Showing papers by "Paul Jen-Hwa Hu published in 2006"

A decision support system for lower back pain diagnosis: uncertainty management and clinical evaluations

Abstract: Lower back pain (LBP) is a common medical problem that deprives many individuals of their normal lifestyles and keeps them from routine activities. Diagnosing LBP is challenging because it requires highly specialized knowledge involving a complex anatomical and physiological structure as well as diverse clinical considerations. Although a handful of studies have proposed or developed systems to support LBP diagnosis and improve knowledge sharing, these systems have limited scope, lack systematic evaluations, and/or ignore diagnoses that consist of multiple parts (i.e., decision outcomes), each of which corresponds to a particular medical condition, disease, or abnormality. In this study, we design, implement, and evaluate a Web-based decision support system that employs an intuitive and easy-to-use framework to assess the patient's information and recommend a diagnosis consisting of one or multiple parts. Our system design addresses the challenging characteristics of a LBP diagnosis and uses verbal probability estimation to represent and reason about the associated uncertainty. Our evaluations are systematic, including knowledge base verification, system validation using a modified Turing test, and clinical efficacy assessment involving 5 clinicians and 180 real-world cases collected from geographically dispersed clinics. Our evaluation design is more thorough than those used by most previous studies, and the proposed system is relatively ready for clinical deployment. Therefore, this study both contributes to decision support systems research and has advanced clinical support for LBP diagnosis. In light of some of the limitations of this study, we also identify and discuss several areas that need continued investigation.

Examining Cross-Agency Collaborations in E-Government Initiatives

Abstract: Cross-agency collaborations are critical to the success of e-government, which has great potential to transform the way that governments work, share information and deliver services to external and internal clients. Most prior research examining cross-agency collaborations has focused on "what" and "why" issues, thus offering only limited discussions on how to ensure effective cross-agency collaborations. In this study, we propose a framework for the institution structure critical to effective cross-agency collaborations in e-government initiatives. We then apply this framework to examine the institution (enterprise) efforts for implementing OneStop Business Registration (OSBR), a successful e-government initiative in the State of Utah. Our framework encompasses critical enablers supported by a fundamental infrastructural underpinning. Institution structures that follow the proposed framework can facilitate the horizontal integration among multiple autonomous agencies while coping with the existing bureaucratic structures without challenging each agency’s objectives, constraints, or autonomy. Our analysis and findings have important implications to e-government research and practice, which are also discussed.

Evaluating a decision support system for patient image pre-fetching: an experimental study

Abstract: When reading images from a newly taken radiological examination, a radiologist often needs to reference relevant prior images of the same patient to confirm a preliminary diagnosis, compare suspicious radiographic signs, or evaluate the progression of a known underlying pathological process, injury, or abnormality. To mitigate the stress and time requirements for the reading radiologist's image searches, some healthcare organizations have taken a pre-fetching approach to make relevant patient prior images conveniently accessible. Motivated by the importance of patient-image pre-fetching to radiologists' examination readings, as well as by the limited scope and ad hoc evaluation of most previously reported systems, we develop the Image Retrieval Expert System (IRES) and experimentally evaluate its effect on the radiologist's examination-reading efficiency, service quality, and satisfaction using the current pre-fetching practice of the studied organization as a benchmark. Our overall analysis suggests that image pre-fetching has an important effect on radiologists' examination readings and that radiologists (including residents) can become more efficient, effective, and satisfied when supported by IRES pre-fetching than by the benchmark practice. However, the exact magnitude or statistical significance of the IRES-induced improvements may vary with examination category and/or radiologists' experience. Our findings have several important implications for research and patient image management practices, which also are discussed.

Examining the Business-Technology Alignment in Government Agencies: A Study of Electronic Record Management Systems in Taiwan

Abstract: For e-government to succeed, government agencies must manage their records and archives of which the sheer volume and diversity necessitate the use of electronic record management systems (ERMS) Using an established business–technology alignment model, we analyze an agency’s strategic alignment choice and examine the outcomes and agency performance associated with that alignment The specific research questions addressed in the study are as follows: (1) Do strategic alignment choices vary among agencies that differ in purpose or position within the overall government hierarchy? (2) Do agencies’ alignment choices lead to different outcomes? and (3) Does performance in implementing, operating, and using ERMS vary among agencies that follow different alignment choices? We conducted a large-scale survey study of 3,319 government agencies in Taiwan Our data support the propositions tested Based on the findings, we discuss their implications for digital government research and practice

Customers' Trust in Online Vendors and Their Dropout Decisions: A Cross-Country Study

Abstract: Customer dropout represents a critical challenge to online vendors and has significantly hindered the proliferation of B-to-C e-commerce. In this study, we investigate the relationship between customers’ trust in an online vendor and their decisions to exit of the vendor’s website along the general consumer decision process. We analyze important salient trust antecedents for each stage of the decision process and empirically test them and their correlation with the dropout decision by conducting an online study that involves undergraduate business students from two major universities in the U.S. and Hong Kong, respectively. Our comparative analysis results are fairly consistent and suggest that customers’ trust in an online vendor has significant effects on their decisions to exit of the vendor’s website, and that important salient trust antecedents appear to vary in different stages of the consumer decision process. Interestingly, our findings show that customers tend to rely on general, subjective antecedents that pertain to personal traits or perceptions about the website’s ease of use for assessing the trustworthiness of an online vendor in the early stages but focus on specific, objective, transaction-oriented antecedents specific to their purchase decision making in the later stages. Our results show little differences between the investigated countries and have important implications for e-commerce research and practice, which are discussed in the paper.