Artificial intelligence promotes shared decision-making through recommending tests to febrile pediatric outpatients

BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.

Shared Decision-Making after Implementation of the Chronic Care Model (CCM)—An Evaluative Approach

Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis of best available evidence. Methods: Data were collected from two teams that took part in a focus group interview, and the transcript was analysed by means of qualitative thematic analysis. Results: One overall theme emerged—Preventing the violation of human dignity based on three themes, namely, Changing understanding and attitudes, Increasing depressed elderly persons’ autonomy and Clarifying the mental healthcare team coordinator’s role and responsibility. The results of this study reveal that until recently, paternalism has been the dominant decision-making model within healthcare, without any apparent consideration of the patient perspective. Community mental healthcare can be improved by shared decision-making in which team members initiate a dialogue focusing on patient participation to prevent the violation of human dignity. However, in order to determine how best to empower the patient, team members need expert knowledge and intuition.

Evolutionary Decision-Making and Planning for Autonomous Driving Based on Safe and Rational Exploration and Exploitation

Decision-making and motion planning are extremely important in autonomous driving to ensure safe driving in a real-world environment.This study proposes an online evolutionary decision-making and motion planning framework for autonomous driving based on a hybrid data-and model-driven method.First,a data-driven decision-making module based on deep reinforcement learning(DRL)is developed to pursue a rational driving performance as much as possible.Then,model predictive control(MPC)is employed to execute both longitudinal and lateral motion planning tasks.Multiple constraints are defined according to the vehicle’s physical limit to meet the driving task requirements.Finally,two principles of safety and rationality for the self-evolution of autonomous driving are proposed.A motion envelope is established and embedded into a rational exploration and exploitation scheme,which filters out unreasonable experiences by masking unsafe actions so as to collect high-quality training data for the DRL agent.Experiments with a high-fidelity vehicle model and MATLAB/Simulink co-simulation environment are conducted,and the results show that the proposed online-evolution framework is able to generate safer,more rational,and more efficient driving action in a real-world environment.

Consensus model of social network group decision-making based on trust relationship among experts and expert reliability

Due to people’s increasing dependence on social networks,it is essential to develop a consensus model considering not only their own factors but also the interaction between people.Both external trust relationship among experts and the internal reliability of experts are important factors in decision-making.This paper focuses on improving the scientificity and effectiveness of decision-making and presents a consensus model combining trust relationship among experts and expert reliability in social network group decision-making(SN-GDM).A concept named matching degree is proposed to measure expert reliability.Meanwhile,linguistic information is applied to manage the imprecise and vague information.Matching degree is expressed by a 2-tuple linguistic model,and experts’preferences are measured by a probabilistic linguistic term set(PLTS).Subsequently,a hybrid weight is explored to weigh experts’importance in a group.Then a consensus measure is introduced and a feedback mechanism is developed to produce some personalized recommendations with higher group consensus.Finally,a comparative example is provided to prove the scientificity and effectiveness of the proposed consensus model.

Decision-Making in Driver-Automation Shared Control:A Review and Perspectives

Shared control schemes allow a human driver to work with an automated driving agent in driver-vehicle systems while retaining the driver’s abilities to control.The human driver,as an essential agent in the driver-vehicle shared control systems,should be precisely modeled regarding their cognitive processes,control strategies,and decision-making processes.The interactive strategy design between drivers and automated driving agents brings an excellent challenge for human-centric driver assistance systems due to the inherent characteristics of humans.Many open-ended questions arise,such as what proper role of human drivers should act in a shared control scheme?How to make an intelligent decision capable of balancing the benefits of agents in shared control systems?Due to the advent of these attentions and questions,it is desirable to present a survey on the decision making between human drivers and highly automated vehicles,to understand their architectures,human driver modeling,and interaction strategies under the driver-vehicle shared schemes.Finally,we give a further discussion on the key future challenges and opportunities.They are likely to shape new potential research directions.

Older Patients’ Involvement in Shared Decision-Making—A Systematic Review

Shared decision-making has been described as allowing patients to gain more control over their life situation and feel less helpless. The aim of this systematic review was to describe the involvement of older patients in shared decision-making in community settings. In accordance with the systematic review method, a total of 2468 abstracts were read, after which nine quantitative studies were included. A qualitative thematic analysis was performed and two themes emerged;increased understanding of self-management and a desire to strengthen one’s position in relationship with professionals, both of which were essential for empowering older patients to participate in shared decision-making. Older patients’ shared decision-making was seen as a struggle to maintain their autonomy in different areas of everyday life. Emotional and psychological problems made their position more difficult. In order to empower them in relationships with healthcare professionals, older patients require more knowledge (self-efficacy) and information about their illness, which could strengthen their position in the decision-making process. They also need a greater awareness of decisional conflicts that may arise. Age, gender and health status influence older patients’ chance of being respected and taken seriously in relationship with professionals.

Greater awareness of biosimilars and shared decision-making among patients attending rheumatology practices in Colorado,United States:Real-world data

BACKGROUND There is a lack of studies and educational programs focused on biosimilars and shared decision-making among patients diagnosed with various rheumatic diseases.AIM To improve knowledge and awareness of biosimilars and shared decision-making among patients attending rheumatology practices in Colorado as well as to assess a rheumatology patient’s interest in discussing biosimilars as well as shared decision-making with others(e.g.,medical professionals,family members,friends).METHODS Our goal was to work with 80 rheumatology teams in Colorado.We developed and distributed 2000 multi-page brochures to each participating office and later conducted an online anonymous survey.RESULTS There were a total of 49(2.5%)rheumatology patients who responded to our survey.After reading our educational booklet,many survey respondents identified the correct answer in most questions focused on biosimilars or shared decision-making.Our survey results suggest that patients attending rheumatology practices in Colorado are generally not involved in discussions with their providers regarding treatment plans or options.The improvement in scores after reading our educational materials was statistically significant for biosimilars and shared decision-making.CONCLUSION Overall,the level of knowledge and awareness of biosimilars and shared decisionmaking among patients attending rheumatology practices in Colorado was low.More educational programs as well as follow up trainings to measure changes in knowledge and awareness regarding biosimilars and shared decision-making among patients attending rheumatology practices are recommended.

Key elements and checklist of shared decisionmaking conversation on life-sustaining treatment in emergency:a multispecialty study from China

BACKGROUND:Shared decision-making(SDM)has broad application in emergencies.Most published studies have focused on SDM for a certain disease or expert opinions on future research gaps without revealing the full picture or detailed guidance for clinical practice.This study is to investigate the optimal application of SDM to guide life-sustaining treatment(LST)in emergencies.METHODS:This study was a prospective two-round Delphi consensus-seeking survey among multiple stakeholders at the China Consortium of Elite Teaching Hospitals for Residency Education.Participants were identified based on their expertise in medicine,law,administration,medical education,or patient advocacy.All individual items and questions in the questionnaire were scored using a 5-point Likert scale,with responses ranging from"very unimportant"(a score of 1)to"extremely important"(a score of 5).The percentages of the responses that had scores of 4-5on the 5-point Likert scale were calculated.A Kendall’s W coefficient was calculated to evaluate the consensus of experts.RESULTS:A two-level framework consisting of 4 domains and 22 items as well as a ready-touse checklist for the informed consent process for LST was established.An acceptable Kendall’s W coefficient was achieved.CONCLUSION:A consensus-based framework supporting SDM during LST in an emergency department can inform the implementation of guidelines for clinical interventions,research studies,medical education,and policy initiatives.

A Decision-Making Framework Model of Cutting Fluid Selection for Green Manufacturing and the Case Study

Pursuing the green manufacturing (GM) of products i s very beneficial in the alleviation of environment burdens. In order to reap such benefits, green manufacturing is involved in every aspect of manufacturing proc esses. During the machining process, cutting fluid is one of the main roots of e nvironmental pollution. And how to make an optimal selection for cutting fluid f or GM is an important path to reduce the environmental pollution. The objective factors of decision-making problems in the traditional selection of cutting flu id are usually two: quality and cost. But from the viewpoint of GM, environmenta l impact (E) should be considered together. In this paper, a multi-object d ecision-making model of cutting fluid selection for GM is put forward, in which the objects of Quality (Q), Cost(C) and Environmental impact (E) are considered together. In this model, E means to minimize the environmental impact, Q means to maximize the quality and C means to minimize the cost. Each objective is anal yzed in detail too. A case study on a decision-making problem of cutting fluid selection in a gear hobbing process is analyzed, and the result shows the model is practical.

Ranking environmental projects model based on multicriteria decision-making and the weight sensitivity analysis

With the fast growth of Chinese economic, more and more capital will be invested in environmental projects. How to select the environmental investment projects （alternatives） for obtaining the best environmental quality and economic benefits is an important problem for the decision makers. The purpose of this paper is to develop a decision-making model to rank a finite number of alternatives with several and sometimes conflicting criteria. A model for ranking the projects of municipal sewage treatment plants is proposed by using exports＇ information and the data of the real projects. And, the ranking result is given based on the PROMETHEE method. Furthermore, by means of the concept of the weight stability intervals （WSI）, the sensitivity of the ranking results to the size of criteria values and the change of weights value of criteria are discussed. The result shows that some criteria, such as “proportion of benefit to project cost”, will influence the ranking result of alternatives very strong while others not. The influence are not only from the value of criterion but also from the changing the weight of criterion. So, some criteria such as “proportion of benefit to project cost” are key critera for ranking the projects. Decision makers must be cautious to them.

COLLISION AVOIDANCE DECISION-MAKING MODEL OF MULTI-AGENTS IN VIRTUAL DRIVING ENVIRONMENT WITH ANALYTIC HIERARCHY PROCESS

Collision avoidance decision-making models of multiple agents in virtual driving environment are studied. Based on the behavioral characteristics and hierarchical structure of the collision avoidance decision-making in real life driving, delphi approach and mathematical statistics method are introduced to construct pair-wise comparison judgment matrix of collision avoidance decision choices to each collision situation. Analytic hierarchy process （AHP） is adopted to establish the agents＇ collision avoidance decision-making model. To simulate drivers＇ characteristics, driver factors are added to categorize driving modes into impatient mode, normal mode, and the cautious mode. The results show that this model can simulate human＇s thinking process, and the agents in the virtual environment can deal with collision situations and make decisions to avoid collisions without intervention. The model can also reflect diversity and uncertainly of real life driving behaviors, and solves the multi-objective, multi-choice ranking priority problem in multi-vehicle collision scenarios. This collision avoidance model of multi-agents model is feasible and effective, and can provide richer and closer-to-life virtual scene for driving simulator, reflecting real-life traffic environment more truly, this model can also promote the practicality of driving simulator.

The Credit Risk Assessment Model of Internet Supply Chain Finance: Multi-Criteria Decision-Making Model with the Principle of Variable Weight

The characteristics of the financing model are firstly analyzed when the e-commerce enterprises participate in the supply chain finance. Internet supply chain finance models are divided into three categories with the standard of whether the electronic commerce enterprises provide funds for small and medium enterprises instead of banks. And then we further study the financing process and the functions of the e-commerce platform with specific examples. Finally, combined with the characteristics of the supply chain finance model, we set up a small and medium enterprises credit evaluation model based on the principle of variable weight with its dynamic data. At the same time, a multi-time points and multi-indicators decision-making method based on the principle of variable weight is proposed and a specific example is presented. In this paper, the multi-criteria decision-making model with the principle of variable weight has been used two times. At last, a typical case has been analyzed based on this model with a higher accuracy rate of credit risk assessment.

Shared ecological mental model and ecological development of counties:Taking Anji as an example

This paper takes the County of Anji as an example and analyzes the ecological development system of counties based on the theory of mental model and complex ecosystem based on the theory of mental model and complex ecosystem. Anji ecological development system consists of ecological management subsystems, eco-industry subsystems, ecological environment subsystems, and ecological lives of the residents subsystems by shared ecological mental model as its foundation and motive power. These subsystems affect and promote each others, which eventually help people in Anji to achieve the goals of building a harmonious society, creating a beautiful countryside, and enjoying a happy life in overall. This study finds that a county's ecological development should emphasize the establishment, consolidation, externalization, and promotion of the shared ecological mental model, and follow the basic principles of "ecocentrism", "government-led" and "public participation".

The Credit Risk Assessment Model of Internet Supply Chain Finance: Multi-Criteria Decision-Making Model with the Principle of Variable Weight

The characteristics of the financing model are firstly analyzed when the e-commerce enterprises participate in the supply chain finance. Internet supply chain finance models are divided into three categories with the standard of whether the Electronic commerce enterprises provide funds for small and medium enterprises instead of banks. And then we further study the financing process and the functions of the e-commerce platform with specific examples. Finally, combined with the characteristics of the supply chain finance model, we set up a small and medium enterprises credit evaluation model based on the principle of variable weight with its dynamic data. At the same time, a multi time points and multi indicators decision-making method based on the principle of variable weight is proposed and a specific example is presented. In this paper, the Multi-criteria decision-making model with the principle of variable weight has been used two times. At last, a typical case has been analyzed based on this model with a higher accuracy rate of credit risk assessment.

基于改进Theil指数和Shift-Share模型的2012—2021年中国产业偏离分析

文章首先通过对现有文献的梳理和分析,发现针对产业偏离的测算,传统的产业偏离度E系数、Theil指数及Shift-Share模型均存在一定的缺陷,E系数和Theil指数的缺陷主要体现在计算原理方面,而Shift-Share模型的缺陷主要表现在参照系选择的合理性和数据采集的可行性方面。然后,基于现有模型的基本原理,提出了更为合理和更具可操作性的产业偏离测算方法,再采用实证研究的方法,根据2012—2021年的数据,对中国的产业偏离情况进行具体分析,得出尽管中国存在产业偏离,但产业偏离度在逐渐减小。最后,基于修正模型的计算结果,并结合当前的国际国内环境,提出如下政策建议:1)第一产业要依靠创新和科技引领,促进农村劳动力在城乡间有序转移,实现农业生产的规模化和现代化;2)第二产业要加快产业的升级换代,建立和保持独立、自主、完整的工业体系,加大在基础研究方面的投入,尽早突破美西方的技术封锁;3)第三产业的发展重点应该在金融和科教两个方面,要进一步提升香港地区、上海和北京等城市的世界金融中心地位,依靠金融创新来规避现行国际金融体系的不利约束和影响,同时要将科教兴国战略落到实处,努力探索适合中国国情的从小学到大学各阶段的教育模式。

Decision-Making Model of Public Service Facility Configuration in Multi-agent Communities and Its Application

The decision-making process of the public service facility configuration in multi-agent community is usually simplistic and static.In order to reflect dynamic changes and interactions of all behavior subjects including of residents,real estate developers and the government,a decision-making model of public service facility configuration according to the multi-agent theory was made to improve the efficiency of the public service facility configuration in community and the living quality of residents.Taking a community to the east of Jinhui Port in Fengxian District in Shanghai for example,the model analyzed the decision-makers' adaptive behaviors and simulated the decision-making criteria.The results indicate that the decision-making model and criteria can be well of satisfying the purpose of improving validity and rationality of public service facility configuration in large community.

Toward Modelling of Transformational Change Processes in Farm Decision-Making

In the coming decades, agricultural systems will have to adapt to tremendous challenges. Behavioral models have important potential to better understand and steer changes toward sustainability brought about by this context. Relying on a literature review, we distinguish incremental changes (extensions of what is already done) and transformational changes, which involve the reorientation of a considerable amount of farming activities. Transformational changes are particularly important in the context of global change. Existing integrated modelling frameworks based on behavioral theories are suited for incremental changes, but remain limited for transformational changes. Qualitative studies provide important insights on two key aspects of transformational changes, learning and social relations, but they have not been explicitly oriented toward computer modelling yet. Based on this literature and three seminal decision-making approaches, we propose a description of transformational change processes in farm decision-making, as a first step toward an implementation in agent-based models.

Decision-Making Model for Farmer Choosing Land Use Based upon Dynamic Optimization Theory

Using the dynamic optimization theory, we described a decision-making model for farmer choosing land use when there are several different kinds of uses for land. To obtain an empirical model that could be easily applied, decision rules for farmer with a single static expectation were given.

Application of PPC Model Based on RAGA in Real Estate Investment Decision-Making

According to the size of the projector function to evaluate the merits of the program, Projection Pursuit method is applied to real estate investment decision-making by using the real coding based on Accelerating Genetic Algorithm (RAGA) to optimize the Projection Pursuit Classification (PPC) process and a wide range of indicators value was projected linearly. The results are reasonable and verified with an example. At the same time, the subjective of the target weight can be avoided. It provides decision-makers with comprehensive information on all the indicators of new ideas and new