La sensibilisation du grand public aux risques majeurs est un enjeu actuel de leur prévention. En France, la communication préventive sur les risques majeurs est une obligation réglementaire. On peut alors s’interroger sur son efficacité vis à vis de la population. Dans cette thèse, des approches contribuant à l’évaluation de l’efficacité des documents de communication préventive sur les risques sont proposées avec une application au DICRIM (Document d'Information Communal sur les Risques Majeurs). Elles croisent des méthodes à l’interface entre sciences pour l’ingénieur (méthode de la sûreté de fonctionnement), sciences cognitives (modélisation de connaissances) et sciences humaines et sociales (interviews et analyse de discours). Les développements portent sur : - un modèle d’évaluation de la conformité du contenu d’un DICRIM donné en regard de la loi ; - des éléments de représentations cognitives d’élus et d’habitants vis-à-vis du DICRIM et des risques majeurs en général ; - une production d’indicateurs de performance et d’un modèle d’évaluation de la performance d’un DICRIM. Des validations des modèles ont été réalisées sur des cas réels. Les modèles proposent également des rétroactions afin d’améliorer l’efficacité du document si nécessaire, en fonction des notes obtenues à l’aide des indicateurs. Les modèles d’aide à la décision peuvent être utilisés par les municipalités ou les bureaux d’études spécialisés sur tout DICRIM existant ou en création. Leur utilisation ne nécessite pas la mise en oeuvre de moyens particuliers. Par ailleurs, les modèles possèdent des composantes génériques applicables à d’autres types d’outils de communication sur les risques / Raising the general public's sensitisation of major hazards is a current issue in their prevention and is based in particular on the communication of preventive information. In France, this communication is a regulatory obligation. One can then question its effectiveness and how its content and form are perceived by the population. In this thesis, approaches contributing to the evaluation of the effectiveness of preventive risk communication documents are proposed with an application to the DICRIM (“Document d’Information Communal sur les Risques Majeurs” in French; “Communal Information Document on Major Risks” in English). They cross methods at the interface between engineering sciences (method of operational safety), cognitive sciences (knowledge modelling) and human and social sciences (interviews and discourse analysis). The developments concern: - a model for assessing the content conformity of a given DICRIM with the law; - elements of cognitive representations of elected representatives and inhabitants relative to the DICRIM and major hazards in general; - a production of performance indicators and a model for evaluating the performanceof a DICRIM.Model validations were carried out on real cases. The models also provide feedback to improve the effectiveness of the document if necessary, based on the scores obtained using the indicators. Decision support models can be used by municipalities or specialized design offices on any existing or newly created DICRIM. Their use does not require the implementation of particular means. In addition, the models have generic components applicable to other types of risk communication tools.

Sustainability concerns are increasingly shaping customers' behavior as well as companies' strategy. In this context, optimizing the supply chain with sustainability considerations is becoming a critical issue. However, work with quantitative models is still scarce. Our research contributes by revisiting classical inventory models taking sustainability concerns into account. We believe that reducing all aspects of sustainable development to a single objective is not desirable. We thus reformulate single and multi-echelon economic order quantity models as multi-objective problems. These models are then used to study several options such as buyer-supplier coordination or green technology investment. We also consider that firms are becoming increasingly proactive with respect to sustainability. We thus propose to apply multiple criteria decision aid techniques instead of considering sustainability as a constraint. In this sense, the firm may provide preference information about economic, environmental and social tradeoffs and quickly identify a satisfactory solution.

This thesis focuses on expectant parents’ experiences and needs when soft makers are detected at mid-trimester ultrasound, resulting in an unexpected assessment of risk for fetal anomalies. The thesis also describes the prevalence of ultrasonographic fetal soft markers and the incidence of Down syndrome in a low-risk population of 10,535 pregnant women with a total of 10,710 fetuses, as well as the risk of invasive prenatal diagnostics in conjunction with the detection of soft markers. Finally, the thesis aims to explore the value of a web-based patient decision aid (DA) in facilitating informed decision making regarding routine fetal screening for anomalies and the fathers’ role in decision making regarding prenatal screening. A prospective observational study was conducted between 2008–2011 to investigate the prevalence of ultrasonographic fetal soft markers at second trimester screening. During this time period, 12 women and 17 men were interviewed about their experience when soft markers were detected. Based on the results of these interviews, a web-based decision aid (DA) to enhance expectant parents’ decision-making concerning fetal screening was developed and a trial initiated to test its utility. Interviews were conducted with 17 women who received access to the DA, 11 who had chosen to use the DA and six who had not used it. All interview studies were analysed using systematic text condensation (STC) developed by Malterud. Soft markers were detected in 5.9% of the fetuses at mid-trimester ultrasound, whereof 5.1% were isolated. All soft markers showed a positive likelihood ratio (LR+) for DS; however, the association was only statistically significant for the collapsed category ‘any marker’ (isolated, multiple or combined with anomaly), not for isolated markers. An almost 24-fold increase of invasive diagnostic testing was shown in all women, including those with a low estimated risk for aneuploidy, i.e. < 1/200 (paper III). The results from interviews showed that the finding of soft markers created much anxiety and indicated that both women and men lacked awareness of the potential of the ultrasound examination (papers I and II). The results also showed that the men were actively engaged in decision making not only by supporting their partners, but also considered their own values and needs regarding these issues (paper II). It was also evident that women wanted their partners to be engaged in decisions regarding fetal diagnostics (papers I and IV). The web-based patient DA was able to initiate a process of conscious decision making in pregnant women, as a result of their interaction with the tool. The DA allowed for clarification of women’s thoughts and priorities and helped them to understand the significance of the screening result and providing a basis for making informed decisions regarding fetal screening (paper IV).

O interesse em reduzir manifestações patológicas, o possível impacto sobre a satisfação dos clientes e a busca por redução de custos são alguns dos fatores que, durante as fases de projeto arquitetônico, podem tornar complexa a decisão referente à seleção de uma tecnologia de revestimento de fachada. Diante disso, o presente trabalho tem como objetivo propor um modelo de apoio à decisão para seleção de tecnologias de revestimento de fachadas. O desenvolvimento do trabalho envolveu quatro fases de pesquisa. Na primeira, foi realizado um estudo sobre como são tomadas as decisões, com identificação dos atores envolvidos, caracterização das diferenças entre as alternativas potenciais e definição dos contornos da problemática de decisão. Na segunda fase, estruturou-se um modelo de decisão multicritério adequado para o contexto de decisão de interesse. O modelo desenvolvido leva em conta aspectos considerados importantes por profissionais com ampla experiência e incorpora características positivas identificadas em outros modelos encontrados na prospecção da bibliografia existente na área. Em seguida, na terceira fase, foram efetuados testes de aplicação do modelo, com seis decisores, tomando como referência um cenário de decisão fictício, estabelecido levando em conta as características da cidade de Fortaleza. A captura do sistema de valores dos decisores foi efetuada através de formulários. Os resultados oriundos dos formulários, com o auxílio de software e planilhas eletrônicas, serviram de base para que o modelo apresentasse suas recomendações. Durante as aplicações, os resultados parciais das capturas de conhecimento eram discutidos com os participantes do teste e analisados pelo pesquisador, com o objetivo de verificar se o procedimento deveria sofrer refinamentos ou ajustes. Por fim, na quarta fase, foi realizada uma validação qualitativa do modelo, através de entrevistas e formulários nos quais se discutia se a previsão do modelo seria útil e se coadunava com as expectativas dos decisores. Os resultados obtidos indicam que existe viabilidade para aplicação do modelo proposto, pois o mesmo foi considerado útil e válido pelos decisores dentro do seu contexto de aplicação. Acredita-se que, com o desenvolvimento e aperfeiçoamento da ferramenta proposta, a mesma venha a contribuir de forma significativa para apoiar escolhas de decisores na construção civil, em especial, em situações em que existem dúvidas sobre a tecnologia mais apropriada. Mais ainda, ao estruturar o processo de decisão, a mesma permite que se discutam os parâmetros e valores que influenciam cada decisão, permitindo uma melhor reflexão e consenso entre os intervenientes. / Interests in decreasing pathological manifestations, improve customers’ satisfaction and promote cost reductions are important considerations that, during the design building phase, may increase the complexity of the decision regarding facades cladding technology. The main purpose of the present work is to suggest a decision aid model for technological decisions, in the choice of facades cladding technologies. The research development involved four phases. In the first one, it was studied about how decisions are taken, with stakeholders’ identification, potential action characterization, and problematic definition. In the second phase, it was structured a model in accordance with context interests. The decision aid model considers aspects judged as important by experienced professionals and considers positive characteristics identified by models found in the literature of the area. In the third phase, simulation tests were realized with six decision makers, considering a fictitious project in Fortaleza city. Using formularies, individual values were captured from decision makers. The results collected with the aid of software and electronic sheets served as the basis for model recommendations. During the application of the model, partial results were discussed with decisionmakers and analyzed by the researcher so that they could be refined or adjusted. Finally, in the fourth phase, a qualitative validation was carried through interviews and formularies. This phase verified if the decision aid model was considered useful and valid by decision-makers. It was shown that the proposed tool can significantly contribute to help decision makers in the selection of facades cladding technologies, especially in complex situations. More yet, it can help to structure the decision process, becoming an important the tool for discussing the parameters and values influencing decisions, and helping stakeholders to reach a consensed solution.

O interesse em reduzir manifestações patológicas, o possível impacto sobre a satisfação dos clientes e a busca por redução de custos são alguns dos fatores que, durante as fases de projeto arquitetônico, podem tornar complexa a decisão referente à seleção de uma tecnologia de revestimento de fachada. Diante disso, o presente trabalho tem como objetivo propor um modelo de apoio à decisão para seleção de tecnologias de revestimento de fachadas. O desenvolvimento do trabalho envolveu quatro fases de pesquisa. Na primeira, foi realizado um estudo sobre como são tomadas as decisões, com identificação dos atores envolvidos, caracterização das diferenças entre as alternativas potenciais e definição dos contornos da problemática de decisão. Na segunda fase, estruturou-se um modelo de decisão multicritério adequado para o contexto de decisão de interesse. O modelo desenvolvido leva em conta aspectos considerados importantes por profissionais com ampla experiência e incorpora características positivas identificadas em outros modelos encontrados na prospecção da bibliografia existente na área. Em seguida, na terceira fase, foram efetuados testes de aplicação do modelo, com seis decisores, tomando como referência um cenário de decisão fictício, estabelecido levando em conta as características da cidade de Fortaleza. A captura do sistema de valores dos decisores foi efetuada através de formulários. Os resultados oriundos dos formulários, com o auxílio de software e planilhas eletrônicas, serviram de base para que o modelo apresentasse suas recomendações. Durante as aplicações, os resultados parciais das capturas de conhecimento eram discutidos com os participantes do teste e analisados pelo pesquisador, com o objetivo de verificar se o procedimento deveria sofrer refinamentos ou ajustes. Por fim, na quarta fase, foi realizada uma validação qualitativa do modelo, através de entrevistas e formulários nos quais se discutia se a previsão do modelo seria útil e se coadunava com as expectativas dos decisores. Os resultados obtidos indicam que existe viabilidade para aplicação do modelo proposto, pois o mesmo foi considerado útil e válido pelos decisores dentro do seu contexto de aplicação. Acredita-se que, com o desenvolvimento e aperfeiçoamento da ferramenta proposta, a mesma venha a contribuir de forma significativa para apoiar escolhas de decisores na construção civil, em especial, em situações em que existem dúvidas sobre a tecnologia mais apropriada. Mais ainda, ao estruturar o processo de decisão, a mesma permite que se discutam os parâmetros e valores que influenciam cada decisão, permitindo uma melhor reflexão e consenso entre os intervenientes. / Interests in decreasing pathological manifestations, improve customers’ satisfaction and promote cost reductions are important considerations that, during the design building phase, may increase the complexity of the decision regarding facades cladding technology. The main purpose of the present work is to suggest a decision aid model for technological decisions, in the choice of facades cladding technologies. The research development involved four phases. In the first one, it was studied about how decisions are taken, with stakeholders’ identification, potential action characterization, and problematic definition. In the second phase, it was structured a model in accordance with context interests. The decision aid model considers aspects judged as important by experienced professionals and considers positive characteristics identified by models found in the literature of the area. In the third phase, simulation tests were realized with six decision makers, considering a fictitious project in Fortaleza city. Using formularies, individual values were captured from decision makers. The results collected with the aid of software and electronic sheets served as the basis for model recommendations. During the application of the model, partial results were discussed with decisionmakers and analyzed by the researcher so that they could be refined or adjusted. Finally, in the fourth phase, a qualitative validation was carried through interviews and formularies. This phase verified if the decision aid model was considered useful and valid by decision-makers. It was shown that the proposed tool can significantly contribute to help decision makers in the selection of facades cladding technologies, especially in complex situations. More yet, it can help to structure the decision process, becoming an important the tool for discussing the parameters and values influencing decisions, and helping stakeholders to reach a consensed solution.

L’Aide Multicritère à la Décision (AMCD) vise à aider un décideur (DM) confronté à un problème de décision impliquant plusieurs objectifs contradictoires. Les préférences du DM jouent un rôle important au sein du processus d'aide à la décision, puisque les recommandations ne sont pertinentes et acceptables que si le système de valeurs du DM est pris en considération. Un outil d'élicitation des préférences est donc nécessaire pour aider l'analyste à intégrer les préférences du DM de façon appropriée dans les modèles de décision. Nous sommes intéressés par le développement d’outils d'élicitation des préférences pour deux modèles d'agrégation basés sur des points de référence à savoir Electre Tri et une méthode de Rangement basé sur des Points de Référence multiples (RPM). Tout d'abord, nous considérons Electre Tri en utilisant la règle d’affectation optimiste. Nous proposons un outil d'élicitation des préférences, qui infère les paramètres de préférence de ce modèle à partir d’exemples d’affectation du DM, et analyse également la robustesse des affectations résultant de la nature imprécise de l'information préférentiel. En second lieu, un outil d'élicitation des préférences est développé pour le problème de sélection de portefeuille formulée comme des problèmes de tri contraint en utilisant Electre Tri. Les préférences du DM à la fois au niveau individuel et au niveau du portefeuille sont considérés pour infère le modèle Electre Tri. Le modèle élicité évalue intrinsèquement les individus et sélectionne simultanément un portefeuille satisfaisant comme un groupe. Troisièmement, nous nous intéressons à l’élicitation des préférences pour le modèle RPM, qui détermine un pré-ordre comparant des alternatives avec des points de référence. Nous proposons un outil qui infère un modèle RPM parcimonieux à partir de comparaisons par paires du DM. Enfin, trois web services implémentent des outils d'élicitation des préférences pour Electre Tri et ont été intégrées au logiciel de Decision Deck. Les outils d’élicitation des préférences proposés consistent en des algorithmes qui résolvent des programmes linéaires en nombres mixtes. Des expériences numériques approfondies ont été réalisées pour étudier la performance et le comportement des outils d'élicitation proposées. Ces expériences éclairent sur l’applicabilité pratique de ces outils. De plus, les outils ont été appliqués avec succès à trois cas. / Multiple Criteria Decision Aid (MCDA) aims at supporting decision makers (DM) facing decisions involving several conflicting objectives. DM's preferences play a key role in the decision aiding process, since the recommendations are meaningful and acceptable only if the DM's values are taken into consideration. A preference elicitation tool is therefore necessary to help the analyst to incorporate appropriately the DM's preferences in the decision models. We are interested in developing preference elicitation tools for two aggregation models based on reference points, namely Electre Tri and a new Ranking method based on Multiple reference Points (RMP). Firstly, we consider Electre Tri using the optimistic assignment rule. We propose a preference elicitation tool which elicits the preference parameters of the model from assignment examples provided by the DM, and also analyzes the robustness of the assignments related to the imprecise nature of the preference information. Secondly, a preference elicitation tool is developed for portfolio selection problems. These problems are formulated as constrained sorting problems using Electre Tri. The DM's preferences both at the individual and portfolio level are considered to elicit the Electre Tri model. The elicited model evaluates intrinsically the individuals and simultaneously selects a satisfactory portfolio as a group. Thirdly, we are interested in preference elicitation for RMP model, which determines a weak order by comparing alternatives with reference points. A preference elicitation tool is provided which infers a parsimonious RMP model from the DM's pairwise comparisons. Lastly, three web services implementing the preference elicitation tools for Electre Tri have been developed and integrated to Decision Deck software. The proposed preference elicitation tools consist of algorithms solving mixed integer programs. Extensive numerical experiments have been performed to study the performance and behavior of the proposed elicitation tools to give insights into their applicability in practice. Moreover, the tools have been successfully applied to three real-world cases.

O interesse em reduzir manifestações patológicas, o possível impacto sobre a satisfação dos clientes e a busca por redução de custos são alguns dos fatores que, durante as fases de projeto arquitetônico, podem tornar complexa a decisão referente à seleção de uma tecnologia de revestimento de fachada. Diante disso, o presente trabalho tem como objetivo propor um modelo de apoio à decisão para seleção de tecnologias de revestimento de fachadas. O desenvolvimento do trabalho envolveu quatro fases de pesquisa. Na primeira, foi realizado um estudo sobre como são tomadas as decisões, com identificação dos atores envolvidos, caracterização das diferenças entre as alternativas potenciais e definição dos contornos da problemática de decisão. Na segunda fase, estruturou-se um modelo de decisão multicritério adequado para o contexto de decisão de interesse. O modelo desenvolvido leva em conta aspectos considerados importantes por profissionais com ampla experiência e incorpora características positivas identificadas em outros modelos encontrados na prospecção da bibliografia existente na área. Em seguida, na terceira fase, foram efetuados testes de aplicação do modelo, com seis decisores, tomando como referência um cenário de decisão fictício, estabelecido levando em conta as características da cidade de Fortaleza. A captura do sistema de valores dos decisores foi efetuada através de formulários. Os resultados oriundos dos formulários, com o auxílio de software e planilhas eletrônicas, serviram de base para que o modelo apresentasse suas recomendações. Durante as aplicações, os resultados parciais das capturas de conhecimento eram discutidos com os participantes do teste e analisados pelo pesquisador, com o objetivo de verificar se o procedimento deveria sofrer refinamentos ou ajustes. Por fim, na quarta fase, foi realizada uma validação qualitativa do modelo, através de entrevistas e formulários nos quais se discutia se a previsão do modelo seria útil e se coadunava com as expectativas dos decisores. Os resultados obtidos indicam que existe viabilidade para aplicação do modelo proposto, pois o mesmo foi considerado útil e válido pelos decisores dentro do seu contexto de aplicação. Acredita-se que, com o desenvolvimento e aperfeiçoamento da ferramenta proposta, a mesma venha a contribuir de forma significativa para apoiar escolhas de decisores na construção civil, em especial, em situações em que existem dúvidas sobre a tecnologia mais apropriada. Mais ainda, ao estruturar o processo de decisão, a mesma permite que se discutam os parâmetros e valores que influenciam cada decisão, permitindo uma melhor reflexão e consenso entre os intervenientes. / Interests in decreasing pathological manifestations, improve customers’ satisfaction and promote cost reductions are important considerations that, during the design building phase, may increase the complexity of the decision regarding facades cladding technology. The main purpose of the present work is to suggest a decision aid model for technological decisions, in the choice of facades cladding technologies. The research development involved four phases. In the first one, it was studied about how decisions are taken, with stakeholders’ identification, potential action characterization, and problematic definition. In the second phase, it was structured a model in accordance with context interests. The decision aid model considers aspects judged as important by experienced professionals and considers positive characteristics identified by models found in the literature of the area. In the third phase, simulation tests were realized with six decision makers, considering a fictitious project in Fortaleza city. Using formularies, individual values were captured from decision makers. The results collected with the aid of software and electronic sheets served as the basis for model recommendations. During the application of the model, partial results were discussed with decisionmakers and analyzed by the researcher so that they could be refined or adjusted. Finally, in the fourth phase, a qualitative validation was carried through interviews and formularies. This phase verified if the decision aid model was considered useful and valid by decision-makers. It was shown that the proposed tool can significantly contribute to help decision makers in the selection of facades cladding technologies, especially in complex situations. More yet, it can help to structure the decision process, becoming an important the tool for discussing the parameters and values influencing decisions, and helping stakeholders to reach a consensed solution.

Pancreatic cancer is the fourth leading cause of cancer death in Canada. Significant advancements in chemotherapy for advanced pancreatic cancer have resulted in the need for a quantitative comparison between these treatments on a relative scale. Therefore, a systematic review and Bayesian network meta-analysis of randomized clinical trials was conducted using gemcitabine, the standard treatment, as the reference comparator. Based on results from the network meta-analysis, in which optimal treatments were identified and side effects of each treatment evaluated, an Internet-based patient decision aid was developed in order to present the benefits and risks of each therapy option: (1) Best supportive care (2) gemcitabine (3) FOLFIRINOX. The objective of the decision aid was to guide patients through the decision-making process based on their individual preferences and values. The decision aid was deemed to be acceptable and feasible based on results from a pilot study conducted at The Ottawa Hospital Cancer Centre.

In recent years, the accounting profession has faced increased scrutiny because of scandals involving management fraud (e.g., Enron, WorldCom). In response, Statement on Auditing Standards (SAS) #99 has expanded auditors' responsibility for detecting fraud, requiring auditors to gather significantly more information in their assessment of fraud. In addition, the Public Company Accounting Oversight Board (PCAOB) will focus on fraud detection through their inspections of registered accounting firms. In light of the increased emphasis on auditors' responsibility for detecting fraud, public accounting firms face the challenge of improving their fraud detection process, including their assessment of management fraud risk. Decision aids are one way for auditors to improve their assessment of management fraud risk. In fact, several studies from the decision aid literature suggest that aids are useful tools for a variety of tasks, including fraud risk assessment. At the same time, another stream of the decision aid reliance literature, which looks at people's willingness to rely on decision aids, suggests that individuals tend to be reluctant to accept the output given by an aid. Thus, the primary focus of this paper is on uncovering factors that would encourage one to voluntarily use and rely upon a decision aid. Toward that end, 132 senior-level auditors participated in an experiment that examined how several factors (confidence, perceived usefulness, client size, and conformity pressure) affect decision aid usage and reliance. The results show that perceived usefulness and decision aid reliance are significantly related. Further, the results suggest that perceived usefulness affects reliance more than variables examined in prior studies (e.g., confidence). Finally, the results suggest that decision aid usage mediates the relationship between perceived usefulness and reliance. The results of the current study have important implications for research in both the information systems and decision aid reliance areas. First, the study shows that perceived usefulness, a significant construct from the technology acceptance model (TAM) literature, is also a significant factor in determining decision aid usage and reliance. Second, the study further delineates how certain factors affect decision aid reliance.

Purpose. To systematically develop and conduct preliminary evaluation of a decision support intervention to engage patients and their families about whether to accept or decline implantable cardioverter-defibrillator (ICD) pulse generator replacement. Methods. A series of studies using multi-methods and guided by the Ottawa Decision Support Framework and the Normalization Process Theory: 1) an integrative review of patients’ perspectives on ICD decision-making; 2) a systematic review of the risks and benefits of ICD replacement; 3) an embedded mixed methods study to iteratively develop a patient decision aid (PDA) and simultaneously plan for its implementation; and 4) a feasibility pilot randomized controlled trial to evaluate ease of recruitment, decision support intervention delivery and data collection. Findings. The integrative review of 25 articles reported that ICD decision-making was difficult and the majority of patients misunderstood ICD therapy. The systematic review of 17 nonrandomized studies reported that complication rates are higher at replacement as compared to initial implant, mortality benefit post ICD replacement is unclear, and patients’ clinical profile can affect ICD’s effectiveness. Findings from both studies were used to draft a PDA. Interviews with 18 end-users (clinicians, patients, spouses) revealed that the current ICD replacement process is automated and needs to elicit patient preferences. The PDA was considered the optimal tool to initiate the discussion of options. In a feasibility trial, 30 patients were randomized to the decision support intervention (PDA + decision coaching) (n=15) or usual care (n=15). The intervention was used as intended, users found the PDA acceptable but acceptability of decision coaching was variable. Patients exposed to the intervention had better knowledge scores compared to controls. Conclusion. The Ottawa Decision Support Framework and Normalization Process Theory were complementary frameworks to ensure that the decision support intervention has the potential for implementation. To determine whether this approach was successful, future research is required to evaluate and implement the intervention in clinical practice. Findings from the feasibility study will be used to design an effectiveness trial.