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Otine, Charles. "Participatory approach to data warehousing in health care : UGANDA’S Perspective." Licentiate thesis, Karlskrona : Blekinge Institute of Technology, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-00491.
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This licentiate thesis presents the use of participatory approach to developing a data warehouse for data mining in health care. Uganda is one of the countries that faced the largest brunt of the HIV/AIDS epidemic at its inception in the early 1980s with reports of close to a million deaths. Government and nongovernmental interventions over the years saw massive reductions in HIV prevalence rates over the years. This reduction in HIV prevalence rates led to great praises by the international community and a call for other countries to model Uganda’s approach to battling the epidemic. In the last decade the reduction in HIV prevalence rates have stagnated and in some cases increased. This has lead to a call for reexamination of the HIV/AIDS fight with an emphasis on collective efforts of all approaches. One of these collective efforts is the introduction of antiretroviral therapy (ART) for those already infected with the virus. Antiretroviral therapy has numerous challenges in Uganda not least of which is the cost of the therapy especially on a developing country with limited resources. It is estimated that of the close to 1 million infected in Uganda only 300,000 are on antiretroviral therapy (UNAIDS, 2009). Additional challenges of the therapy includes following through a treatment regimen that is prescribed. Given the costs of the therapy and the limited number of people able to access the therapy it is imperative that this effort be as effective as possible. This research hinges on using data mining techniques with monitoring HIV patient’s therapy, most specifically their adherence to ART medication. This is crucial given that failure to adhere to therapy means treatment failure, virus mutation and huge losses in terms of costs incurred in administering the therapy to the patients. A system was developed to monitor patient adherence to therapy, by using a participatory approach of gathering system specification and testing to ensure acceptance of the system by the stakeholders. Due to the cost implications of over the shelf software the development of the system was implemented using open source software with limited license costs. These can be implemented in resource constrained settings in Uganda and elsewhere to assist in monitoring patients in HIV therapy. A algorithm that is used to analyze the patient data warehouses for information on and quickly assists therapists in identifying potential risks such as non-adherence and treatment failure. Open source dimensional modeling tools power architect and DB designer were used to model the data warehouse using open source MYSQL database. The thesis is organized in three parts with the first part presenting the background information, the problem, justification, objectives of the research and a justification for the use of participatory methodology. The second part presents the papers, on which this research is based and the final part contains the summary discussions, conclusions and areas for future research. The research is sponsored by SIDA under the collaboration between Makerere University and Blekinge Institute of Technology (BTH) in Sweden.
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Khalid, Shehla. "Towards Data Governance for International Dementia Care Mapping (DCM). A Study Proposing DCM Data Management through a Data Warehousing Approach." Thesis, University of Bradford, 2010. http://hdl.handle.net/10454/5226.
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Information Technology (IT) plays a vital role in improving health care systems by enhancing the quality, efficiency, safety, security, collaboration and informing decision making. Dementia, a decline in mental ability which affects memory, concentration and perception, is a key issue in health and social care, given the current context of an aging population. The quality of dementia care is noted as an international area of concern.
Dementia Care Mapping (DCM) is a systematic observational framework for assessing and improving dementia care quality. DCM has been used as both a research and practice development tool internationally. However, despite the success of DCM and the annual generation of a huge amount of data on dementia care quality, it lacks a governance framework, based on modern IT solutions for data management, such a framework would provide the organisations using DCM a systematic way of storing, retrieving and comparing data over time, to monitor progress or trends in care quality.
Data Governance (DG) refers to the implications of policies and accountabilities to data management in an organisation. The data management procedure includes availability, usability, quality, integrity, and security of the organisation data according to their users and requirements.
This novel multidisciplinary study proposes a comprehensive solution for governing the DCM data by introducing a data management framework based on a data warehousing approach. Original contributions have been made through the design and development of a data management framework, describing the DCM international database design and DCM data warehouse architecture. These data repositories will provide the acquisition and storage solutions for DCM data. The designed DCM data warehouse facilitates various analytical applications to be applied for multidimensional analysis. Different queries are applied to demonstrate the DCM data warehouse functionality.
A case study is also presented to explain the clustering technique applied to the DCM data. The performance of the DCM data governance framework is demonstrated in this case study related to data clustering results. Results are encouraging and open up discussion for further analysis.
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Chen, Qian. "Data blending in health care : Evaluation of data blending." Thesis, KTH, Skolan för informations- och kommunikationsteknik (ICT), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-202559.
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This report is aimed at those who are interested in data analysis and data blending. Decision making is crucial for an organization to succeed in today’s market. Data analysis is an important support activity in decision making and is applied in many industries, for example healthcare. For many years data analysts have worked on structured data in small volumes, with traditional methods such as spreadsheet. As new data sources emerged, such as social media, data is generated in higher volume, velocity and variety [1]. The traditional methods data analysts apply are no longer capable of handling this situation. Hence scientists and engineers have developed a new technology called data blending. Data blending is the process of merging, sorting, joining and combining all the useful data into a functional dataset [2]. Some of the well-known data blending platforms include Datawatch, Microsoft Power Query for Excel, IBM DataWorks and Alteryx [3]. Synergus AB is a consulting company engaged in health economics, market access and Health Technology Assessment (HTA) [4]. The company does analysis for their clients. Unfortunately the way they work is not efficient. New tools and methods need to be applied in the company. The company has decided to apply data blending in their daily work. My task in this project was to build datasets for analysis and create workflows for future use with a data blending platform. For my interest, I did a research on data blending to understand how this new technology works. During the project I have worked with four data sources. These were Microsoft Excel worksheet, CSV file, MS Access database and JSON file. I built datasets the company needs. I also preceded a case study on data blending process. I focused on the three steps of data handling, namely input, process and output. After the project, I reached a conclusion that data blending offers better performance and functionality. It is easy to learn and use, too.Denna rapport vänder sig till de som är intresserad av data analys och datahantering. Belsut fattande är avgörande för en organisation att lyckas i dagens marknad. Data analys är en viktig stöd inom beslutfattande och tillämpas i många industrier, till exempel hälsovård. I många år har data analyster arbetat med strukturerad data i små volymer, med traditionella arbetsmetoder såsom kalkyblad. Med nya data källor uppstått, såsom sociala media, data är genererad i högre volym, högre hastighet och högre variation. De traditionella metoder data analyster använder är inte längre kapabla av att hantera denna situation. Därför har vetenskapsmän och ingenjörer utvecklat ett ny teknologi kallad datahantering. Datahantering är en process för att sammanfoga, sortera och kombinera all värdeful data till en funktionell dataset. Några av de välkända datahanteringsplatformer inkluderar Datawatch, Microsoft Power Query for Excel, IBM DataWorks and Alteryx. Synergus AB är ett konsultföretag engagerad inom hälsoekonomi, marknad tillträde, och Health Technology Assessment (HTA). Företaget gör analys för deras kunder. Tyvärr är de arbetsmetoder inom företaget inte effektiv. Nya verktyg och metoder måste tillämpas inom företaget. Synergus AB har beslutat att tillämpa datahantering i deras dagliga arbete. Mitt uppdrag i detta projekt var att bygga dataset för analys och skapa arbetsflöde för framtida användning med en datahanteringsplatform. För mitt eget intresse, jag utförde en studie av datahantering för att förstå hur denna nya teknologi fungerar. Under projektet har jag arbetat med fyra data källor. De var Microsft Excel kalkylblad, CSV fil, MS Access databas och JSON fil. Jag byggde dataset företaget behöver. Jag också utförde ett fall studie om datahanteringsprocess. Jag fokuserade mig på de tre steg inom datahantering, nämligen inmatning, bearbetning och utmatning. Efter projektet kom jag till en slutsats att datahantering erjuder bättre prestanda och funktionelitet. Det är också lätt att lära sig och använda.
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Kairouz, Joseph. "Patient data management system medical knowledge-base evaluation." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=24060.
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The purpose of this thesis is to evaluate the medical data management expert system at the Pediatric Intensive Care Unit of the Montreal Children's Hospital. The objective of this study is to provide a systematic method to evaluate and, progressively improve the knowledge embedded in the medical expert system.Following a literature survey on evaluation techniques and architecture of existing expert systems, an overview of the Patient Data Management System hardware and software components is presented. The design of the Expert Monitoring System is elaborated. Following its installation in the intensive Care Unit, the performance of the Expert Monitoring System is evaluated, operating on real vital sign data and corrections were formulated. A progressive evaluation technique, new methodology for evaluating an expert system knowledge-base is proposed for subsequent corrections and evaluations of the Expert Monitoring System.
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Vela, Sandra A. "Canadian life and health insurance productivity evaluation using data envelopment analysis." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0023/MQ50377.pdf.
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Fraker, Shannon E. "Evaluation of Scan Methods Used in the Monitoring of Public Health Surveillance Data." Diss., Virginia Tech, 2007. http://hdl.handle.net/10919/29511.
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With the recent increase in the threat of biological terrorism as well as the continual risk of other diseases, the research in public health surveillance and disease monitoring has grown tremendously. There is an abundance of data available in all sorts of forms. Hospitals, federal and local governments, and industries are all collecting data and developing new methods to be used in the detection of anomalies. Many of these methods are developed, applied to a real data set, and incorporated into software. This research, however, takes a different view of the evaluation of these methods.
We feel that there needs to be solid statistical evaluation of proposed methods no matter the intended area of application. Using proof-by-example does not seem reasonable as the sole evaluation criteria especially concerning methods that have the potential to have a great impact in our lives. For this reason, this research focuses on determining the properties of some of the most common anomaly detection methods. A distinction is made between metrics used for retrospective historical monitoring and those used for prospective on-going monitoring with the focus on the latter situation. Metrics such as the recurrence interval and time-to-signal measures are therefore the most applicable. These metrics, in conjunction with control charts such as exponentially weighted moving average (EWMA) charts and cumulative sum (CUSUM) charts, are examined. Two new time-to-signal measures, the average time-between-signal events and the average signal event length, are introduced to better compare the recurrence interval with the time-to-signal properties of surveillance schemes. The relationship commonly thought to exist between the recurrence interval and the average time to signal is shown to not exist once autocorrelation is present in the statistics used for monitoring. This means that closer consideration needs to be paid to the selection of which of these metrics to report.
The properties of a commonly applied scan method are also studied carefully in the strictly temporal setting. The counts of incidences are assumed to occur independently over time and follow a Poisson distribution. Simulations are used to evaluate the method under changes in various parameters. In addition, there are two methods proposed in the literature for the calculation of the p-value, an adjustment based on the tests for previous time periods and the use of the recurrence interval with no adjustment for previous tests. The difference in these two methods is also considered. The quickness of the scan method in detecting an increase in the incidence rate as well as the number of false alarm events that occur and how long the method signals after the increase threat has passed are all of interest. These estimates from the scan method are compared to other attribute monitoring methods, mainly the Poisson CUSUM chart. It is shown that the Poisson CUSUM chart is typically faster in the detection of the increased incidence rate.Ph. D.
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Du, Hank C. T. "An evaluation of the contribution of pharmacy sales data for purposes of public health." Thesis, Cardiff University, 2013. http://orca.cf.ac.uk/58915/.
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The contribution of over-the-counter (OTC) medicines sales data from pharmacies for public health (PH) has previously attracted interest in the UK. In this study, data for several OTC medicines were utilised to explore their contribution to (a) understand the impact of medicine reclassification or increased regulation on supply and (b) the surveillance of infectious diseases in the community in Wales. Following the reclassification of ophthalmic chloramphenicol (June 2005) an increase in primary care supply (OTC + prescription) of 54% (47,026 units) in eye drops and 29% (15,657 units) in eye ointment were observed (2004 to 2010). Despite this increase the items of eye drops prescribed were similar 12 months before and five years after the reclassification. The impact of regulatory changes concerning the non-prescription sale of opioid-containing analgesics was studied. In the 12 months following September 2009 legislative changes there was a significant fall in sales of codeine- and dihydrocodeinecontaining solid oral dosage forms (p<0.05). Similarly, following the pack size restriction of non-prescription pseudoephedrine and ephedrine products (April 2008), significant (p<0.05) year-on-year reductions in the total weight of pseudoephedrine sold were observed. Sales of non-prescription ophthalmic chloramphenicol were monitored on a small area basis in two areas with known outbreaks of infective conjunctivitis. In both areas sales data did not demonstrate the required sensitivity. When monitoring seasonal influenza, significant positive correlations were observed between cough/cold/flu medicines sales and indicators of influenza activity in Wales. In alignment with the professional standards for PH practice for pharmacy produced by the Royal Pharmaceutical Society, the work undertaken demonstrated a number of potential uses of medicines sales data for PH. Routine data collection, particularly if captured at time/point of sale, would further enhance its usefulness in detecting and tracking PH incidents.
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Towers, Isabel Margaret Falcon. "The valuation of health outcomes data from clinical trials for use in economic evaluation." Thesis, University of Sheffield, 2005. http://etheses.whiterose.ac.uk/6075/.
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Kelman, Christopher William, and christopher kelman@cmis csiro au. "Monitoring Health Care Using National Administrative Data Collections." The Australian National University. National Centre for Epidemiology and Population Health, 2001. http://thesis.anu.edu.au./public/adt-ANU20020620.151547.
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With the inevitable adoption of information technology into all areas of human pursuit, the potential benefits for health care should not be overlooked. In Australia, details of most health care encounters are currently recorded for administrative purposes. This results in an impressive electronic data-bank that could provide a national resource for health service evaluation.
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Evaluation of health services has become increasingly important to provide indicators of the benefits, risks and cost-effectiveness of treatments. However, if administrative data are to be used for this purpose, several questions must first be addressed: Are the current data collections accessible? What outcome measures can be derived from these data? Can privacy issues be managed? Could the quality of the data be improved? Is the existing infrastructure adequate to supply data for evaluation purposes? Could the existing system provide a basis for the development of an integrated health information system?
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The aims of the project were:
· To examine the potential for using administrative data to generate outcome measures and surveillance indicators.
· To investigate the logistics of gaining access to these data for the purpose of research. This to be achieved within the current ethical, political and financial framework.
· To compare the Australian health-service data system with the current international state-of-the-art.
· To develop suggestions for expansion of the present system as part of an integrated health record and information system. This system to manage patient records and provide data for quality management, treatment surveillance and cost-effectiveness evaluation as a routine activity.
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The thesis is presented in two parts. In the first part, a historical cohort study is described that involved patients with implantable medical devices. The potential to evaluate outcomes was investigated using all national health-service information currently available in electronic form. Record linkage techniques were used to combine and augment the existing data collections. Australias national health databases are to varying degrees, amenable to such linkage and cover doctor visits, pharmaceuticals, hospital admissions and deaths. The study focused on medical devices as an illustrative case but the results are applicable to the routine assessment of all medical and surgical interventions.
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For the Australian Medical Devices study, the records of 5,316 patients who had medical device implants in 1993-94 were selected from the archives of a major private health insurer. Five groups of medical implants were studied: heart valves, pacemakers, hips, vascular grafts and intra-optic lenses. Outcomes for these patients, including death, re-operation and health service utilisation, were compared and analysed.
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A comparison study was performed using data from the Manitoba Health database in Winnipeg, Canada. Manitoba provides a very similar demographic group to that found in Australia and is an example of a prototype integrated-health-information system. One of the principal advantages for research is that personally identified data about medical and hospital services are collected for all patients. Selection bias is eliminated because individual consent is not required for this type of research and all selected patients could be included in the study.
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The two studies revealed many barriers to the use of administrative data for health outcomes research. Service event data for the Australian cohort could be collected but only after long delays and hospital morbidity data were not available for the entire cohort. In contrast to the situation in Australia, the Manitoba data were both accessible and complete, but were lacking in detail in some areas.
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Analysis of the collected data demonstrated that without the addition of clinical data only general indications of trends could be deduced. However, with minimal supplementary clinical data, it was possible to examine differences in performance between brands of medical devices thus indicating one of the uses for this type of data collection.
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In the second part of the thesis, conclusions are presented about the potential uses and limitations of the existing system and its use as a basis for the development of a national Integrated Health Record and Information System (IHRIS). The need for the establishment of a systemic quality management system for health care is discussed.
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The study shows that linked administrative data can provide information about health outcomes which is not readily available from other sources. If expanded and integrated, the system that is currently used to collect and manage administrative data, could provide the basis for a national health information system. This system would provide many benefits for health care. Benefits would include the monitoring, surveillance and cost-effectiveness analysis of new and existing treatments involving medical devices, drugs and surgical procedures. An integrated health information system could thus provide for both clinical and administrative needs, while in addition providing data for research.
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Unfortunately, in Australia, the use of administrative data for this purpose is not currently feasible. The principal barrier is the existence of a culture within the Australian health care system which is not supportive of research and is deficient in quality and safety measures.
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Recent initiatives by both the Commonwealth and state governments have supported the introduction of measures to improve quality and safety in health care. It is argued here that an Integrated Health Record and Information System (IHRIS) would provide an essential component of any such scheme. The results of this study have important policy implications for health care management in both the administrative and clinical domains.
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Olupot-Olupot, Peter. "Evaluation of Antiretroviral Therapy Information System In Mbale Regional Referral Hospital, Uganda." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7320_1272589584.
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HIV/AIDS is the largest and most serious global epidemic in the recent times. To date, the epidemic has affected approximately 40 million people (range 33 &ndash
46 million) of whom 67%, that is, an estimated 27 million people are in the Sub Saharan Africa. The Sub Saharan Africa is also reported to have the highest regional prevalence of 7.2% compared to an average of 2% in other regions. A medical cure for HIV/AIDS remains elusive but use of antiretroviral therapy (ART) has resulted in improvement of quality and quantity of life as evidenced by the reduction of mortality and morbidity associated with the infection, hence longer and good quality life for HIV/AIDS patients on ART.
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Karve, Sudeep. "Evaluation of Ischemic Stroke-Related Healthcare Utilization Trends Using Recent National Data: 2000 – 2005." The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1242827395.
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Armstrong, Iain. "Application and evaluation of high speed data transfer for decision support in remote health care." Thesis, Robert Gordon University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.342743.
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Antel, Samson. "Computational analysis of magnetic resonance data assista in pre-surgical evaluation of epilepsy patients." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82820.
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This dissertation presents a series of studies aimed at applying machine learning methods to information derived from magnetic resonance (MR) based examinations in order to aid in the pre-surgical evaluation of patients with epilepsy. Two forms of epilepsy were studied: non-lesional temporal lobe epilepsy (TLE) and extra-temporal lobe epilepsy (ETLE) due to malformations of cortical development (MCD).Regarding patients with TLE, our aim was to predict outcome, in terms of reduction of seizure frequency, following surgical resection. To this end, we trained a Bayesian classifier on results from volumetric magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI), which allow rapid, non-invasive measurement of structural and metabolic data, respectively. We demonstrated that the pattern of MR markers can predict whether or not a patient with TLE will benefit from surgery.
In our studies of patients with ETLE, we focused on patients whose epilepsy was due to focal cortical dysplasia (FCD), a common form of MCD. In these patients, the identification of FCD lesions is critical in helping to direct the site of surgical resection. This is commonly performed by visual analysis of conventional MRI. The MRI characteristics of FCD are well known; however, in many patients, lesions of FCD are characterized by minor structural abnormalities that go unrecognized or are too subtle to be detected by standard radiological analysis. Thus, the objective of this part of the dissertation was to use mathematical models of the MRI characteristics of FCD as a basis for automated detection of FCD lesions. The mathematical models included first-order statistical and morphological operators which can help measure visually discernable MRI characteristics of FCD lesions, and second-order texture analysis, which can quantify information regarding tissue structure or organization not readily accessible through visual analysis. A Bayesian classifier trained on these models demonstrated a significantly increased sensitivity in lesion detection compared to standard analysis of conventional MRI.
Both components of this thesis present clinically useful techniques for applying machine learning methods to MR data to assist in the pre-surgical evaluation of epilepsy patients. These methods are intended to be used in conjunction with conventional approaches.
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Roberts, Ann Elizabeth. "Health care performance management : insights from applications of data envelopment analysis." Thesis, University of Stirling, 2001. http://hdl.handle.net/1893/2400.
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The comprehensive measurement of efficiency and performance in the Health Service in the UK has become one of the most important managerial developments of recent years. The reasons for this development were examined, particularly in relation to the difficulties involved with performance assessment in such a context. The most widely utilised techniques were evaluated from the perspective of the Health Care Manager and a number of serious limitations were identified. In response to these limitations, the technique of Data Envelopment Analysis was evaluated as an alternative. It has been proposed as an appropriate and useful tool for the assessment of efficiency, although the literature on DEA showed limited practical application to public sector services in the UK. The many facets of the technique were investigated and literature on its application to hospital data was reviewed. A two-stage application procedure for the DEA technique was developed in response to this evaluation, to be used in the measurement hospital efficiency. The procedure was based on a deep theoretical understanding of the DEA methodology. The most important elements of the process were related to selection of the initial sample, the identification of the variables to be included in the DEA model and the definition of the weight restrictions to be incorporated. Input from Health Care Managers was used to guide the application and data from a sample of acute hospitals in Scotland was utilised in the analysis. The application procedure showed how the practicalities of the DEA technique could be enhanced, in particular through the inclusion of weight restrictions. This led to the development of efficiency strategies for the inefficient hospitals, which could be related to the policy objectives or managerial structure of the hospitals in the sample. It was concluded that there were many potential benefits of the DEA approach to efficiency assessment and the two-stage application procedure defined here, which could be seen to fulfil many of the requirements of the Health Care Manager. It was determined that combining theoretical and practical issues can enhance the applicability of the DEA methodology.
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McGee, Margaret Ann. "Health care outcomes evaluation of total hip arthroplasty patients : comparison of patient and doctor derived data /." Title page, contents and abstract only, 1999. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmm145.pdf.
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Malherbe, WF. "Die gehalte van ondersoeke en die institusionele oordra van data oor aanmeldbare voedselvergiftigingsuitbrake." Thesis, Cape Technikon, 1997. http://hdl.handle.net/20.500.11838/801.
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Thesis (MTech(Environmental Health)--Cape Technikon, Cape Town,1997The study project researched the quality of the investigations and the institutional transfer of data regarding notifiable food poisoning outbreaks reflected in "the study region", that is to say North-, East- and Western Cape Provinces. In comparing the data of the central-, provincial- and local governments' total notifiable food poisoning outbreaks notifications for specific local areas, problems relating to incomplete and poor data, poorly completed reports and ignorance of health workers re notifiable medical conditions were identified. Various conclusions and recommendations were made for "the purpose of future improvements.
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Welch, C. A. "Implementation, evaluation and application of multiple imputation for missing data in longitudinal electronic health record research." Thesis, University College London (University of London), 2015. http://discovery.ucl.ac.uk/1464072/.
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Longitudinal electronic health records are a valuable resource for research because they contain information on many patients over long follow-up periods. Missing data commonly occur in these data because it was collected for clinical and not research purposes. Analysing data with missing values can potentially bias estimates and standard errors resulting in invalid inferences. Multiple imputation, commonly used in research to impute missing values, is increasingly regarded as the standard method for handling missing data in medical research because of its practicality and flexibility under the assumption the data is missing at random (MAR). Until now, few imputation approaches are sufficiently flexible to account for the longitudinal and dynamic structure of electronic health records. However, the two-fold fully conditional specification (FCS) algorithm was proposed to impute missing values in longitudinal data, but this methods was not currently validated in the complex setting of longitudinal electronic health records. I propose to adapt, evaluate and implement the two-fold FCS algorithm to impute missing data from large primary care database. To achieve this, first I investigate the extent and patterns of missing data in a longitudinal clinical database for health indicators associated with cardiovascular disease risk to determine if the MAR assumption is plausible. Additionally, I develop methods to identify and remove outliers, which can potentially bias imputations, from data with repeated measurements before imputation. Next, I adapt and develop the two-fold FCS multiple imputation algorithm to impute missing values in longitudinal clinical data for health indicators associated with cardiovascular disease risk and I validate the two-fold FCS algorithm to assess bias and precision through challenging simulation studies. I develop a new software programme which implements this adapted version of the two-fold FCS algorithm to impute missing values in longitudinal data. Finally, I apply the two-fold FCS algorithm in THIN to (i) model cardiovascular disease risk and (ii) understand factors associated with greater total cholesterol reduction in patients with type II diabetes.
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Bittner, Olin J. "Designing a Data-Tracking System for a Private Therapeutic Day School." Antioch University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1448896028.
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Kromanis, Rolands. "Structural performance evaluation of bridges : characterizing and integrating thermal response." Thesis, University of Exeter, 2015. http://hdl.handle.net/10871/17440.
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Bridge monitoring studies indicate that the quasi-static response of a bridge, while dependent on various input forces, is affected predominantly by variations in temperature. In many structures, the quasi-static response can even be approximated as equal to its thermal response. Consequently, interpretation of measurements from quasi-static monitoring requires accounting for the thermal response in measurements. Developing solutions to this challenge, which is critical to relate measurements to decision-making and thereby realize the full potential of SHM for bridge management, is the main focus of this research. This research proposes a data-driven approach referred to as temperature-based measurement interpretation (TB-MI) approach for structural performance evaluation of bridges based on continuous bridge monitoring. The approach characterizes and predicts thermal response of structures by exploiting the relationship between temperature distributions across a bridge and measured bridge response. The TB-MI approach has two components - (i) a regression-based thermal response prediction (RBTRP) methodology and (ii) an anomaly detection methodology. The RBTRP methodology generates models to predict real-time structural response from distributed temperature measurements. The anomaly detection methodology analyses prediction error signals, which are the differences between predicted and real-time response to detect the onset of anomaly events. In order to generate realistic data-sets for evaluating the proposed TB-MI approach, this research has built a small-scale truss structure in the laboratory as a test-bed. The truss is subject to accelerated diurnal temperature cycles using a system of heating lamps. Various damage scenarios are also simulated on this structure. This research further investigates if the underlying concept of using distributed temperature measurements to predict thermal response can be implemented using physics-based models. The case study of Cleddau Bridge is considered. This research also extends the general concept of predicting bridge response from knowledge of input loads to predict structural response due to traffic loads. Starting from the TB-MI approach, it creates an integrated approach for analyzing measured response due to both thermal and vehicular loads. The proposed approaches are evaluated on measurement time-histories from a number of case studies including numerical models, laboratory-scale truss and full-scale bridges. Results illustrate that the approaches accurately predicts thermal response, and that anomaly events are detectable using signal processing techniques such as signal subtraction method and cointegration. The study demonstrates that the proposed TB-MI approach is applicable for interpreting measurements from full-scale bridges, and can be integrated within a measurement interpretation platform for continuous bridge monitoring.
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Khan, Iftekhar. "Modelling health-related quality of life data for economic evaluation of cancer treatments : applications in lung cancer." Thesis, University College London (University of London), 2018. http://discovery.ucl.ac.uk/10042103/.
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INTRODUCTION: The annual economic burden of treating cancer to the National Health Service (NHS) in the United Kingdom (UK) is over £15 billion; and for non small cell lung cancer (NSCLC), one of the leading causes of cancer deaths in the world, this is £2.4 billion. Economic evaluation plays an essential role in assessing the relative value of lung cancer treatments. Modelling (HRQoL) data is fundamental in determining the cost-effectiveness of cancer treatments. This thesis aims to investigate modelling of HRQoL data collected from lung cancer patients for economic evaluation. In particular, the role of modelling to improve utility prediction is investigated. The sensitivity of disease specific and generic HRQoL measures are also explored. In addition, methods to extrapolate utilities beyond cancer progression and identifying a selection procedure from relevant published algorithms are developed. METHODS: Data from two clinical trials and a prospective observational study in NSCLC patients were designed and executed to develop several mapping models (Linear, Non-Linear, Joint, and Bayesian). The sensitivity of EQ-5D-3L and EQ-5D-5L were compared with a cancer specific measure (QLQ-C30). Simulation methods were used to develop an approach for selecting algorithms. RESULTS: Two and three-part Beta-Binomial models improve predictions. Joint models also contribute to improved prediction of utilities. Bayesian Networks may help reduce the over-prediction in poor health states. The EQ-5D-5L offers better mapping and is more sensitive for detecting treatment benefit compared to EQ-5D-3L. It is also viable to develop decision criteria for selecting between several published algorithms. CONCLUSION: Methodological improvements in modelling HRQoL for the economic evaluation of cancer treatments have been demonstrated. Improvements in model structure, prediction and selection are empirically demonstrated.
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Brind'Amour, Katherine. "Maternal and Child Health Home Visiting Evaluations Using Large, Pre-Existing Data Sets." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1468965739.
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Thayer, Jenny P. "Evaluation of the Inland Counties trauma patient data collection, management, and analysis." CSUSB ScholarWorks, 1986. https://scholarworks.lib.csusb.edu/etd-project/378.
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Ducharme, Robin Beverly. "Preparing for a Safety Evaluation of Rotavirus Vaccine Using Health Services Data in Ontario: The Development of a Diagnostic Algorithm for Intussusception, an Estimation of Baseline Incidence and an Evaluation of Methods." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/30347.
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In view of the recent implementation of a publicly funded rotavirus vaccination program in Ontario, we undertook studies to help guide the design of a safety evaluation of the vaccine with respect to intussusception. We used administrative data to develop and validate an algorithm for intussusception, and quantified its incidence in Ontario. We also conducted a systematic review of study designs used to evaluate post-licensure vaccine safety, and discussed each design’s strengths and weaknesses.
The validated algorithm for intussusception was sensitive (89.3%) and highly specific (>99.9%). We observed the highest mean incidence (34 / 100,000) in males <1 year of age.
While other designs are more robust, the inability to ascertain individual vaccination status from Ontario’s administrative data dictated our selection of an ecological design for safety evaluation of rotavirus vaccine.
Data assimilated from this thesis represent a critical step toward the timely evaluation of rotavirus vaccine safety in Ontario.
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Semlow, Andrea R. "The Power of Place: A Qualitative Evaluation of Stream Monitoring Data Usage by Decision-Makers in Dane County, WI." Thesis, University of North Texas, 2005. https://digital.library.unt.edu/ark:/67531/metadc1505147/.
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Has years of citizen-based nutrient sampling and baseline water quality monitoring efforts only had a "trivial" impact on natural resource management decisions? This thesis will explore this and other findings from a qualitative evaluation of the Rock River Coalition (RRC) citizen-based stream monitoring project in Dane County, Wisconsin, USA. These findings are the culmination of 47 semi-structured interviews with decision-makers from seven client-identified categories and participant observations of board meetings and other watershed groups. Interview questions focused on current strategies of data design and dissemination with the goal of constructing a clearer picture of existing data usage by Dane County decision-makers. In the wider picture of citizen science and community-based research, this case study aims to highlight barriers to data use and potential solutions. The results of this case study were understood through four key frames: (1) Bourdieu's concept of symbolic capital, (2) Barzilai‐Nahon's theory of network gatekeeping, (3) Newman et al.'s framework for leveraging the power of place, and (4) a Foucauldian approach to the production of scientific knowledge. The findings of this study highlight the presence of gatekeeping mechanisms within the scientific field as well as government institutions, problematize the practice of placemaking, assert there is untapped symbolic capital to be wielded by citizen scientists, and trace the "innovation" of volunteer water monitoring data in Dane County.
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Semlow, Andrea R. "The Power of Place: A Qualitative Evaluation of Stream Monitoring Data Usage by Decision-Makers in Dane County, Wisconsin." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1505147/.
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Has years of citizen-based nutrient sampling and baseline water quality monitoring efforts only had a "trivial" impact on natural resource management decisions? This thesis will explore this and other findings from a qualitative evaluation of the Rock River Coalition (RRC) citizen-based stream monitoring project in Dane County, Wisconsin, USA. These findings are the culmination of 47 semi-structured interviews with decision-makers from seven client-identified categories and participant observations of board meetings and other watershed groups. Interview questions focused on current strategies of data design and dissemination with the goal of constructing a clearer picture of existing data usage by Dane County decision-makers. In the wider picture of citizen science and community-based research, this case study aims to highlight barriers to data use and potential solutions. The results of this case study were understood through four key frames: (1) Bourdieu's concept of symbolic capital, (2) Barzilai‐Nahon's theory of network gatekeeping, (3) Newman et al.'s framework for leveraging the power of place, and (4) a Foucauldian approach to the production of scientific knowledge. The findings of this study highlight the presence of gatekeeping mechanisms within the scientific field as well as government institutions, problematize the practice of placemaking, assert there is untapped symbolic capital to be wielded by citizen scientists, and trace the "innovation" of volunteer water monitoring data in Dane County.
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Maras, Melissa Ann. "Building Evaluation Capacity in Schools." Miami University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=miami1215117424.
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Rovithis, Dimitrios. "Econometric methods for evaluating the cost-effectiveness of health care interventions using observational data." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:4138e3c6-8939-48ae-b98e-f42728be5758.
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This thesis explores the use of observational microdata in cost-effectiveness analysis. The application of econometric methods adjusting for selection bias is first reviewed and critically appraised in the economic evaluation literature using a structured template. Limitations of identified studies include lack of good quality evidence regarding the performance of different analytical approaches; inadequate assessment of the sensitivity of their results to violations of fundamental assumptions or variations to crucial estimator parameters; failure to combine the cost and effectiveness outcomes in a summary measure; and no consideration of stochastic uncertainty for the purpose of evaluating cost-effectiveness. Data from the Birthplace national cohort study are used in an attempt to address these limitations in the context of an empirical comparison of estimators relying on regression, matching, as well as the propensity score. It is argued that although these methods cannot address the potential impact of unobservable confounding, a novel approach to bias-corrected matching, combining entropy balancing with seemingly unrelated regression, still has the potential to offer important advantages in terms of analytical robustness. The net economic benefit is proposed as a straightforward way to exploit the strengths of rigorous econometric methodology in the development of reliable and informative cost-effectiveness analyses.
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Aran, Meltem A. "Measuring treatment effects in poverty alleviation programs : three essays using data from Turkish household surveys." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:98fada59-d38d-4179-b151-c17196c86acf.
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The dissertation is a compilation of three essays on Turkey's poverty alleviation programs. The first paper focuses on the welfare impact of the global financial Crisis on Turkish households. The second paper considers the protective impact of the Green Card non-contributory health insurance program in Turkey during the Crisis in 2008-2009. The third paper uses experimental data from the field in eastern Turkey, to look at patterns of agricultural technology diffusion in a rural development program implemented in a post-conflict setting.
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Darulis, Zilvinas. "Use and Perceptions of Lithuanian Computerized Health Information System." Thesis, Nordic School of Public Health NHV, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3280.
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The study was user survey method based, performed to get the overview of use and perceptions of health caremanagers towards Lithuanian computerized health information system as a tool for decision – making. Aims of the study were to describe LCHIS, its inputs and potential use; to account for a surveyofpotential users, health care administrators; to discuss the need for improvement of the system and itsuse. Methods. User survey method was applied. Literature search was performed and the questionnaire was constructed after interview with four respondents and clarification of questions. Totally 100 ofrespondents from different health care institutions were interviewed. Data was analysed using normal statistical methods, using MS Excel 2000 and statistical package SPSS 10.0 as tools. Main results. Concerning the awareness about the existing of LCHIS, 68% of the respondents saidtheyhave heard about it and 15% said theyhave been using this system daily. As many as 68% of respondents didn’t really take care about the existence of LCHIS, while the size of respondents being satisfied and not was pretty the same. The number of satisfied with the structure was rather small ifcomparing with those partially satisfied. As many as 76% of the respondents said they haven’t been using the system at all. 24% of the respondents were satisfied with the certain groups of healthindicators within the system. Group of morbidity indicators and group of hospital activity indicatorswere among the mostly used (17% together). Almost 20% of the respondents said it was easy for them to use LCHIS; the same number of health care administrators trusted the information comingfrom LCHISand they have experienced the situation, where they have used LCHIS for planning ormanagement in current situation. As many as 82% of health care managers agreed heads or administrative staff of hospitals supposed to be the key members, who must encourage them to use the system. Conclusions. About two thirds of health care administrators interviewed knew about LCHIS and the rest had been or were users. In the comments this group claimed they were supporting their decisions by using the systemand indicators in it. As many as 96% of the respondents stated there was a needfor statistical information and skills for dailydecision - making and managerial activities. The respondents, who used LCHIS, trusted the information in the system and found it useful in their dailywork as health managers. The main comments, why respondents didn’t use the system or didn’tknow about it, was lack of information technologies in work place, lack of computer skills and lackof support from hospital authoritiesISBN 91-7997-097-4
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Otine, Charles. "HIV Patient Monitoring Framework Through Knowledge Engineering." Doctoral thesis, Blekinge Tekniska Högskola [bth.se], School of Planning and Media Design, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-00540.
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Uganda has registered more than a million deaths since the HIV virus was first offi¬cially reported in the country over 3 decades ago. The governments in partnership with different groups have implemented different programmes to address the epidemic. The support from different donors and reduction in prices of treatment resulted in the focus on antiretroviral therapy access to those affected. Presently only a quarter of the approximately 1 million infected by HIV in Uganda are undergoing antiretroviral therapy. The number of patients pause a challenge in monitoring of therapy given the overall resource needs for health care in the country. Furthermore the numbers on antiretroviral therapy are set to increase in addition to the stringent requirements in tracking and monitoring of each individual patient during therapy. This research aimed at developing a framework for adopting knowledge engineering in information systems for monitoring HIV/AIDS patients. An open source approach was adopted due to the resource constrained context of the study to ensure a cost effec¬tive and sustainable solution. The research was motivated by the inconclusive literature on open source dimensional models for data warehouses and data mining for monitor¬ing antiretroviral therapy. The first phase of the research involved a situational analysis of HIV in health care and different health care information systems in the country. An analysis of the strengths, weaknesses and opportunities of the health care system to adopt knowledge bases was done. It proposed a dimensional model for implementing a data warehouse focused on monitoring HIV patients. The second phase involved the development of a knowledge base inform of an open source data warehouse, its simulation and testing. The study involved interdisciplinary collaboration between different stakeholders in the research domain and adopted a participatory action research methodology. This involved identification of the most appropriate technologies to foster this collabora¬tion. Analysis was done of how stakeholders can take ownership of basic HIV health information system architecture as their expertise grow in managing the systems and make changes to reflect even better results out of system functionality. Data mining simulations was done on the data warehouse out of which two machine learning algorithms (regression and classification) were developed and tested using data from the data warehouse. The algorithms were used to predict patient viral load from CD4 count test figures and to classify cases of treatment failure with 83% accu¬racy. The research additionally presents an open source dimensional model for moni¬toring antiretroviral therapy and the status of information systems in health care. An architecture showing the integration of different knowledge engineering components in the study including the data warehouse, the data mining platform and user interac-tion is presented.
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Ekman, Mattias. "Studies in health economics : modelling and data analysis of costs and survival." Doctoral thesis, Stockholm : Economic Research Institute, Stockholm School of Economics [Ekonomiska forskningsinstitutet vid Handelshögsk.] (EFI), 2002. http://www.hhs.se/efi/summary/598.htm.
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Weber, Ingrid Brigitte. "Evaluation of the notifiable disease surveillance system in Gauteng Province, South Africa." Diss., University of Pretoria, 2007. http://hdl.handle.net/2263/26850.
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Objectives. To describe the qualitative aspects of the notifiable diseases surveillance system of the Gauteng Province, South Africa; to conduct a cross-sectional survey on knowledge and practices pertaining to disease notification among private sector primary health care providers in Gauteng Province; to measure the degree of underreporting of notifiable diseases versus positive laboratory diagnoses using malaria as a cases study; and to identify the correctible short-comings in the Gauteng Health Department’s diseases surveillance system and to recommend ways of addressing these to improve the system and its performance. Design. This is an evaluation study consisting of both the qualitative aspects and quantitative descriptive components of the notifiable disease system in Gauteng Province. The study designs used for the qualitative description were literature and policy review and a semi-structured interview with communicable disease coordinators. The quantitative research comprised of a telephonic questionnaire administered to a random sample of private general practioners and secondary data analysis comparing malaria cases notified to the Gauteng Provincial Department of Health with public and private sector laboratory data and clinical surveillance data. Setting. The study setting was the Gauteng Provincial Health Department and public and private health care service providers in Gauteng Province. The study period extended from 1 January to 30 June 2006. Subjects. The subjects of the study were the Gauteng Health Department’s disease surveillance system, public and private sector health care providers including private primary health care practitioners. Outcome measures. Outcome measures for the qualitative system description were the status of selected system attributes namely usefulness, simplicity, flexibility, data quality, acceptability, sensitivity, positive predictive value, representativeness and stability. Outcome measures for the knowledge and practice survey of private general practitioners were reporting compliance and knowledge of notifiable conditions. The primary outcome measure for the secondary data analysis was the proportion of laboratory diagnosed cases of malaria notified to the provincial health department. Results. The notifiable disease surveillance system in Gauteng is deemed useful by the public sector communicable disease coordinators but less so by the private sector general practitioners. Data quality as indicated by completeness of residential detail reporting on meningococcal notifications varied between 29% and 57% by district. Thirty seven percent of general practitioners report compliance with notifications and the mean score for knowledge on notification status of medical conditions was 56%. The sensitivity of notifications of malaria compared with laboratory notifications was 26% with relatively higher notification rates where cases occurred in children under 15 years of age. Conclusions. The notifiable disease surveillance system in Gauteng Province is relatively flexible and reasonably structured however this research suggests that there is suboptimal use of the information for local action in certain areas. Private General Practitioners self-report a low level of compliance citing time constraints and lack of motivation; knowledge of the notification status of selected medical conditions is lower than expected. The completeness and accuracy of notification data, as demonstrated in malaria notifications, is insufficient to gauge a true picture of burden of disease in the province.Dissertation (MMed)--University of Pretoria, 2007.
School of Health Systems and Public Health (SHSPH)
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Stein, Kenneth William Thomas. "The establishment and evaluation of an Internet panel of members of the public to provide preference data for health technology assessment." Thesis, University of Bristol, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.443700.
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Markey, Jessica. "A Community-Engaged Research Approach to the Development of an Assessment Tool for Historical Data Collection of SAARA Client Population." VCU Scholars Compass, 2010. http://scholarscompass.vcu.edu/etd/2114.
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Through collaboration between the Substance Abuse and Addiction Recovery Alliance (SAARA) and several community partners, a need was identified for a new measurement tool to gather comprehensive client histories for program evaluation and development. The purpose of this study was to (1) develop a culturally relevant and organizationally appropriate mechanism for the collection of comprehensive client histories and (2) to provide the opportunity for staff to engage in a new process of developing and implementing data collection strategies. As a result of the use of a community-based participatory approach, (1) a missed opportunity for program evaluation and development was identified, (2) a community-based research study was developed, (3) staff were invested in development of the tool, and (4) staff engaged in a capacity-building exercise in which they were provided the skills and tools needed to replicate this process independently in the future.
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Johansson, Axel. "Patient Empowerment and Accessibilityin e-Health Services : Accessibility Evaluation of a Mobile WebSite for Medical Records Online." Thesis, Uppsala universitet, Avdelningen för visuell information och interaktion, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-262241.
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This thesis evaluates a DEMO version of the mobile web site for medical recordsonline, m.minavardkontakter.se, from a web accessibility point of view. The evaluationis an expert evaluation based on the ISO standard for web accessibility, Web ContentAccessibility Guidelines (WCAG) 2.0 that is complemented with an evaluation basedon fictitious characters, so called personas. The personas were used to representthree groups of people with different kinds of disabilities; perceptual impairment(aniridia), physical impairment (rheumatism) and cognitive impairment (aphasia). Bycombining and comparing these two methods of evaluation, the thesis also evaluatesthe methods themselves. It was seen from both evaluations that the mobile web sitedoes not entirely fulfill the requirements (success criteria) for web accessibility.WCAG 2.0 found more problems in accessibility than did the personas. However, thepersonas found some problems that were overseen by WCAG 2.0, especially whenthe mobile web site was explored using voice synthesis. The results from the twoevaluations were combined in a set of recommendations for improvement, ranked inorder of importance according to the author. The results conclude that WCAG 2.0 isa good tool for evaluating web accessibility but it is recommended to continue to usethe personas in the future development of the mobile web site.
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Kong, Wei. "EXPLORING HEALTH WEBSITE USERS BY WEB MINING." Thesis, Universal Access in Human-Computer Interaction. Applications and Services Lecture Notes in Computer Science, 2011, Volume 6768/2011, 376-383, DOI: 10.1007/978-3-642-21657-2_40, 2011. http://hdl.handle.net/1805/2810.
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Indiana University-Purdue University Indianapolis (IUPUI)With the continuous growth of health information on the Internet, providing user-orientated health service online has become a great challenge to health providers. Understanding the information needs of the users is the first step to providing tailored health service. The purpose of this study is to examine the navigation behavior of different user groups by extracting their search terms and to make some suggestions to reconstruct a website for more customized Web service. This study analyzed five months’ of daily access weblog files from one local health provider’s website, discovered the most popular general topics and health related topics, and compared the information search strategies for both patient/consumer and doctor groups. Our findings show that users are not searching health information as much as was thought. The top two health topics which patients are concerned about are children’s health and occupational health. Another topic that both user groups are interested in is medical records. Also, patients and doctors have different search strategies when looking for information on this website. Patients get back to the previous page more often, while doctors usually go to the final page directly and then leave the page without coming back. As a result, some suggestions to redesign and improve the website are discussed; a more intuitive portal and more customized links for both user groups are suggested.
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Guerrero, Ludueña Richard E. "Data Driven Approach to Enhancing Efficiency and Value in Healthcare." Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/456670.
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Healthcare is changing, and the era of data-driven healthcare organisations is increasingly popular. Data-Driven approaches (e.g., Machine Learning, Metaheuristics, Modelling and Simulation, Data Analytics, and Data Visualisation) can be used to increase efficiency and value in health services.
Despite extensive research and technological development, the evidence impact of those methodologies in the healthcare sector is limited. In this Thesis we argue that an approach without borders in terms of academic societies and field of study could help to tackle this lack of impact to enhance efficiency and value in healthcare. This Thesis is based on solving practical problems in healthcare, with the research drawing upon both theoretical and empirical analysis.
The research is organised in four stages. In the first, a variety of techniques from Modelling and Simulation were studied and used to analyse current performance and to model improved and more efficient future states of healthcare systems. The focus was the analysis of capacity, demand, activity, and queues both at hospital and population levels. In the second part, a Genetic Algorithm was used to solve a Routing Home Healthcare problem. In the third part, Social Network Analysis was used to visualise and analyse email networks. In the final part, a new healthcare system performance metric is proposed and implemented using a case study. New frameworks to implement these methodologies in the context of real-world problems are presented throughout the Thesis.
In collaboration with University of Southampton, Wessex Academic Health Science Network (AHSN), and NHS England, several projects were developed and implemented for healthcare improvement in the UK. The work aims to increase early detection of cancer and thereby reduce premature mortality. The research was conducted working closely with NHS organisations across the Wessex region in England to produce bespoke endoscopy service modelling, as well as population level models. At a regional level, a Colorectal Cancer Screening Programme model was developed. An analysis of endoscopy activity, capacity and demand across the region was conducted. Future demand for endoscopy services in five years' time was estimated, and we found that the system has enough capacity to attend the expected future activity. A new healthcare system performance metric is presented as a tool to improve healthcare services.
Genetic Algorithm metaheuristic was applied in a variant of the Home Health Care Problem (HHCP), focusing on the route planning of clinical homecare.
Working with the Hospital del Mar Medical Research Institute of Barcelona and the Agency of Health Quality and Assessment of Catalonia a study was developed to estimate future utilisation scenarios of knee arthroplasty (KA) revision in the Spanish National Health System in the short-term (2015) and long-term (2030) and their impact on primary KA utilisation. One of the findings was that the variation in the number of revisions depended on both the primary utilisation rate and the survival function applied. Future activity and resources needed was estimated.
A Social Network Analysis (SNA) project was developed in collaboration with the Wessex AHSN to analyse and extract insight from an organisational email, using SNA and Data Mining.
A new healthcare system performance metric - based on the Overall Equipment Effectiveness (OEE) measure - is proposed and evaluated using real data from and Endoscopy Unit from a UK based hospital.
To summarise, this work identifies four key techniques to use in the investigation of health data - Machine Learning Algorithms, Metaheuristic, Discrete Event Simulation and Data Analytics & Visualisations. Following a review of the different subjects and associated issues, those four techniques were evaluated and used with an applied-focus to solve healthcare problems. Key learning points from all different studies, as well as challenges and opportunities for the application of data-driven methodologies are discussed in the final chapter of the Thesis.La asistencia sanitaria está cambiando y la era de las organizaciones sanitarias basadas en datos es cada vez más popular. Los enfoques basados en datos (por ejemplo, Aprendizaje Automático; Meta-heurísticas; Modelamiento y Simulación; y Análisis y Visualización de datos) pueden utilizarse para aumentar la eficiencia y el valor en los servicios sanitarios. A pesar de la amplia investigación y el desarrollo tecnológico, la evidencia sobre el impacto de estas metodologías en el sector sanitario es limitada. En esta tesis argumentamos que un enfoque sin fronteras en términos de sociedades académicas y campo de estudio podría ayudar a abordar esta falta de impacto para aumentar la eficiencia y el valor en la asistencia sanitaria. Esta tesis se basa en la resolución de problemas prácticos en el sector sanitario, con un enfoque tanto teórico como práctico. La investigación se organizó en cuatro etapas. En la primera, una variedad de técnicas de modelamiento y simulación fueron estudiadas y aplicadas en el análisis y simulación de mejores y más eficientes configuraciones de sistemas sanitarios. El objetivo fue un análisis de capacidad, demanda, actividad y listas de esperas a nivel hospitalario y poblacional. En la segunda parte, un Algoritmo Genético fue implementado para resolver un problema de ruteo de personal sanitario encargado de atención de salud en el hogar. En la tercera parte, Análisis de Redes Sociales fue utilizado para visualizar y analizar una red de usuarios de correos electrónicos. En la etapa final, se propone una nueva métrica para evaluar el rendimiento de sistemas sanitarios, la cual fue implementada a través de un caso de estudio. Diferentes marcos de referencia para la implementación de estas metodologías en problemas reales se presentan a lo largo de la tesis.
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Cong, Ze. "Value of pharmaceutical innovation the access effects, diffusion process, and health effects of new drugs /." Santa Monica: RAND, 2009. http://www.rand.org/pubs/rgs_dissertations/2009/RAND_RGSD242.pdf.
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Gottberg, Kristina. "Studies of people living with multiple sclerosis in Stockholm county : evaluation of methods for data collection and aspects of functining and use of health care services /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-784-7/.
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Kadiyala, Akhil. "Development and Evaluation of an Integrated Approach to Study In-Bus Exposure Using Data Mining and Artificial Intelligence Methods." University of Toledo / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1341257080.
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Kołtowska-Häggström, Maria. "Quality of Life in Adult Patients with Growth Hormone Deficiency : Bridging the gap between clinical evaluation and health economic assessment." Doctoral thesis, Uppsala University, Department of Pharmacy, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8353.
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The goals of this thesis are to evaluate quality of life (QoL) in adult patients with growth hormone deficiency (GHD) in relation to population normative data, to construct a preference-weighted index (utility) from a disease-specific QoL measure and to assess it in a clinical context.
The study included samples from the general population and patients with GHD from four European populations: England & Wales, the Netherlands, Spain and Sweden. The country-specific patient cohorts were retrieved from KIMS (Pfizer International Metabolic Database).
A questionnaire was developed that contained items from existing QoL questionnaires including, among others, Quality of Life Assessment in Growth Hormone Deficiency in Adults (QoL-AGHDA) and the EQ-5D. The QoL-AGHDA is a disease-specific measure for use in adults with GHD. The EQ-5D is a generic instrument which describes health states for which country-specific preference-based weights are available. Thus, it was possible to generate preference-weighted indices (utilities) based on data generated by both instruments.
This thesis reports QoL-AGHDA normative values for the populations of England & Wales, the Netherlands, Spain and Sweden, and confirms the extent of QoL impairment in patients with GHD in comparison with the general population. Long-term GH replacement resulted in sustained improvements in overall QoL towards normative country-specific values, as well in most of the dimensions that were impaired before treatment.
For use in health economic evaluations, models for generating utilities (QoL-AGHDAutility) from QoL-AGHDA were developed. It is believed that these models may facilitate medical decision making, given that they provide a tool for obtaining utilities in the absence of directly collected preference-weighted indices.
QoL-AGHDAutility effectively monitored treatment effects in patients with GHD. Moreover, this study confirmed a QoL-AGHDAutility deficit before treatment and a gain after starting GH replacement.
The novel aspect of the present approach was to apply preference-weighted indices derived from a disease-specific measure to assess QoL in the clinical context, together with patient demographic and clinical characteristics. The robustness of this analysis is reinforced by the fact that utilities in both general and patient populations were generated using the same methodology.
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Neumann, Anne, Enno Swart, Dennis Häckl, Roman Kliemt, Stefanie March, Denise Küster, Katrin Arnold, et al. "The influence of cross-sectoral treatment models on patients with mental disorders in Germany: study protocol of a nationwide long-term evaluation study (EVA64)." BioMed Central, 2018. https://tud.qucosa.de/id/qucosa%3A33821.
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Background
Close, continuous and efficient collaboration between different professions and sectors of care is necessary to provide patient-centered care for individuals with mental disorders. The lack of structured collaboration between in- and outpatient care constitutes a limitation of the German health care system. Since 2012, a new law in Germany (§64b Social code book (SGB) V) has enabled the establishment of cross-sectoral and patient-centered treatment models in psychiatry. Such model projects follow a capitation budget, i.e. a total per patient budget of inpatient and outpatient care in psychiatric clinics. Providers are able to choose the treatment form and adapt the treatment to the needs of the patients. The present study (EVA64) will investigate the effectiveness, costs and efficiency of almost all model projects established in Germany between 2013 and 2016.
Methods/design
A health insurance data-based controlled cohort study is used. Data from up to 89 statutory health insurance (SHI) funds, i.e. 79% of all SHI funds in Germany (May 2017), on inpatient and outpatient care, pharmaceutical and non-pharmaceutical treatments and sick leave for a period of 7 years will be analyzed. All patients insured by any of the participating SHI funds and treated in one of the model hospitals for any of 16 pre-defined mental disorders will be compared with patients in routine care. Sick leave (primary outcome), utilization of inpatient care (primary outcome), utilization of outpatient care, continuity of contacts in (psychiatric) care, physician and hospital hopping, re-admission rate, comorbidity, mortality, disease progression, and guideline adherence will be analyzed. Cost and effectivity of model and routine care will be estimated using cost-effectiveness analyses. Up to 10 control hospitals for each of the 18 model hospitals will be selected according to a pre-defined algorithm.
Discussion
The evaluation of complex interventions is an important main task of health services research and constitutes the basis of evidence-guided advancement in health care. The study will yield important new evidence to guide the future provision of routine care for mentally ill patients in Germany and possibly beyond.
Trial registration
This study was registered in the database “Health Services Research Germany” (trial number: VVfD_EVA64_15_003713).
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Forsyth, Rowena Public Health & Community Medicine Faculty of Medicine UNSW. "Tricky technology, troubled tribes: a video ethnographic study of the impact of information technology on health care professionals??? practices and relationships." Awarded by:University of New South Wales. School of Public Health and Community Medicine, 2006. http://handle.unsw.edu.au/1959.4/30175.
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Whilst technology use has always been a part of the practice of health care delivery, more recently, information technology has been applied to aspects of clinical work concerned with documentation. This thesis presents an analysis of the ways that two professional groups, one clinical and one ancillary, at a single hospital cooperatively engage in a work practice that has recently been computerised. It investigates the way that a clinical group???s approach to and actual use of the system creates problems for the ancillary group. It understands these problems to arise from the contrasting ways that the groups position their use of documentation technology in their local definitions of professional status. The data on which analysis of these practices is based includes 16 hours of video recordings of the work practices of the two groups as they engage with the technology in their local work settings as well as video recordings of a reflexive viewing session conducted with participants from the ancillary group. Also included in the analysis are observational field notes, interviews and documentary analysis. The analysis aimed to produce a set of themes grounded in the specifics of the data, and drew on TLSTranscription?? software for the management and classification of video data. This thesis seeks to contribute to three research fields: health informatics, sociology of professions and social science research methodology. In terms of health informatics, this thesis argues for the necessity for health care information technology design to understand and incorporate the work practices of all professional groups who will be involved in using the technology system or whose work will be affected by its introduction. In terms of the sociology of professions, this thesis finds doctors and scientists to belong to two distinct occupational communities that each utilise documentation technology to different extents in their displays of professional competence. Thirdly, in terms of social science research methodology, this thesis speculates about the possibility for viewing the engagement of the groups with the research process as indicative of their reactions to future sources of outside perturbance to their work.
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Rouamba, Toussaint. "Optimal use of routinely collected data among pregnant women to improve malaria surveillance in Burkina Faso: Contribution of Bayesian spatiotemporal modelling." Doctoral thesis, Universite Libre de Bruxelles, 2020. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/314119.
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Background: The control of malaria in pregnancy remains a large challenge in Burkina Faso, despite the adoption of control measures known to be effective. Known effective programs include individual measures, such as intermittent preventive treatment during pregnancy, and the use of long lasting insecticide nets and daily supplementation of ferrous sulphate (200 mg) along with folic acid. Besides these measures, health programs that aim at enhancing the well-being of the population and improve maternal and child health have emerged, including results-based financing (in 2014), a project promoting health in 130 communities (implemented in 2015), and free health care (implemented in 2016). This thesis attempts to assess the effects of health programs on the space–time patterns of malaria (morbidity and mortality) through routinely collected data in pregnancy and explore the various prediction approaches to address challenges in routine health data reporting. Methods: We utilized a substantial range of data and applied advanced quantitative approaches while considering the specific distribution of the data. Our thesis is based on the valorization (analyses) of malaria surveillance data (aggregated by space and time units) recorded in the health information system of Burkina Faso between 2011 and 2019. These analyses also integrate environmental remote sensing data, data from periodic surveys, and data from other sources. These data were coupled into a database. After performing appropriate descriptive analyses considering the complexity of the data design, we performed spatio-temporal Bayesian modeling to determine areas with high risk and assess the effect of health programs on the space–time patterns of malaria incidence among pregnant women at the community-level; to explore an approach to estimate health facility readiness from survey data designed to be regionally representative (and then quantify the effect of this readiness on severe-malaria cases and case fatality); and to explore the prediction approaches used to address challenges in routine health data reporting, thereby supporting a malaria early warning system. Results: Our results show spatial and temporal heterogeneity and indicate that the annual incidence of malaria increased between 2013 and 2018, while the mortality rate decreased significantly. Some communities with a high malaria burden experienced a reduction in their risk through the deployment of the health programs mentioned above. The risk of a pregnant woman dying from severe malaria was 2.5 times higher in districts with low operational capacity. Finally, our thesis proposed an approach to respond to crisis situations that would affect data collection and could be used to set the target or provide early warnings for epidemics or other notifications. Conclusion: Our thesis provides useful tools for disease surveillance in developing countries to help optimize the scarce resources in malaria high burden areas. The results of our thesis could be used by the Ministry of Health to strengthen the capacity of existing surveillance tools and to develop rational strategies and/or new tools for monitoring malaria cases and associated deaths in communities.Contexte :La lutte contre le paludisme pendant la grossesse reste un grand défi au Burkina Faso, malgré l'adoption de mesures de contrôle dont l'efficacité est reconnue. Les programmes dont l'efficacité est reconnue comprennent des mesures individuelles, telles que le traitement préventif intermittent pendant la grossesse, l'utilisation de moustiquaires imprégnées d'insecticide de longue durée et la supplémentation quotidienne en sulfate ferreux (200 mg) ainsi qu'en acide folique. Outre ces mesures, des programmes de santé visant à accroître le bien-être de la population et à améliorer la santé maternelle et infantile ont vu le jour, notamment le financement basé sur les résultats (en 2014), le projet de promotion de la santé dans 130 communes (mis en œuvre en 2015) et la gratuité des soins de santé (mise en œuvre en 2016). Cette thèse tente d'évaluer les effets des programmes de santé sur les caractéristiques spatio-temporelles du paludisme (morbidité et mortalité) par le biais de données de routine collectées pendant la grossesse et d'explorer les différentes approches de prévision pour relever les défis de la rapportage systématique des données de santé. Méthodes :Nous avons utilisé un large éventail de données et appliqué des approches quantitatives avancées tout en tenant compte de la distribution spécifique des données. Notre thèse est basée sur la valorisation (analyses) des données de surveillance du paludisme (agrégées par unités spatiales et temporelles) enregistrées dans le système d'information sanitaire du Burkina Faso entre 2011 et 2019. Ces analyses intègrent également des données de télédétection environnementale, des données issues d'enquêtes périodiques et des données provenant d'autres sources. Ces données ont été couplées pour constituer une base de données. Après avoir effectué des analyses descriptives appropriées en tenant compte de la complexité de la conception des données, nous avons procédé à une modélisation bayésienne spatio-temporelle pour déterminer les zones à haut risque et évaluer l'effet des programmes de santé sur les tendances spatio-temporelles de l'incidence du paludisme chez les femmes enceintes au niveau communautaire ;pour explorer une approche permettant d'estimer la capacité opérationnelle des établissements de santé à partir de données d'enquête conçues pour être représentatives au niveau régional (et ensuite quantifier l'effet de cette capacité opérationnelle sur les cas de paludisme grave et la mortalité) ;et pour explorer les approches de prévision utilisées pour relever les défis relatifs au rapportaga systématique des données de santé, pouvant aussi servir à un système d'alerte précoce du paludisme. Résultats :Nos résultats montrent une hétérogénéité spatiale et temporelle et indiquent que l'incidence annuelle du paludisme a augmenté entre 2013 et 2018, tandis que le taux de mortalité a diminué de manière significative. Certaines communes où la charge du paludisme est élevée ont connu une réduction de leur risque grâce au déploiement des programmes de santé mentionnés ci-dessus. Le risque qu'une femme enceinte meure d'un paludisme grave était 2,5 fois plus élevé dans les districts ayant une faible capacité opérationnelle. Enfin, notre thèse a proposé une approche pour répondre aux situations de crise qui affecterait la collecte de données et pourrait être utilisée pour fixer l'objectif ou fournir des alertes précoces pour les épidémies ou autres notifications. Conclusion :Notre thèse fournit des outils utiles pour la surveillance des maladies dans les pays en développement afin de contribuer à optimiser les ressources limitées dans les zones à forte incidence de paludisme. Les résultats de notre thèse pourraient être utilisés par le ministère de la santé pour renforcer la capacité des outils de surveillance existants et pour développer des stratégies rationnelles et/ou de nouveaux outils de surveillance des cas de paludisme et des décès associés dans les communautés.
Doctorat en Sciences de la santé Publique
info:eu-repo/semantics/nonPublished
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Wagner, Ryan G. "The Burden of Epilepsy : using population-based data to define the burden and model a cost-effective intervention for the treatment of epilepsy in rural South Africa." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-120163.
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Rationale Epilepsy is a common, chronic, neurological condition that disproportionately affects individuals living in low- and middle- income countries, including much of sub-Saharan Africa. Epilepsy is treatable, with the majority of individuals who take anti-epileptic drugs experiencing a reduction, or elimination, of seizures. Yet the number of individuals taking and adhering to medication in Africa is low and interventions aimed at improving treatment are lacking. Aims To define the epidemiology of convulsive epilepsy in rural South Africa in terms of incidence, mortality and disability-adjusted life years; to determine outpatient, out-of-pocket costs resulting from epilepsy treatment; to establish the level of adherence to anti-epileptic drugs amongst people with epilepsy; and, to determine whether the introduction of routine visits to people with epilepsy by community health workers is a cost-effective intervention for improving adherence to anti-epileptic drugs. Methods Nested within the Agincourt Health and Demographic Surveillance System, this work utilized a cohort of individuals diagnosed with convulsive epilepsy in 2008 to determine health care utilization and out-of-pocket costs due to care sought for epilepsy. Additionally, using blood samples from the cohort, anti-epileptic drug adherence was measured and, following the cohort, mortality rates were determined. Using these collected epidemiological parameters, disability-adjusted life years due to convulsive epilepsy were determined. Finally, combining the epidemiological and cost parameters, a community health worker intervention was modeled to determine its incremental cost-effectiveness ratio. Key Findings The burden of convulsive epilepsy is lower in rural South Africa than other parts of Africa, likely due to lower levels of known risk factors. Yet the burden, especially in terms of mortality, remains high, as does the treatment gap and health care utilization. Findings from the economic evaluation found the introduction of a community health worker to be highly cost-effective and would likely lower the burden of epilepsy in rural South Africa. Implications Epilepsy contributes to the burden of disease in rural South Africa, with high levels of mortality and a substantial treatment gap. The introduction of a community-health worker is likely to be one cost-effective, community based intervention that would lower the burden of epilepsy by improving adherence to anti-epileptic drugs. Implementing this intervention, based on these findings, is a justified and important next step.
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Fahey, Rebecca Lee. "Evaluation of the System Attributes of Timeliness and Completeness of the West Virginia Electronic Disease Surveillance System' NationalEDSS Based System." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1341.
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Despite technological advances in public health informatics, the evaluation of infectious
disease surveillance systems data remains incomplete. In this study, a thorough
evaluation was performed of the West Virginia Electronic Disease Surveillance System
(WVEDSS, 2007-2010) and the West Virginia Electronic Disease Surveillance System NationalEDSS -Based System (WVEDSS-NBS; March 2012 - March 2014) for Category II infectious diseases in West Virginia. The purpose was to identify key areas in the surveillance system process from disease diagnosis to disease prevention that need improvement. Grounded in the diffusion of innovation theory, a quasi-experimental, interrupted, time-series design was used to evaluate the 2 data sets. Research questions examined differences in mean reporting time, the 24-hour standard, and comparison of complete fields (DOB, gender etc.) of the data sets using independent samples t tests. The study found (a) that the mean reporting times were shorter for WVEDSS compared to WVEDSS-NBS (p < .05) for all vaccine-preventable infectious diseases (VPID) in Category II except for mumps; (b) that the 24-hour standard was not met for WVEDSS compared to WVEDSS-NBS (p < .05) for all VPID in Category II except for mumps, and (c) that most fields were complete for WVEDSS compared to WVEDSS-NBS (p < .05) for all VPID in Category II except for meningococcal disease. Healthcare professionals in the state can use the results of this research to improve the system attributes of timeliness and completeness. Implications for positive social change included improved access to public health data to better understand health disparities, which, in turn could reduce morbidity and mortality within the population.
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Gerdes, Mike. "Health Monitoring for Aircraft Systems using Decision Trees and Genetic Evolution." Diss., Aircraft Design and Systems Group (AERO), Department of Automotive and Aeronautical Engineering, Hamburg University of Applied Sciences, 2019. http://d-nb.info/1202830382.
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Reducing unscheduled maintenance is important for aircraft operators. There are significant costs if flights must be delayed or cancelled, for example, if spares are not available and have to be shipped across the world. This thesis describes three methods of aircraft health condition monitoring and prediction; one for system monitoring, one for forecasting and one combining the two other methods for a complete monitoring and prediction process. Together, the three methods allow organizations to forecast possible failures. The first two use decision trees for decision-making and genetic optimization to improve the performance of the decision trees and to reduce the need for human interaction. Decision trees have several advantages: the generated code is quickly and easily processed, it can be altered by human experts without much work, it is readable by humans, and it requires few resources for learning and evaluation. The readability and the ability to modify the results are especially important; special knowledge can be gained and errors produced by the automated code generation can be removed. A large number of data sets is needed for meaningful predictions. This thesis uses two data sources: first, data from existing aircraft sensors, and second, sound and vibration data from additionally installed sensors. It draws on methods from the field of big data and machine learning to analyse and prepare the data sets for the prediction process.
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Hinnenthal, Marie [Verfasser], Andreas [Akademischer Betreuer] Brieden, Andreas [Gutachter] Brieden, and Claudius [Gutachter] Steinhardt. "Endpoint-oriented clustering of individual patient data : A new approach for the health economic evaluation of medical interventions / Marie Hinnenthal ; Gutachter: Andreas Brieden, Claudius Steinhardt ; Akademischer Betreuer: Andreas Brieden ; Universität der Bundeswehr München, Fakultät für Wirtschafts- und Organisationswissenschaften." Neubiberg : Universitätsbibliothek der Universität der Bundeswehr München, 2017. http://d-nb.info/116168848X/34.
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Hinnenthal, Marie Verfasser], Andreas [Akademischer Betreuer] [Brieden, Andreas [Gutachter] Brieden, and Claudius [Gutachter] Steinhardt. "Endpoint-oriented clustering of individual patient data : A new approach for the health economic evaluation of medical interventions / Marie Hinnenthal ; Gutachter: Andreas Brieden, Claudius Steinhardt ; Akademischer Betreuer: Andreas Brieden ; Universität der Bundeswehr München, Fakultät für Wirtschafts- und Organisationswissenschaften." Neubiberg : Universitätsbibliothek der Universität der Bundeswehr München, 2017. http://nbn-resolving.de/urn:nbn:de:bvb:706-5411.
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Schiele, Saskia [Verfasser], Andreas [Akademischer Betreuer] Brieden, Andreas [Gutachter] Brieden, and Claudius [Gutachter] Steinhardt. "Explainable Analytics in Medicine : A new approach to investigate individual patient data for the health economic evaluation of medical interventions / Saskia Schiele ; Gutachter: Andreas Brieden, Claudius Steinhardt ; Akademischer Betreuer: Andreas Brieden ; Universität der Bundeswehr München, Fakultät für Wirtschafts- und Organisationswissenschaften." Neubiberg : Universitätsbibliothek der Universität der Bundeswehr München, 2021. http://d-nb.info/1233485164/34.
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