Medicine ◽  
2006 ◽  
Vol 1 (3) ◽  
pp. 270-283 ◽  
Author(s):  
Nils Lahmann ◽  
Ruud Halfens ◽  
Theo Dassen
Keyword(s):  
Risk Assessment ◽  
At Risk ◽  
Nursing Homes ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Medical Specialties ◽  
Braden Scale ◽  
Not At Risk

AbstractWhen conducting prevalence surveys pressure ulcers were found in participants clearly identified not to be at risk. This article determines and analyses persons in German hospitals and nursing homes who suffer from pressure ulcers but are not at risk. In the years 2002, 2003 and 2004 there were 7,097 nursing home residents and 23,966 hospital patients examined in annual pressure ulcer prevalence surveys. A risk assessment according to the Braden Scale was performed for each participant on the day of the survey. “Not at risk” participants were defined by Braden score cut-off > 20 points. There were 440 of 3,012 (14.6%) persons with pressure ulcer who were considered not to be at risk. In hospitals, 16.1% of all patients with pressure ulcers were not at risk, in nursing homes it was 8.2%. A high variance between medical specialties and individual institutions was found in the number of those not at risk but with pressure ulcer. In the group not at risk, persons with and without a pressure ulcer differed regarding activity and friction and shear in nursing homes. In hospitals those persons differed regarding age and all single items of the Braden scale apart from sensory perception. Pressure ulcers that are more severe, located at the hip or lower back or the origin of which is unknown are more likely to be considered to be at risk by the Braden risk assessment tool.The results may indicate insufficient abilities of the Braden scale for certain kind of pressure ulcer wounds.

scholarly journals Risk Assessment Tool for Pressure Ulcer Development in Indian Surgical Wards

2012 ◽  
Vol 77 (3) ◽  
pp. 206-212 ◽  
Author(s):  
Sushma Kumari ◽  
Deborshi Sharma ◽  
Anshika Rana ◽  
Reetesh Pathak ◽  
Romesh Lal ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Pressure Ulcer ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Pressure Ulcer Development

Pressure ulcer risk assessment: retrospective analysis of Braden Scale scores in Portuguese hospitalised adult patients

2015 ◽  
Vol 24 (21-22) ◽  
pp. 3165-3176 ◽  
Author(s):  
Pedro Sardo ◽  
Cláudia Simões ◽  
José Alvarelhão ◽  
César Costa ◽  
Carlos J Simões ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Retrospective Analysis ◽  
Pressure Ulcer ◽  
Adult Patients ◽  
Braden Scale ◽  
Scale Scores

Predicting Job Performance with a Fuzzy Rule-Based System

2003 ◽  
Vol 02 (03) ◽  
pp. 425-444 ◽  
Author(s):  
J. Philip Craiger ◽  
Michael D. Coovert ◽  
Mark S. Teachout
Keyword(s):  
Job Performance ◽  
Fuzzy Rule ◽  
Data Sets ◽  
Behavioral Models ◽  
Classification Problems ◽  
Rule Based ◽  
Job Experience ◽  
Rule Based System ◽  
Us Air Force ◽  
And Performance

Classification problems affect all organizations. Important decisions affecting an organization's effectiveness include predicting the success of job applicants and the matching and assignment of individuals from a pool of applicants to available positions. In these situations, linear mathematical models are employed to optimize the allocation of an organization's human resources.Use of linear techniques may be problematic, however, when relationships between predictor and criterion are nonlinear. As an alternative, we developed a fuzzy associative memory (FAM: a rule-based system based on fuzzy sets and logic) and used it to derive predictive (classification) equations composed of measures of job experience and job performance. The data consisted of two job experience factors used to predict measures of job performance for four US Air Force job families. The results indicated a nonlinear relationship between experience and performance for three of the four data sets. The overall classification accuracy was similar for the two systems, although the FAM provided better classification for two of the jobs. We discuss the apparent nonlinear relationships between experience and performance, and the advantages and implications of using these systems to develop and describe behavioral models.

The introduction and evaluation of a pressure ulcer risk assessment tool for photopheresis outpatients

2017 ◽  
Vol 26 (12) ◽  
pp. S16-S22
Author(s):  
Cherie Rushton ◽  
Rachel Goodgrove ◽  
Leeah Robertson ◽  
Tracie Taylor ◽  
Peter Taylor ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Pressure Ulcer ◽  
Assessment Tool ◽  
Risk Assessment Tool
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