Fermatean Hesitant Fuzzy Sets with Medical Decision Making Application

Fermatean fuzzy set idea obtained by combining fermatean fuzzy sets and hesitant fuzzy sets can be used in practice to simplify the solution of complicated multi-criteria decision-making (MCDM) problems. Initially, the notion of fermatean hesitant fuzzy set is given and the operations related to this concept are presented. Aggregation operators according to fermatean hesitant fuzzy sets are given and basic properties of these operators are studied. To choose the best alternative in practice, a novel MCDM method that is obtained with operators has been created. Finally, an example of infectious diseases was examined to indicate the effectiveness of the suggested techniques.

Rethinking individual autonomy in medical decision-making for young adults reliant on caregiver support: A case report and analysis

There is a gap in the clinical bioethics literature concerning the approach to assessment of medical decision-making capacity of adolescents or young adults who demonstrate diminished maturity due to longstanding reliance on caregiver support, despite having reached the age of majority. This paper attempts to address this question via the examination of a particular case involving assessment of the decision-making capacity of a young adult pregnant patient who also had a physically disabling neurological condition. Drawing on concepts from adolescent bioethics and feminist critiques of bioethical theory, we argue that limited life experience, secondary to a disabling neurological condition, can result in a lack of adult-like capacity even in a patient who is legally an adult. In such cases, it may be that autonomy, to the extent that it is to be relevant and meaningful, must be viewed through a relational lens. Furthermore, clinicians may avoid unjustifiably paternalistic practices by working with the patient help her gain a better appreciation of the consequences of her decision, thereby calling forward her capacity rather than resorting to being directive in counseling. We conclude that lessons from this case can be used to approach ethically complex instances of medical decision-making in adult patients with normal cognition but diminished experiential maturity.

A review and content analysis of U.S. Department of Corrections end-of-life decision making policies

Purpose With a rapidly growing population of older adults with chronic illness in US prisons, the number of people who die while incarcerated is increasing. Support for patients’ medical decision-making is a cornerstone of quality care for people at the end of life (EOL). This study aims to identify, describe, and analyze existing policies regarding EOL decision-making in U.S. Departments of Corrections. Design/methodology/approach This study performed an iterative content analysis on all available EOL decision-making policies in US state departments of corrections and the Federal Bureau of Prisons. Findings This study collected and reviewed available policies from 37 of 51 prison systems (73%). Some areas of commonality included the importance of establishing health-care proxies and how to transfer EOL decision documents, although policies differed in terms of which patients can complete advance care planning documents, and who can serve as their surrogate decision-makers. Practical implications Many prison systems have an opportunity to enhance their patient medical decision-making policies to bring them in line with community standard quality of care. In addition, this study was unable to locate policies regarding patient decision-making at the EOL in one quarter of US prison systems, suggesting there may be quality-of-care challenges around formalized approaches to documenting patient medical wishes in some of those prison systems. Originality/value To the best of the authors’ knowledge, this is the first content analysis of EOL decision-making policies in US prison systems.

Medical Decision Making for Cardiac MRI with CFD “Detection of Severe Stenosis Using a 5D Model of the Descending Aorta”

The aim of this study is to develop a reliable 5D (x, y, z, time, flow dimension) model for medical decision making. Sophisticated techniques for the assessment of serious stenosis were developed using time-dependent instantaneous pressure gradients through the aorta (flow rate, Reynolds number, velocity, etc.). A 74 cardiac MRI scan and 3057 scans were performed on a 10-year-old patient with congenital valve and valvular aortic stenosis on sensitive MRI and coarctation (operated and then dilated) in the sense of shone syndrome. The occlusion rate was estimated to be 80.5%. The stenosis area was approximately 15 mm long and 10 mm high. The fluid solver (NS) exhibited a significant shear stress of −3.735 × 10−5 Pa within the first 10 iterations. There was a significant drop in the flux mass of −0.0050 (kg/s), as well as high blood turbulence in vortex field lines and low geometry Reynolds cells. The fifth dimension was used for negative velocity prediction (−81.4 cm/s). The discoveries of the 5D aortic simulation are convincing based on the evaluation of its physical and biomedical features.

"Doctor Knows Best"

We often consider medical practitioners to be epistemic authorities: “Doctor knows best,” as the saying goes. The place of expert judgment in evidence-based medicine hierarchies, and the crucial role of patient preferences and values in medical decision-making, however, pose problems for making sense of such authority. I argue that there is an account of such medical epistemic authority that does justice to the complexities of the doctor–patient relationship, while maintaining that medical practitioners hold an epistemically privileged position. Such a view can better inform medical practice by clearly illuminating the distinct roles of patients and doctors in decision-making processes.

Evaluating the Effects of Symptom Monitoring on Menopausal Health Outcomes: A Systematic Review and Meta-Analysis

Evidence suggests that monitoring and appraising symptoms can result in increased engagement in medical help-seeking, improved patient-doctor communication, and reductions in symptom prevalence and severity. To date, no systematic reviews have investigated whether symptom monitoring could be a useful intervention for menopausal women. This review explored whether symptom monitoring could improve menopausal symptoms and facilitate health-related behaviours. Results suggested that symptom monitoring was related to improvements in menopausal symptoms, patient-doctor communication and medical decision-making, heightened health awareness, and stronger engagement in setting treatment goals. Meta-analyses indicated large effects for the prolonged use of symptom diaries on hot flush frequencies. Between April 2019 and April 2021, PsychInfo, EMBASE, MEDLINE, CINAHL, Cochrane, ProQuest, PsychArticles, Scopus, and Web of Science were searched. Eighteen studies met the eligibility criteria and contributed data from 1,718 participants. Included studies quantitatively or qualitatively measured the impact of symptom monitoring on menopausal populations and symptoms. Research was narratively synthesised using thematic methods, 3 studies were examined via meta-analysis. Key themes suggest that symptom monitoring is related to improvements in menopausal symptoms, improved patient-doctor communication and medical decision-making, increased health awareness, and stronger engagement in goal-setting behaviours. Meta-analysis results indicated large effects for the prolonged use of symptom diaries on hot flush frequency: 0.73 [0.57, 0.90]. This review is limited due to the low number of studies eligible for inclusion, many of which lacked methodological quality. These results indicate that symptom monitoring has potential as an effective health intervention for women with menopausal symptoms. This intervention may be beneficial within healthcare settings, in order to improve patient-doctor relations and adherence to treatment regimes. However, findings are preliminary and quality assessments suggest high risk of bias. Thus, further research is needed to support these promising outcomes.Systematic Review Registration Number:https://www.crd.york.ac.uk/prospero/display_record.php?, PROSPERO, identifier: CRD42019146270.