Design of Aided Decision-Making Program for Prioritizing Construction Projects in Urban Road Network Planning

The importance and complexity of prioritizing construction projects (PCP) in urban road network planning lead to the necessity to develop an aided decision making program (ADMP). Cost benefit ratio model and stage rolled method are chosen as the theoretical foundations of the program, and then benefit model is improved to accord with the actuality of urban traffic in China. Consequently, program flows, module functions and data structures are designed, and particularly an original data structure of road ...

Decision aids can decrease decisional conflict in patients with hip or knee osteoarthritis: Randomized controlled trial

BACKGROUND The interest in shared decision making has increased considerably over the last couple of decades.Decision aids(DAs)can help in shared decision making.Especially when there is more than one reasonable option and outcomes between treatments are comparable.AIM To investigate if the use of DAs decreases decisional conflict in patients when choosing treatment for knee or hip osteoarthritis(OA).METHODS In this multi-center unblinded randomized controlled trial of patients with knee or hip OA were included from four secondary and tertiary referral centers.Onehundred-thirty-one patients who consulted an orthopedic surgeon for the first time with knee or hip OA were included between December 2014 and January 2016.After the first consultation,patients were randomly assigned by a computer to the control group which was treated according to standard care,or to the intervention group which was treated with standard care and provided with a DA.After the first consultation,patients were asked to complete questionnaires about decisional conflict(DCS),satisfaction,anxiety(PASS-20),gained knowledge,stage of decision making and preferred treatment.Follow-up was carried out after 26 wk and evaluated decisional conflict,satisfaction,anxiety,health outcomes(HOOS/KOOS),quality of life(EQ5D)and chosen treatment.RESULTS After the first consultation,patients in the intervention group(mean DCS:25 out of 100,SD:13)had significantly(P value:0.00)less decisional conflict compared to patients in the control group(mean DCS:39 out of 100,SD 11).The mean satisfaction score for the given information(7.6 out of 10,SD:1.8 vs 8.6 out of 10,SD:1.1)(P value:0.00),mean satisfaction score with the physician(8.3 out of 10,SD:1.7 vs 8.9 out of 10,SD:0.9)(P value:0.01)and the mean knowledge score(3.3 out of 4,SD:0.9 vs 3.7 out of,SD:0.6)(P value:0.01)were all significantly higher in the intervention group.At 26-wk follow-up,only 75 of 131 patients(57%)were available for analysis.This sample is too small for meaningful analysis.CONCLUSION Providing patients with an additional DA may have a positive effect on decisional conflict after the first consultation.Due to loss to follow-up we are unsure if this effect remains over time.

Decision Making in Sustainable Development: Some Methods to Evaluate Energy and Nonrenewable Resources Waste When Using Some Plastics

This paper explores a decision making model for a multidisciplinary problem in nature. This problem considers the role of energy use in sustainable development and the potential sources to increase energy efficiency during its whole life cycle;it also deals with multicriteria decision making of plastic materials used in a day to day basis. Exergy analysis of plastic materials used to the manufacture of disposable polyethylene bags comparing them with other materials that can be used for substitution will be important to take decisions. We are also interested in plastic poly (ethylene Terephthalate or PET) bottles. The calculation of the incoming and outgoing Exergy flows during the production processes are carried out. The Exergy loss considering the sustainability concept, Green House Gases emissions, real energy flows needed to the chain of processes, material balances in the productions chains and value added, are presented as a set of criteria to make decisions of alternative materials including the actual ones. A case study for Mexico’s market will be developed in order to prove the methodology. It offers some interesting data about consumption and production of bags and bottles.

Role of decision aids in orthopaedic surgery

Medical treatment of patients inherently entails the risk of undesired complication or side effects. It is essential to inform the patient about the expected outcomes, but also the possible undesired outcomes. The patients preference and values regarding the potential outcomes should be involved in the decision making process. Even though many orthopaedic surgeons are positive towards shared decision-making, it is minimally introduced in the orthopaedic daily practice and decision-making is still mostly physician based. Decision aids are designed to support the physician and patient in the shareddecision-making process. By using decision aids, patients can learn more about their condition and treatment options in advance to the decision-making. This will reduce decisional conflict and improve participation and satisfaction.

A Novel System on Efficient Matching, Decision Making and Distributing

The object matching and distribution problem is a traditional challenge in different kinds of networks, such as kidney distribution networks. Applying differential element analysis methods, decision tree, integer linear programming the-ory and stochastic processes ideas, we propose models for the objects matching, the distribu-tion network, the exchange system and the in-dividual decision-making strategy, and thor-oughly analyze the relationship between the matching rate and the waiting time, and their impacts on the efficiency of the donor-matching process. And as the experiments, we evaluate the algorithms and system by kidney matching, decision making and distribution problems on real world data.

跨文化视角下我国医患共同决策的研究进展

医患共同决策是一种以患者为中心的决策模式,护士应在其中扮演重要角色。然而,不同的文化背景会对医患共同决策产生影响,医疗伦理观念和法律差异也对医患共同决策的实施提出了挑战。在中国的家庭主义传统下,实现理想的患者自主决策模式存在一定难度。基于此,文章提出未来我国护理研究应更多关注医患共同决策过程中的跨文化调试,强调医患共同决策过程中护士的参与和作用,寻找文化平衡来构建有多角色参与的中国的医患共同决策模式和工具。

基于物联网重症监护设备的临床辅助决策研究

目的:减轻医生临床压力,提高信息化辅助临床诊断决策水平。方法:运用物联网采集装置,采集重症监护室、普通病房呼吸机、监护仪等治疗设备生命体征和报警信息,设计假阳性报警过滤和临床辅助诊断信息化模型工具。结果:通过实施假阳性报警过滤和临床辅助诊断信息化工具,为医院阳性报警、远程ICU等应用推广提供数据支持。结论:重症监护室信息化辅助决策的研究与应用,可提升临床医生的决策效率,减轻临床工作压力,提高医疗服务水平。

基于微形变分析的电容式MEMS加速度计温漂误差精密估计方法

针对传统的电容式微机电系统(micro-electro-mechanical system,MEMS)加速度计(capacitive MEMS accelerometers,CMA)温漂误差(temperature drift error,TDE)补偿方法存在非精准溯源TDE致使TDE估计精度低、反复尝试估计模型构型导致构建过程复杂繁琐的问题,提出基于微形变分析的CMA TDE精密补偿方法。首先,通过微形变分析内部结构精准溯源TDE,基于径向基函数神经网络(radial basis function neural network,RBFNN)构建改进型TDE精密估计模型;其次,基于专家经验和模糊理论提出Expert-Fuzzy辅助决策下TDE估计模型辨识方法,为改进模型提供有效的构型指导;然后,设计升温试验测试CMA,构建传统模型和改进模型并通过对比其输出偏置稳定性评估TDE估计性能。实验结果表明,改进模型构建过程大大简化,补偿后CMA偏置稳定性提升约35%。本方法能够更加精准地估计TDE,有效解耦硅基材料的温度依赖性并提升CMA的环境适应性。

护理人员共享决策能力现状及影响因素研究

目的了解护理人员共享决策能力的现状并探讨影响因素,为共享决策能力教育与培训提供依据。方法采用一般资料调查表、护理人员共享决策能力量表、杰弗逊共情量表和组织支持感量表对7所综合医院的2363名护理人员进行调查。结果护理人员共享决策能力得分(3.79±0.72)分,共情能力(5.64±0.70)分,组织支持(3.73±0.79)分。多元线性回归分析显示,工作年限、是否接受过共享决策教育培训、共情能力、组织支持是护理人员共享决策能力的影响因素(均P<0.05)。结论护理人员共享决策能力处于中等水平。护理管理者应根据相关影响因素,制定培训计划,以提高护理人员共享决策能力。

癌症患者决策辅助工具应用体验质性研究的Meta整合

目的对成年癌症患者决策辅助工具应用体验进行系统整合,为开发我国本土化决策辅助工具、实现共享决策提供循证指导。方法计算机检索PubMed、Cochrane Library、CINAHL、Embase、Web of Science、ProQuest、中国知网、万方数据库、维普网、中国生物医学文献数据库中关于癌症患者决策辅助工具应用体验的质性研究,检索时限为建库至2023年7月。采用JBI循证卫生保健中心质性研究质量评价标准(2020)进行文献质量评价,以Meta整合方法对文献研究结果进行整合。结果纳入17篇文献,提炼出50个研究结果,归纳出7个类别,最终形成3个整合结果:患者对决策辅助工具总体满意度较高、增强患者决策参与体验、阻碍因素。结论决策辅助工具可以帮助癌症患者了解治疗方案并积极参与决策,满足患者的决策需求,缓解决策冲突,从而改善患者的临床结局。

多元共享决策模式对瘢痕子宫再次妊娠分娩方式的影响

目的探究决策辅助手册联合在线分娩决策支持的多元共享决策模式对瘢痕子宫再次妊娠女性分娩方式的影响。方法选取2019年9月至2022年10月在某三甲医院产检的94例瘢痕子宫再次妊娠女性为研究对象,采用随机数字表法分为观察组与对照组。对照组接受常规孕期宣教,观察组在常规孕期宣教的基础上接受多元共享决策干预。分别对两组分娩决策冲突程度、分娩方式偏好、分娩后决策后悔程度和最终分娩方式进行比较。结果观察组在接受多元共享决策干预后,决策冲突量表得分降低(P<0.001),在分娩方式偏好调查中表示“不确定”的人数减少,选择经阴道生产的人数增加;最终观察组孕妇行剖宫产者30人(68.2%),阴道分娩者14人(31.8%);观察组孕妇对本次分娩决策后悔程度低于对照组(P<0.001)。结论对瘢痕子宫再次妊娠女性开展多元共享决策可降低其决策冲突程度、增强阴道试产意愿并帮助其做出理性科学的分娩决策。

手术病人决策辅助的研究进展

介绍病人决策辅助的定义、使用情景、意义、内涵、形式以及开发的理论基础、质量评价、应用现状、目前存在的问题,以期为我国开展相关研究提供参考。

2型糖尿病病人饮食决策辅助工具最佳证据总结

目的:整合2型糖尿病(T2DM)病人饮食决策辅助工具的最佳证据,为临床护理人员提供参考。方法:根据“6S”证据模型检索临床决策网、指南网、英文数据库、中文数据库、国内外糖尿病协会网站中关于T2DM病人饮食决策的相关文献,并对各类研究的文献质量评价后进行证据提取及汇总。结果:共纳入10篇文献,包括指南4篇、系统评价1篇、质性研究1篇、随机对照试验(RCT)4篇,依据现有证据总结出目标评估、核心要素、呈现形式、健康教育、结局指标5个方面共28条T2DM病人饮食决策辅助工具最佳证据。结论:总结的T2DM病人饮食决策辅助工具最佳证据为临床护理人员编制及应用相关工具提供了循证依据,护理人员可结合临床情况和病人饮食决策情况开展实践研究。

2型糖尿病患者饮食决策辅助工具编制及应用研究

目的编制2型糖尿病(type 2 diabetes mellitus,T2DM)患者饮食决策辅助工具,并评价其临床应用效果。方法基于T2DM饮食决策辅助工具最佳证据、渥太华决策支持框架、国内外T2DM患者饮食决策相关研究,形成T2DM患者饮食决策辅助工具初稿,并根据国际患者决策辅助工具要求通过专家会议、用户评估对工具初稿进行修订和完善。选取2022年4月—9月在湖南省某三级甲等医院内分泌科住院的62例T2DM患者为研究对象,按照入院顺序将其分入对照组(4月—6月入院,n=31)和试验组(7月—9月入院,n=31),对照组接受常规护理,试验组接受常规护理联合T2DM患者饮食决策辅助工具干预。分别于干预前、出院3个月后比较两组糖尿病饮食治疗依从性、决策冲突,以及客观指标[BMI、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]水平。结果编制的T2DM患者饮食决策辅助工具由决策阶段评估、信息支持、利弊分析、支持系统、价值思考、决策制订倾向性和决策确认7个部分组成。最终对照组29例、试验组30例完成本研究。出院3个月后,试验组糖尿病饮食治疗依从性得分高于对照组(P<0.05);决策冲突总得分、FPG、HbA1c、LDL-C低于对照组(P<0.05)。结论T2DM患者饮食决策辅助工具的运用在一定程度上可以提高T2DM患者饮食治疗依从性,降低其决策冲突水平,改善其血糖与血脂水平。

基于网络的患者决策辅助在肿瘤患者临床决策中的应用进展

介绍基于网络的患者决策辅助工具在肿瘤患者临床决策中的应用概况,阐述其设计特征,包括内容丰富且信息呈现可视化、决策设置个性化、功能交互性、临床可持续性;总结决策辅助工具在肿瘤患者临床决策中的具体应用,包括癌症筛查决策、癌症预防决策、癌症治疗决策、癌症患者生育力决策、预立医疗照护计划,提出此类工具在临床应用的挑战和建议,旨在为我国开发和应用基于网络的癌症患者决策辅助工具提供可行性参考。

预立医疗照护计划决策辅助工具的研究进展

从预立医疗照护计划决策辅助工具的内容、类型、理论模型、质量评价、应用效果和启示进行综述,旨在提高公众对预立医疗照护计划相关知识的知晓率,为后续进一步开展干预性研究提供参考。

患者决策辅助工具开发流程研究现状

患者决策辅助工具是实施医患共同决策的有效手段。本文介绍国际上主要组织关于患者决策辅助工具的开发流程与方法,探讨其特点和差异,分析国内开发患者决策辅助工具的挑战,提出相应建议,以期为国内患者决策辅助工具的开发提供参考。

决策辅助工具对老年患者治疗决策影响的Meta分析

目的 :评价决策辅助工具对老年患者治疗决策的影响,以期为医护人员开展决策辅助工具在临床中的应用提供证据支持。方法 :计算机检索中英文数据库中关于决策辅助工具对老年患者治疗决策影响的随机对照试验,检索时限为2012年11月至2022年11月。经2名研究者独立筛选文献、提取资料和评价文献质量后,采用RevMan 5.3软件进行Meta分析。结果 :最终纳入12篇文献,共1 317例患者。Meta分析结果显示,决策辅助工具可以降低老年患者的决策冲突水平,增加决策知识(P<0.05),对减少决策后悔和提高老年患者决策满意度的作用差异无统计学意义(P>0.05)。结论 :决策辅助工具有助于改善老年患者的决策质量,但对老年患者决策后悔和满意度的影响仍存在争议,未来须开展更多大样本、高质量的研究,以进一步验证其有效性。

维特鲁威图:一种直观展示证据汇总结果的可视化工具

临床实践指南的制订包含一系列循证决策过程。其中,从证据至推荐是极具挑战性的一环。推荐意见的形成需决策者全面、准确地理解证据,综合权衡干预措施的潜在获益与风险,并根据临床实际作出利弊平衡的价值判断和选择。相较于传统的证据汇总呈现形式,应用可视化工具可有效促进证据信息的传递和分析,简化信息阅读,提升决策效率。基于此目的,本文在既往研究的基础上改良制作了证据汇总可视化工具维特鲁威图,并结合实例阐述其使用方法和优势,以期为研究者提供参考和借鉴。