Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “decision intelligence”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,189 records · Page 66Linked to original sources
PubMed1999

Healthcare knowledge management through building and operationalising healthcare enterprise memory.

In this paper we suggest that the healthcare enterprise needs to be more conscious of its vast knowledge resources vis-à-vis the exploitation of knowledge management techniques to efficiently manage its knowledge. The development of healthcare enterprise memory is suggested as a solution, together with a novel approach advocating the operationalisation of healthcare enterprise memories leading to the modelling of healthcare processes for strategic planning. As an example, we present a simulation of Service Delivery Time in a hospital's OPD.

Artificial Intelligence↗
PubMed2001

Prediction in medicine by integrating regression trees into regression analysis with optimal scaling.

OBJECTIVES: A new data-analysis strategy is proposed to solve the problems of selecting interaction terms in linear regression on the one hand, and of statistically testing the significance of regression trees on the other hand. METHODS: The proposed strategy combines two data mining techniques: regression trees and regression analysis with optimal scaling (CATREG). The method traces small regression trees using the bootstrap and integrates the results as interaction variables (called "trunk variables") into CATREG. RESULTS: An application to data from cardiac patients shows a relative increase of 19% variance accounted for (16% cross-validated variance), by the CATREG model including the trunk variables compared to the model excluding these variables. CONCLUSIONS: This study indicates that trunk variables can be useful to model interaction effects in prediction problems.

Artificial Intelligence↗
PubMed2002

Machine learning for sub-population assessment: evaluating the C-section rate of different physician practices.

We apply machine learning to the problem of subpopulation assessment for Caesarian Section. In subpopulation assessment, we are interested in making predictions not for a single patient, but for groups of patients. Typically, in any large population, different subpopulations will have different "outcome" rates. In our example, the C-section rate of a population of 22,176 expectant mothers is 16.8%; yet, the 17 physician groups that serve this population have vastly different group C-section rates, ranging from 11% to 23%. The ultimate goal of subpopulation assessment is to determine if these variations in the observed rates can be attributed to (a) variations in intrinsic risk of the patient sub-populations (i.e. some groups contain more "high-risk C-section" patients), or (b) differences in physician practice (i.e. some groups do more C-sections). Our results indicate that although there is some variation in intrinsic risk, there is also much variation in physician practice.

Artificial Intelligence↗
PubMed2003

Intelligent intravenous infusion pumps to improve medication administration safety.

Intravenous (IV) medications are vital in the management of hospitalized patients. Inpatients frequently receive several IV medications concurrently, and these are commonly delivered with infusion pump systems. In particular, critically ill patients receive potent "high-alert" IV drugs, many with narrow safety margins requiring careful nursing titration. However, while intravenous medications have important benefits, errors associated with IV medication administration can result in severe or life-threatening adverse drug events (ADEs). Although errors in prescribing are often intercepted, administration errors do not get caught with most current systems While several safety improvements in IV infusion pump design have reduced mechanical complications, errors with IV drug administration such as incorrect programming persist. Intelligent IV infusion pumps have integrated software to provide point of care decision support (DS). This software includes drug library profiles configured for specific patient care units and includes programming of safety limits for drug/dose calculations.

Decision Making, Computer-Assisted↗
PubMed2004

An approach to knowledge base construction based on expert opinions.

OBJECTIVES: To describe, validate and demonstrate an approach for knowledge base construction based on expert opinions. METHODS: A knowledge base containing the frequency of occurrence of manifestations in epileptic seizures is constructed based on information provided by neurologists/epileptologists. The reliability of the responses is determined with the inter-rater intraclass correlation coefficient (ICC). If the ICC is not large enough the Spearman-Brown prophecy formula can be used to predict the number of additional experts. We propose a method to assess whether an additional expert provides information consistent with the already acquired data as well as a method to detect experts with deviating opinions. The power of the first method was determined. RESULTS: Data were collected for five seizure types. The ICCs determined from the responses for the various seizure types after inclusion of the additional experts was in all cases almost equal to 0.9, the target value. Yet one expert with diverging opinions concerning the frequency of occurrence of manifestations for different seizure types could be identified. Excluding this participant improved the reliability of the data. The power of the methods was good (> or =0.75). CONCLUSIONS: It is shown that human experts can provide reliable information about the frequency of occurrence of manifestations in epileptic seizures. In addition, the described approach correctly identified neurologists/epileptologists with both consistent and diverging opinions about the frequency of occurrence of manifestations in a number of seizure types.

Artificial Intelligence↗
PubMed2006

Personalized cardiovascular risk management linking SCORE and behaviour change to Web-based education.

The PULSE (Personalization Using Linkages of SCORE and behaviour change readiness to web-based Education) project objectives are to generate and evaluate a web-based personalized educational intervention for the management of cardiovascular risk. The program is based on a patient profile generated by combining: (a) an electronic patient data capture template (DCT); (b) the Systematic COronary Risk Evaluation (SCORE) algorithm; and (c) a Stage of Change determination model. The DCT inherently contains a set of evidence-based parameters for patient description and disease evaluation. The patient's stage of behaviour change determines messages consistent with the individual's change processes, decisional balance, and self-efficacy. The interventions are designed to address both medical and psychosocial aspects of risk management and, as such, we combine staged lifestyle modification materials and non-staged messages based on Canadian clinical guidelines to motivate personal risk management. The personalization decision logic is represented in Medical Logic Modules implemented in Java. An intelligent interactive system generates the personally relevant materials and delivers the education to the patient via the Web. An evaluation study will be conducted to determine whether web-based personalized educational strategies exert favourable influence on patient's interest, knowledge, and perceived compliance to the suggested lifestyle modifications.

Adult↗
PubMed1990

Impact of medical hospitalization on treatment decision-making capacity in the elderly.

A growing population of hospitalized elderly will need to make an increasing number of treatment decisions. No generally accepted criteria currently exist to assess the decision-making capacity of these elders. In this study, three hypothetical clinical vignettes were developed to assess treatment decision-making capacity in 25 presumably competent, medically ill, nondistressed, hospitalized elders and 25 healthy, age- and education-matched controls. The patients' understanding of the vignettes was evaluated and compared with their understanding of a standard consent form; with their performance on a mini-mental state examination; and with physician judgements about their decisional capacity. Vignette results indicate a significant difference between study and control groups in understanding of key treatment issues. Healthy controls demonstrated a better understanding of these issues. Twenty-eight percent of the patients had significant decisional impairments by vignette assessment but were not identified by mental status scores or physician judgments. Results suggest that presumably competent, medically ill elders may be at risk for developing decisional impairments during hospitalization for acute illness. Obtaining informed consent directly from many of these patients may not be feasible.

Aged↗
PubMed1987

The definition and classification of mental retardation.

Problems with current definitions of mental retardation were recognized. Classification systems based on the behavioral capabilities of retarded persons were criticized since there are so many noncognitive determinants of performance. It was proposed that mental retardation be defined solely by IQ scores at least 2 SDs below the population mean. This suggestion was predicated on the view that the behavioral sciences currently have no better way to assess intellectual functioning. Etiology was seen as such a significant predictor of group differences that the organic, familial, and undifferentiated categories would be used in classification. Social adaptation and expected performance were seen as correlates of class membership rather than defining features of retardation, since they have no reliable method of measurement. Problems of labeling were discussed, but the practice was deemed useful if it leads to beneficial services and interventions.

Child↗
PubMedDate not supplied

Electrodiagnostic testing in back and extremity pain.

OBJECTIVE: The usefulness of electrodiagnostic testing by the primary care provider is shown in two cases of suspected compression-type neural lesions of the lumbar spine. CLINICAL FEATURES: A 54-yr-old female with acute lumbar spine pain that radiated into the hip and a 26-yr-old male with sharp gluteal pain that radiated into the thigh and ankle were admitted into an inpatient care facility for intensive therapy. Plain film radiographs were obtained initially. In addition, electrodiagnostic testing was performed to evaluate the L5 and S1 nerve roots, which suggested compressive-type lesions. Non-enhanced CT of the lumbar spine was performed and revealed central disk herniation or protrusion in each case. INTERVENTION AND OUTCOME: One patient exhibiting central compression signs of bladder dysfunction was referred for medical intervention. The remaining patient received flexion-distraction type of chiropractic manipulation with physiologic therapeutics and was discharged to outpatient care after 16 days. CONCLUSIONS: Electrodiagnostic testing can provide the primary care provider the data needed to make an informed decision regarding advanced imaging studies and to institute appropriate therapy or to intelligently refer a patient for follow-up.

Adult↗
PubMed1996

Intelligent fetal heart rate computer systems in intrapartum surveillance.

The intrapartum cardiotocogram has had a disappointing impact on clinical practice. Misinterpretation of the cardiotocogram not only causes an increase in unnecessary intervention but is also implicated in a large proportion of patients with birth asphyxia and avoidable perinatal morbidity. Over the past 10-20 years, groups have attempted to develop computer systems capable of analysing the cardiotocogram but with limited success. The likely explanation is that these conventional systems analyse the cardiotocogram in isolation from clinical factors. More recently, research has focused on the use of artificial intelligence techniques which can assess the whole clinical picture to support clinical decision making during labour. The current literature is reviewed and a system that has been validated by comparison of its performance with 17 experts is described.

Cardiotocography↗
PubMed1998

The pictorial context dependency of savant artists: a research note.

The relative immunity of the concept of size constancy in the face of changes to the retinal image as well as the pictorial device of linear perspective were investigated with 9 savant artists and 9 controls. For drawing use of pictorial rules seemed independent of levels of intelligence; however, when a construction instead of a drawing task had to be carried out, diagnosis rather than the presence or absence of talent was the decisive factor.

Adult↗
PubMed1983

Language-based cognitive abilities in adult aphasia: rationale for intervention.

The purpose of this investigation is to explore operational definitions of cognition, intelligence, information processing, language-based cognitive abilities, cognitive processes and products, problem solving, decision making, and the complex events that happen in the brain when one stimulates a patient. These definitions are explored in order to develop a coherent and generative rationale for therapy. It is hypothesized that a specification of the underlying targets of our stimulation therapy may increase the effectiveness of our intervention efforts.

Aphasia↗
PubMedDate not supplied

Expert system support using Bayesian belief networks in the prognosis of head-injured patients of the ICU.

The present study concerns the construction and operation of a Bayesian analytical system, namely a Bayesian belief network (BBN) for the prognosis at 24 h of head-injured patients of the intensive care unit. The construction of a BBN incorporates the maintenance of a large database including all the critical variables corresponding to the specific clinical domain. This database is processed to provide the necessary libraries of conditional probability values. BBNs permit the combination of prognostic evidence in a cumulative manner and provide a quantitative measure of certainty in the final decision. The user views the changes at each step, thus being capable of deciding upon the necessary pieces of information in order to reach a certain belief threshold. The system produces results that are compatible with the opinions of medical experts regarding the prognosis of patients exhibiting certain patterns of clinical or laboratory data.

Adult↗
PubMed1986

Knowledge coupling, medical education and patient care.

Medical education and the acquisition of professional credentials do not guarantee that medical knowledge (information that is taught, apart from the reality of practice, or gleaned from the literature) will be coupled rigorously to the decision-making process of everyday clinical practice. The limitations of the unaided human mind in a memory-based educational system must be forthrightly acknowledged by those who would be responsible for curriculum reform, so the need for new premises and new tools will be recognized and implemented. Because of their knowledge of the many variables that are unique to them, the patients themselves must be given a much more central role in the process of medical care and medical education. Weaknesses of specialization and credentialing in the present obsolete system are analyzed. The behavior of a well-defined system of education and medical care, and the function of the performers within it, are described. Causes of resistance to curricular reform founded on new premises and use of new tools, such as computers, are considered. New computer tools, as components of a problem-solving decision support system (knowledge couplers, knowledge networks, the coupler editor and documentation system, and the computerized patient record), are described. How these might be incorporated into a new type of medical education curriculum is presented. Finally, new goals, within the context of the new premises being implemented into a new system of education and medical care, are outlined.

Artificial Intelligence↗
PubMed1993

Mental status and fragile X expression in relation to FMR-1 gene mutation.

The fragile X mental retardation syndrome is caused by unstable expansion of a CGG repeat in the FMR-1 gene. Clinical expression is associated with a large expansion of the CGG repeat. The mutation in the FMR-1 gene and the cytogenetic expression of the fragile site at Xq27.3 have been studied in 52 fragile X male patients. The percentage of the cytogenetic expression of the fragile site at Xq27.3 positively correlates with the mean size of the full mutation in the FMR-1 gene (p < 0.0001) irrespective of the presence of additional premutation alleles. We noted a less frequent occurrence of additional premutation alleles in adult patients compared with juveniles, suggesting a continued mitotic instability in life. Additionally, the level of mental retardation has been ascertained in 35 patients using the Stanford-Binet or Terman-Merrill test of general intelligence. The presence of a full mutation in the FMR-1 gene seemed decisive for the occurrence of mental impairment in the patient. No correlation is observed between the degree of mental retardation and the size of the full mutation. The degree of mental retardation seemed not to be influenced by the presence of premutation alleles in part of the cells in addition to a full mutation. One patient is described with the 'Prader-Willi-like' subphenotype of the fragile X syndrome, showing a deletion in the FMR-1 gene in a part of his cells in addition to a full mutation.

Adult↗