Purpose:The thesis will shed light on the overall need of CDSSs in the Swedish health care system,  and  it  will  also  present  a  specific  efficiency  problem  that  could  be  solved  by implementing a CDSS. The need for a CDSS is where an implementation would improve patient outcome, by delivering the right care at the right time, and where the CDSS could reduce the cost of the delivered care. A better understanding of the current need could help eliminate the existing empirical gap and ultimately lead to better and more efficient health care in Sweden. The research question was formulated as: Where within Swedish health care can a need for increased efficiency be met through the implementation of a realistic CDSS system? Design and methodology: The  thesis  is  a  case  study  where qualitative data, collected through a literature review and interviews, was used to answer the research question. The methodology used was tailored to the unique setting of the research and in accordance to the purpose of the study. The method was divided into five phases. (1) Finding an area of focus, such as a specific diagnosis, within the health care system where the need for a CDSS system is deemed high. (2) Mapping the care chain of the identified area of interest. (3) Developing hypotheses concerning where in the care chain challenges could be solved using a clinical decision support system. (4) Confirming or rejecting the proposed hypotheses through interviews with relevant experts. (5) Presenting the specific efficiency problem that could be solved using a CDSS and a presentation of the design of said CDSS. Findings: The efficiency problem that could be solved using a CDSS was identified to be within the area of heart failure treatment. There were a multitude of areas of improvement found along the care chain and a number of them could be solved by developing and using specific CDSSs. A CDSS that could help physicians, within the primary care system, to identify patients that  could benefit from  being  assessed  by  cardiology specialist was  proposed  as  the  most beneficial  CDSS  system.  The  proposed  CDSS  would  be  both  beneficial  and  realistically implementable. / Syftet med uppsatsen är att belysa det övergripande behovet av kliniska beslutsstödssystem inom den svenska vården och slutligen finna det mest trängande behovet. En bättre förståelse för detta behov kan hjälpa att minska det existerande empiriska gapet och slutligen leda till en bättre och mer effektiv vård i Sverige. Forskarfrågan formulerades som uppdraget att finna ett behov för ökad effektivitet inom svensk sjukvård, som kan lösas genom implementering av ett realistiskt kliniskt beslutsstöd. Design och metodologi: Uppsatsen är en casestudie där kvalitativ data, samlad genom en litteraturstudie samt intervjuer, användes för att besvara forskningsfrågan. Metodologin som brukades var anpassad efter den unika naturen för forskningen, samt i enighet med syftet av studien. Metoden delades in i fem faser. (1) Finna ett fokusområde, exempelvis en specifik diagnos, där behovet av ett kliniskt beslutsstöd bedömdes högt. (2) Kartlägga vårdkedjan för den identifierade diagnosen. (3) Utveckla hypoteser angående var inom vårdkedjan som  utmaningar skulle kunna lösas med ett kliniskt beslutsstöd. (4) Bekräfta eller förkasta ypoteserna genom intervjuer med relevanta experter. (5) Presentera problemet med det mest trängande behovet efter ett kliniskt beslutsstöd och hur ett sådans skulle utformas. Fynd: Effektivitetsproblemet som kunde lösas bäst via ett kliniskt beslutsstöd identifierades att vara inom området hjärtsviktsbehandling. Det fanns flertalet områden med utvecklingspotential som urskiljdes ur vårdkedjan för hjärtsviktspatienter, och vissa av dessa utmaningar kunde lösas genom utveckling och implementering av specifika kliniska beslutsstöd. Det kliniska beslutsstöd som skulle lösa det mest trängande behovet inom vården idag föreslås vara ett system som hjälper läkare inom vårdcentralerna att identifiera patienter som skulle gagnas av en remiss till en kardiolog. Det föreslagna kliniska beslutsstödet skulle vara både fördelaktigt för vårdpersonal samt patienter samt är realistiskt implementerbart.

Information visualization dashboards are a widely used supportive tool in decision making. These tools can be difficult to create and utilize especially for the novice user. There is an extensive collection of company related data for decision making, resulting in a need of assistive tools. Prototypes were developed to research and identify design guidelines how to support fund managers in their decision making. This was carried out as a qualitative study involving 7 experts in fund management. The results provide insights and guidelines in decision supportive design for dashboards. The results indicate that there is a threshold in the number of displayed elements without limiting the cognitive analysis by the user. Three aspects; size, distribution and time should be included in the generating of suitable graphics. Assistive tools for connecting multiple context domains has been identified as a crucial element of decision support design. These guidelines should be investigated further in larger and more diverse studies in order to prove its full validity. / Information visualiserings dashboards är ett väl etablerat verktyg i beslutsfattning. Sådana verktyg kan vara utmanande att skapa och använda speciellt för en oerfaren användare. Idag samlas det in stora mängder av företagsrelaterad data för beslutsfattning vilket resulterar i ett behov av hjälpande verktyg. I den här studien utvecklades flera prototyper för att undersöka och tag fram designriktlinjer för hur man ska utforma och hjälpa fondförvaltare i sitt beslutsfattande. En kvalitativ studie genomfördes med 7 experter inom fond och kapitalförvaltning i framtagandet av designriktlinjer. Resultaten visar riktlinjer för beslutsstöd i utformningen av dashboards. Resultaten indikerar att det finns en gräns för hur många element man bör presentera för en användare utan att försvåra användarens kognitiva analysförmåga. Tre karaktärsdrag; storlek, distribution och tid påverkar utformningen av passande grafik. Studien har även identifierat behovet av verktyg för sammankopplingen mellan flera olika kontextdomäner i och med den kollaborativa delen av beslutsfattning. Dessa designriktlinjer ligger till grund för fortsatt undersökning i större och mer varierade studier för att styrka dess validitet.

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Advances in microprocessor and communications technologies are making it possible to deploy advanced traffic signal controllers capable of integrating emergency vehicle preemption and transit priority operations. However, investment planning for such an integrated system is not a trivial task. Investment planning for such a system requires a holistic approach that considers institutional, technical and financial issues from a systems perspective. Two distinct service providers, fire and rescue providers and transit operators, with separate operational functions, objectives, resources and constituents are involved. Performance parameters for the integrated system are not well defined and performance data are often imprecise in nature. Transportation planners and managers interested in deploying integrated emergency vehicle preemption and traffic priority systems do not have an evaluation approach or a common set of performance metrics to make an informed decision. There is a need for a simple structured analytical approach and tools to assess the impacts of an integrated emergency vehicle preemption and transit priority system as part of investment decision making processes. This need could be met with the assistance of a decision support system (DSS) developed to provide planners and managers a simple and intuitive analytical approach to assist in making investment decisions regarding emergency vehicle preemption and transit signal priority. This dissertation has two research goals: (1) to develop a decision support system framework to assess the impacts of advanced traffic signal control systems capable of integrating emergency vehicle preemption and transit signal priority operations for investment planning purposes; and (2) to develop selected analytical tools for incorporation into the decision support system framework. These analytical tools will employ fuzzy sets theory concepts, as well as cost and accident reduction factors. As part of this research, analytical tools to assess impacts on operating cost for transit and fire and rescue providers have been developed. In addition, an analytical tool was developed and employs fuzzy multi-attribute decision making methods to rank alternative transit priority strategies. These analytical tools are proposed for incorporation into the design of a decision support system in the future. / Ph. D.

A decision support system for preventive integrated pest management (IPM) and nonpoint source (NPS) pollution control was designed, implemented and evaluated. The objective of the system was to generate plans at the farm level to satisfy economic and production goals while limiting risks of insect pest outbreaks, nitrate and pesticide leaching and runoff, and soil erosion. The system is composed of a constraint satisfaction planner (CROPS-LT), a modified version of CROPS (Stone, 1995), a farm-level resource management system (FLAME), an NPS module, which includes a weather generator, CLIGEN (Nicks et al. 1995), and an NPS distributed-parameter model, ANSWERS (Bouraoui, 1994), databases, a database engine and utility programs. The performance of the system was analyzed and performance enhancing features were added to increase the planner's ability to find near-optimal plans within a limited planning time. Using heuristics to sort potential crop rotations based on profit generally improved the planner's performance, as did removal of fields that were not suitable for growing target crops. Not surprisingly, the planner was best able to find plans for crops that can be grown in a variety of rotational systems. Throughout, the ability to apply environmental constraints selectively to individual fields greatly improved the planner's ability to find acceptable plans. Preventive IPM (PIPM) heuristics to control corn rootworms CRW (<I>Diabrotica virgifera virgifera</I> and <I>D. barberi</I>) were added to the planner. The model was represented and solved as a constraint satisfaction problem. Results indicated that plans obtained using PIPM heuristics had less risk of CRW damage, reduced chemical control costs, higher profit and reduced soil erosion as compared to a control plan. Linking the planner to the NPS model in a feedback control loop improved the planner's ability to reduce soil losses while preserving economic and production goals. / Ph. D.

There is a body of evidence indicating that the implementation of current Architecture, Engineering, and Construction (AEC) industry business models and practices have caused negative impacts on global energy supply, ecosystems, and local or regional economies. In order to eliminate such negative impacts, AEC practitioners are seeking new business models in which the Building Information Modeling (BIM) technology can be considered an important technology driver. Despite the fact that the majority of AEC practitioners have used BIM tools for construction-level modeling purposes, some early adopters of BIM technology began to use BIM tools to better inform their design decisions. Corresponding to the increasing demand for decision support functionality, a number of studies showed that a part of BIM technology will be developed toward decision support and artificial intelligence domains. The use of computer-based systems to support decision making processes can usually be found in the business management field. In this field, decision support and business intelligence systems are widely used for improving the quality of managerial decisions. Because of its theories and principles, Decision Support Systems (DSS) can be considered as one of the potential information technologies that can be applied to enhance the quality of design decisions. The DSS also has the potential to be constructed as a system platform for implementing building information contained in BIM models associated with other databases, analytical models, and expert knowledge used by AEC practitioners. This study explores an opportunity to extend the capability of BIM technology toward the decision support and artificial intelligence domains by applying the theories and principles of DSS. This research comprises the development of a prototype BIM interoperable web-based DSS for vegetated roofing system selection. The prototype development can be considered a part of an ongoing research agenda focusing on the development of the integrated web-based DSS for holistic building design conducted within the College of Architecture and Urban Studies (CAUS), Virginia Tech. Through a post-use interview study, the developed prototype is used as a tool for evaluating the possibility for the DSS development and the usefulness of DSS in improving the quality of vegetated roofing system design decisions. The understanding gained from the post-use study is used to create a guideline for developing a fully functional DSS for holistic building design that will be developed in the future. / Ph. D.

Many concrete problems may be cast in a multi-objective optimisation framework. The redundancy of existing methods for solving multi-objective programming problems susceptible to inconsistencies, coupled with the necessity for making in- herent assumptions before using a given method, make it hard for a nonspecialist to choose a method that ¯ts the situation at hand well. Moreover, using a method blindly, as suggested by the hammer principle (when you only have a hammer, you want everything in your hand to be a nail) is an awkward approach at best and a caricatural one at worst. This brings challenges to the design, development, implementation and deployment of a Decision Support System able to choose a method that is appropriate for a given problem and to apply the chosen method to solve the problem under consideration. The choice of method should be made according to the structure of the problem and the decision maker's opinion. The aim here is to embed a sample of methods representing the main multi-objective programming techniques and to help the decision maker find the most appropriate method for his problem. / Decisions Sciences / M. Sc. (Operations Research )

Dissertation (PhD)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: Municipal water distribution maintenance is very important for sustainable urban development. Water pipe breaks result not only in a disruption in service but also in significant loss of water, which otherwise could have been sold to the consumer. In countries where water is scarce, such as South Africa, water losses can be detrimental to the living standard of people. Water pipe breaks can furthermore cause extensive damage to nearby lower-lying properties. Existing decision support systems available in the field of water distribution system maintenance are mainly focused on leak detection and pipe rehabilitation/replacement strategy. These existing systems, however, do not address the actual causes of pipe breaks and pipe break impact is also not supported. The aim of this research is to develop a spatial decision support system (SDSS) for pipe break susceptibility analysis and impact assessment. The engineer (or public works administrator) can apply the SDSS to model the complex pipe break phenomena in the municipal water distribution system. The SDSS can identify pipes susceptible to breaking and pipes with potentially high break impact as far as water loss and damage caused to nearby property are concerned. This combined pipe break susceptibility analysis and potential impact assessment should promote more informed decision-making on preventative maintenance measures to be taken and their prioritisation. The dissertation consists offive parts. In the first part (Chapters 1-4) theories on information systems, fuzzy logic, object-oriented modelling, Unified Modelling Language (UML) and pipe break causes are presented. This literature review provides a basis on which the SDSS for pipe break susceptibility analysis and impact assessment can be developed. In the second part (Chapter 5) the general user requirements and design of the SDSS are given. The general SDSS architecture, the general system functionality and the user interface are described and designed in this part of the dissertation. The third part (Chapter 6) provides the detailed user requirements and design of the subsystems of the SDSS. Specialised functionality for pipe break susceptibility analysis and impact assessment is added to the general design of the SDSS. Subsystems are designed for analysing the pipe break susceptibility due to age, air-pocket formation and tree-root attack. Pipe break impact assessment subsystems are also designed for assessing water loss and potential damage caused to nearby property. Finally, a combined analysis subsystem is designed for combined pipe break susceptibility analysis and impact assessment. In the fourth part (Chapter 7), the SDSS is applied to the water distribution system of the Paarl Municipality to identify pipes in the network that have both high break susceptibility and also high break impact. The pipe break susceptibility analysis model of the SDSS is also tested and calibrated by comparing the model results with actual pipe break occurrence data of the study area. The final chapter (Chapter 8) contains the summary and recommendations regarding the functionality of the newly developed SDSS. / AFRIKAANSE OPSOMMING: Die instandhouding van munisipale waterverspreidingstelsels is uiters belangrik vir volhoubare stedelike ontwikkeling. Waterpypbreuke lei nie alleenlik tot onderbreking in diensverskaffing nie, maar ook tot beduidende waterverlies en verlies aan inkomste uit waterverkope. In lande waar water skaars is, soos in Suid-Afrika, kan waterverliese die lewenstandaard van die bevolking nadelig beïnvloed. Waterpypbreuke kan ook groot skade aan naby-geleë laag-liggende eiendomme aanrig. Besluitnemingstelsels tans beskikbaar op die gebied van instandhouding van waterverspreidingstelsels is hoofsaaklik gerig op lekkasie-opsporing en pyprehabilitasie- en pypvervangingstrategieë. Hierdie bestaande stelsels spreek egter nie die eintlike oorsake van pypbreuke aan nie, daar word ook nie op die impak van pypbreuke ingegaan nie. Die doelwit van hierdie navorsing is om 'n ruimtelike besluitnemingstelsel (RBS) - vir pypbreuk-risiko-analise en impakberaming te ontwikkel. Die ingenieur (of stelselbestuurder) kan met behulp van die RBS die komplekse pypbreukverskynsel in 'n munisipale waterverspreidingstelsel modelleer. Die RBS kan pype met hoë breek-potensiaal identifiseer asook pype wat, indien dit breek, groot waterverlies of skade aan naby-geleë eiendomme sal veroorsaak. Hierdie gekombineerde pypbreuk-risiko-analise en impakberaming behoort meer oordeelkundige besluitneming te bevorder deur beter prioritisering van voorkomende instandhoudingsmaatreëls en die uitvoering daarvan. Die proefskrif bestaan uit vyf dele. In die eerste deel (Hoofstukke 1-4) word die teorieë oor inligtingstelsels, 'fuzzy logic', objek-georiënteerde modellering, 'unified modelling language (UML)' en die oorsake van pypbreuke behandel. Hierdie literatuurstudie skep die basis waaruit die RBS vir pypbreukrisikobepaling en impakberaming ontwikkel sal word. In die tweede deel (Hoofstuk 5) word die algemene gebruikersbehoeftes en die ontwerp van die RBS uiteengesit. Die algemene RBS struktuur en die gebruikerskoppelvlak word in hierdie deel van die proefskrif beskryf en ontwerp. In die derde deel (Hoofstuk 6) word die gedetailleerde gebruikersbehoeftes en die ontwerp van die substelsels van die RBS uiteengesit. Gespesialiseerde funksionaliteit vir pypbreuk-risikobepaling en impakberaming is tot die algemene ontwerp van die RBS bygevoeg. Substelsels is ontwerp vir die ontleding van pypbreuk-risiko as gevolg van ouderdom, lugblaas-vorming en boomwortelaanval. Substelsels vir impakberaming is ook ontwerp om waterverlies en potensiële skade aan eiendomme vas te stel. Ten slotte word 'n gekombineerde ontledingsubstelsel vir gekombineerde pypbreuk-risikobepaling en impakberaming opgestel. In die vierde deel (Hoofstuk 7) word die RBS toegepas op die waterverspreidingstelsel van die Paarlse munisipaliteit om pype uit te ken wat beide 'n hoë breuk-risiko en 'n hoë breuk-impak bevat. Die pypbreuk-analise model van die RBS is ook getoets en gekalibreer deur die resultate van die model te vergelyk met data van werklike pypbreuke in die studiegebied. Die laaste hoofstuk (Hoofstuk 8) bevat die samevatting en die aanbevelings rakende die funksionaliteit van die voorgestelde RBS.