Showing papers on "Clinical decision support system published in 1986"

A perspective on the role of decision analysis in clinical practice.

Abstract: The upsurge in interest in clinical decision support techniques is not accidental. Clinical decision situations are more and more characterized by complexity and uncertainty, due to increasing diagnostic and therapeutic possibilities, the fast growth of medical knowledge, the increasing quality demands by the public, and the pressure towards cost-conscious decision making. On the other hand, information science is increasingly able to provide the tools for building decision-support systems. There are several approaches to the development of decision aids. The present paper is mainly concerned with one potentially very powerful method: decision analysis. Basically, decision analysis is a method for explicitating, structuring and analysing clinical decision situations for individual patients. Suggestions for therapy choice, and diagnostic and prognostic statements are obtained by integrating the probability and value judgments made during the analysis. A clinical decision analysis can conveniently be divided into four stages: defining and structuring the clinical problem, assessing the relevant probabilities and utilities, calculation of the preferred course of action, including sensitivity analysis, and formulation of the results of the analysis in a clinically useful way. An optimistic scenario of the future role of decision analysis in clinical medicine would describe--among others--decision-consultation departments, decision-oriented clinical data-bases and medical knowledge bases, research groups for development, testing, and updating of clinical strategies, decision-analysis courses in all levels of medical education, and decision-oriented clinical textbooks. Moreover, decision analysis will help in setting priorities in clinical research, in quality control and peer review, and in development of protocols for use by the paramedical personal. Some illustrations from applied decision analysis are given.

Strategic decision making and group decision support systems

Abstract: Decision conferencing extends the usefulness of DSS to the most difficult problems faced by executive teams.

Tactical Decision Making and Decision Support Systems.

Abstract: Even with their potential barely tapped, DSS are making significant contributions to improving decision-making effectiveness in institutions.

Health Services Research and Development: the Veterans Administration Program.

Abstract: Health expenditures are rising inexorably; health status shows relatively little gain; technological possibilities are outstripping our ability or willingness to provide a commensurate level of resources. Clinical and administrative managers face increasingly difficult choices among alternative interventions in attempting to resolve these problems. If health services research is to succeed as a tool for assisting these decisions, clinicians, administrators, and researchers must view it as an integral part of management. This paper describes this concept of health services research and its implementation by the VA HSRD HSRD Special Projects Program, responsive to system-wide issues, including technology assessment and transfer; and Resources Program, the Service's own management system. The Service's impact on improving veterans health care is already apparent. However, the true value of the HSR&D system will become apparent only in the 1990s, after the capacity for conducting health services research has been built and integrated fully with clinical and administrative practice. The VA, the nation's largest health care system, has a unique opportunity to demonstrate how health services research can improve health care.

Institutional Research as Decision Support.

Abstract: The advent of Decision Support Systm redefines the primary professional role for institutional researchers.

Medicine and health care: implications for health sciences library practice.

Abstract: The American health care system is experiencing a period of unprecedented change. This paper identifies and discusses the major changes in patient care, research, control of the health care system, and medical education, and their implications for health sciences librarians. These changes have resulted in new demands for effective information delivery and a broader health sciences library clientele. There are both challenges and opportunities for health sciences librarians as they respond to information pressures of the current health care environment and anticipate future needs.

The Future of Decision Support Systems in Institutional Research.

Abstract: Decision Support Systems need not be expansiue or expensive in order to be effective in institutional settings.

Health knowledge in Ja'afaru L.E.A. Primary.

Abstract: ealth knowledge in the areas of personal hygiene, basic nutrition, environmental hygiene and comfl municable diseases was assessed in a sample of 192 children of Ja’afaru L.E.A. Primary School, Zaria, Nigeria. The study showed that there was no marked difference in health knowledge between the sexes. Generally, the knowledge scores by class showed that pupils in higher classes scored more than those in lower classes. Cross tabulation of knowledge scores with parental education did not show much difference in scores of pupils with illiterate fathers and those whose fathers had completed primary education. However, there was marked difference in scores of those with illiterate fathers and those whose fathers completed secondary or postsecondary education. On the whole, more than 25W of the pupils were deficient in respect to some specific questions on some aspects of personal hygiene, basic food groups and communicable diseases. It was recommended that the school health education programme should lay more emphasis on the weak areas identified. Also the Parent-Teachers Association (P.T.A.) should be reactivated and the parents should be more involved with health care of the pupils through the forum of the P.T.A. meetings. An outreach programme whereby social workers can visit and communicate information to parents who may not want to be involved in the P.T.A. was also recommended for the school.

Time in clinical decision support systems: Temporal reasoning in ONCOCIN and ONYX

Abstract: Time is an essential part of our environment. We use temporal reasoning to analyze the past for recurring patterns or trends in order to predict and plan for future events. Temporal relationships allow us to understand how events are related and what events are likely to occur in the future. As time proceeds, new information may force a re-evaluation of our expectations made with previous data. This re-evaluation may result in altered plans or predictions based on the new expectations, it is this special property of continual change that makes time an interesting but diff icult subject for computer-based modeling.