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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
111

Perspective maternelle de la consultation anténatale pour travail préterme : une approche relationnelle

Orr Gaucher, Nathalie 07 1900 (has links)
Une femme à risque d’un accouchement prématuré vit un enjeu de santé très éprouvant et stressant ; elle sera souvent hospitalisée pour recevoir des traitements médicaux visant à prolonger la grossesse et améliorer le pronostic du bébé. Dans ce contexte, une consultation avec un néonatalogiste est demandée. Plusieurs associations professionnelles médicales ont émis des lignes directrices sur cette consultation, insistant sur le besoin d’informer les parents au sujet des complications potentielles de la prématurité pour leur enfant. Ces recommandations s’inspirent du point de vue médical, et très peu d’études ont examiné la perspective, les attentes et les besoins des parents à risque d’un accouchement prématuré. Ce projet de thèse a pour objectif de proposer un modèle de relation médecin-patient informé de la perspective maternelle de la consultation anténatale, pour développer une approche clinique répondant à leurs besoins. Afin d’examiner cette problématique de façon complète, un travail constant de va-et-vient a été effectué entre la recension de données empiriques et une réflexion normative bioéthique féministe. Un projet de recherche empirique a d’abord permis d’explorer les attentes et le vécu de ces femmes. Les participantes espéraient recevoir plus que de l’information sur les complications de la prématurité. Elles souhaitaient que le néonatologiste soit attentif à leur situation particulière et qu’il développe une relation de confiance avec elles, leur permettant d’explorer leurs futurs rôles de mères et les encourageant à formuler leurs propres questions. Le cadre théorique féministe d’autonomie relationnelle a ensuite permis de proposer une approche de soin qui sache répondre aux besoins identifiés par les patientes, tout en adressant des enjeux de pouvoir intrinsèques à la clinique, qui influencent la santé et l’autonomie de ces femmes. Cette approche insiste sur l’importance de la relation de soin en clinique, contrastant avec un modèle encourageant une vision réductrice de l’autonomie, dans laquelle un simple transfert de données scientifiques serait équivalent au respect de la norme médicolégale du consentement éclairé. Ce modèle relationnel propose des actions concrètes et pratiques, encourageant les cliniciens à entrer en relation avec chaque patiente et à considérer l’influence qu’ils exercent sur l’autonomie relationnelle de leurs patientes. / Women at risk of preterm labour experience a highly stressful situation for which they are often hospitalised to receive the medical care required to delay their baby’s birth or to improve his outcome. Professional medical associations have published guidelines encouraging consultations with a neonatologist in these contexts. These emphasize informing parents about prematurity’s potential complications and outcomes. However, they are based on expert medical opinions, and little is known about parents’ perspectives of the antenatal consultation for preterm labour. This thesis proposes to elaborate a clinical model of a physician-patient relationship, grounded in mothers’ experiences and expectations from the antenatal consultation for preterm labour. In order to offer a comprehensive analysis of this clinical and ethical issue, both empirical data and a normative feminist bioethical framework were used. An empirical quantitative research project was first conducted to explore women’s experiences and their expectations regarding the antenatal consultation. Participants hoped to receive more than information from the antenatal consultation for preterm labour. Indeed, they hoped the neonatologist would strive to understand their unique and distinctive situations. They wanted the physician to develop trusting relationships, in which they would be enabled to ask questions important to them and in which many topics could be discussed – such as their roles as mothers of a premature baby. A feminist theory of relational autonomy was then used to examine this data. An approach to care responsive to women’s experiences is suggested, which considers not only their individual needs, but which is also critical of the many power imbalances inherent to the clinical setting that influence patients’ health and autonomy. This approach emphasizes the importance of relationships in the physician-patient encounter; it offers a striking contrast to consultation models that endorse a minimal conception of patient autonomy, in which the simple transfer of medical knowledge and data is believed to uphold the legal doctrine of informed consent. This relational model suggests practical and tangible means for physicians to engage in relationships with their patients and to consider the influence they have on their patients’ relational autonomy.
112

Health economic evaluation of alternatives to current surveillance in colorectal adenoma at risk of colorectal cancer

McFerran, Ethna January 2018 (has links)
The thesis provides a comprehensive overview of key issues affecting practice, policy and patients, in current efforts for colorectal cancer (CRC) disease control. The global burden of CRC is expected to increase by 60% to more than 2.2 million new cases and 1.1 million deaths by 2030. CRC incidence and mortality rates vary up to 10-fold worldwide, which is thought to reflect variation in lifestyles, especially diet. Better primary prevention, and more effective early detection, in screening and surveillance, are needed to reduce the number of patients with CRC in future1. The risk factors for CRC development include genetic, behavioural, environmental and socio-economic factors. Changes to surveillance, which offer non-invasive testing and provide primary prevention interventions represent promising opportunities to improve outcomes and personalise care in those at risk of CRC. By systematic review of the literature, I highlight the gaps in comparative effectiveness analyses of post-polypectomy surveillance. Using micro-simulation methods I assess the role of non-invasive, faecal immunochemical testing in surveillance programmes, to optimise post-polypectomy surveillance programmes, and in an accompanying sub-study, I explore the value of adding an adjunct diet and lifestyle intervention. The acceptability of such revisions is exposed to patient preference evaluation by discrete choice experiment methods. These preferences are accompanied by evidence generated from the prospective evaluation of the health literacy, numeracy, sedentary behaviour levels, body mass index (BMI) and information provision about cancer risk factors, to highlight the potential opportunities for personalisation and optimisation of surveillance. Additional analysis examines the optimisation of a screening programme facing colonoscopy constraints, highlighting the attendant potential to reduce costs and save lives within current capacity.
113

臺灣地區國民小學學校本位決策與校長領導方式、教師工作滿意度之關係研究

閻自安 Unknown Date (has links)
本研究主要目的為:一、了解學校本位決策的意義、目的、特色、原則與倡導理由,以及哲學、社會學與心裡學理論基礎。二、探索學校本位決策的歷史沿革與典範轉移。三、分析國內外學校本位決策的實施概況與困境,並探索推動學校本位決策的可行策略。四、找出可供檢視學校本位決策符合程度的因素,並探討此因素與校長領導方式、教師工作滿意度的關係。五、根據學校本位決策的相關文獻與國內學校本位決策情形的實證研究,提出可供參考的建議。 本研究以自編「學校本位決策工作環境知覺問卷」為工具,抽取臺灣地區160所公、私立國民小學973位教師為對象,調查其所任教學校符合學校本位決策的現況,以及校長領導方式、教師工滿意度的情形,並探究三者間的關係。本研究將學校本位決策分為「決策參與」、「決策自主」、「決策尊重」、「團體決策」與「家長參與」等五個向度,將校長領導方式分為「民主」與「威權」兩個向度,而將教師工作滿意度區分為「行政管理」、「工作本身」、「校長領導」與「同僚關係」等四個向度。 本研究主要研究發現如下: 一、國小校務決策方式符合學校本位決策的程度 1.學校本位決策情形大致符合。 2.決策自主程度最高,決策尊重程度最低。 3.參與班級事務的決策較多,參與學校事務的決策較少。 4.小型學校的學校本位決策程度高於中、大型學校。 5.女校長領導的學校,其學校本位決策程度高於男校長領導的學校。 6.院轄市的學校,其學校本位決策情形高於省縣轄市與鄉鎮離島的學校。 二、校長領導方式與學校本位決策的關係 1.校長領導方式愈民主,則學校本位決策愈易塑造。 2.校長領導方式愈威權,則學校本位決策愈難塑造。 三、學校本位決策與教師工作滿意度的關係 1.學校本位決策程度愈高,則教師的工作滿意度也愈高。 2.學校決策參與的程度愈高,則教師對行政管理與校長領導的滿意度也愈高。 3.學校決策自主的程度愈高,則教師對行政管理、工作本身、校長領導與同僚關係的滿意度也愈高。 4.學校愈尊重教師的決策,則教師對行政管理與校長領導的滿意度也愈高。 5.學校採用團體決策的程度愈高,則教師對行政管理、工作本身與同僚關係的滿意度也愈高。 6.家長參與學校決策的程度愈高,則教師對校長領導的滿意度也就愈低。 四、校長領導方式、學校本位決策與教師工作滿意度的整體關係 1.校長的民主領導取向會影響學校本位決策情形,而學校本位決策情形也會影響教師的工作滿意度。 2.民主領導較會影響決策參與、自主、尊重、團體決策與家長參與,而威權領導僅會影響決策參與和尊重。 3.決策自主較會影響教師對行政管理、工作本身、校長領導與同僚關係的滿意度,而團體決策影響教師對同僚關係的滿意度,家長參與會影響教師對校長領導的滿意度。 本研究並對學校、教育行政單位與未來研究方向提供以下幾點建議: 一、對學校的建議: 1.領導者應加強民主領導能力的培養,避免採用威權的領導方式;2.給予教師更多自主決策的空間,以提升教師的工作滿意度;3.加強團隊合作,以提高教師的工作滿意度;4.鼓勵家長適度參與,建立親師合作的伙伴關係;5.調整校長的角色扮演,以利學校本位決策的實施;6.授權教師或學生參與決策,減少行政管理上的衝突。 二、對教育行政單位的建議: 1.實施學校本位決策,以提升教師工作滿意度;2.發展小型學校,以利學校本位決策的推行;3.提高非都市地區的決策自主與家長參與,以均衡城鄉決策品質的差異;4.實施學校本位決策時,應以學生學習效果的提高為目標,而非爭奪權力;5.確立中央、地方與學校的權限與責任劃分;6.在開放參與的同時,應強化配套措施的設計。 三、對未來研究的建議: 1.在研究對象方面--擴大研究的群體;2.在研究方法方面--深化研究的脈絡;3.在研究工具方面--增加決策的向度;4.在研究變項方面--探討其他變項的關連。 / The purposes of the study were (1) to understand meanings, objectives, characteristics, principles, reasons of advocacy and theoretical perspectives of school-based decision making(SBDM); (2) to inquiry into the historical development of SBDM;(3) to analyze its difficulties and strategies when implementing SBDM; (4) to address the relationships among SBDM, the principal's leadership, and teachers' job satisfaction; (5) to propose suggestions based on results. A questionnaire developed in the study was mailed to a total sample of 973 respondents in 160 elementary schools. The relationships among SBDM, principal's leadership style, and teachers' job satisfaction were inquired. From the statistical analysis of the results, the main findings of this study were drawn: 1.It accords with SBDM above average level in the elementary school. Teachers get the most autonomy and the least respect in the process of participation in school decision making. Teachers participate in work-level decisions more than organizational-level decisions. Small schools are more accordant with SBDM than middle schools and large schools. A schools led by a female principal is more accordant with SBDM than a school led by a male principal. Schools in metropolitans are more accordant with SBDM than schools in prefectures, cities, towns, and islands. 2.A principal is more democratic, the school led by him is more accordant with SBDM. Adversely, a principal is more authoritative, the school led by him is less accordant with SBDM. 3.It is more accordant with SBDM in the elementary school, teachers' job satisfaction is greater. Teachers participate in decision making more often, and they feel more satisfactory about school administrative management and principal's leadership. Teachers participate in decision making more autonomous, and they feel more satisfactory about school administrative management, work, principal's leadership, and colleague relationships. Teachers have the respect of the school to participate in decision making more often, and teachers feel more satisfactory about school administrative management and principal's leadership. Teachers make decision through teamwork more often, and they feel more satisfactory about school administrative management, work, and colleague relationships. Parents participate in decision making more often, but teachers feel less satisfactory about school administrative management, work, and colleague relationships. 4.Democratic leadership influences the success of SBDM, and the implementation of SBDM influences teachers' job satisfaction. Democratic leadership increases participative decision making, autonomous decision making, respectful decision making, group decision making, and parents participation. Authoritative leadership decreases participative decision making and respectful decision making. Autonomous decision making influences teachers' job satisfaction about school administrative management, work, principal leadership, and colleague relationship. Group decision making influences teachers' job satisfaction about colleague relationships. Parents participation influences teachers' job satisfaction about principal's leadership. Suggestions for the elementary schools, educational administrative institutions, and future study are provided. Firstly, six suggestions for the elementary schools are as follow: 1.Cultivate democratic leadership;2.Make teachers participate in decision making more autonomous;3.Encourage teamwork;4.Let parents participate in decision making moderately, so build parents-teacher partnership;5.Adjust the principal leadership to feminine leadership style. 6. Include teachers and students in the decision making processes of schooling. Secondly, six suggestions for educational administrative institutions are as follow: 1.Implement SBDM to increase teachers' job satisfaction;2.Diminish scale of a school to make SBDM succeed more easily;3.Let decision making more autonomous and parents participation more often in non-metropolitans;4.Focus the main goal of SBDM on increasing student learning;5.Identify authority and power of the central office, local areas, and schools;6.Implement SBDM along with other relative policies. Finally, four suggestions for future study are as follow: 1.Enlarge scopes of population;2.Adopt much more 0research methods;3.Increase dimensions of participation;4.Study more relative variables with SBDM.
114

'n Model vir leerlingdeelname aan skoolbestuur / Jurgens Johannes Kok

Kok, Jurgens Johannes January 2000 (has links)
Since the democratic election in 1994 and the publishing of the SA Schools Act on the 16th of November 1996 the South African education system has undergone a fundamental transformation. Pupils are regarded as a specific interest group that stands in a partnership relationship with other interest groups (stakeholders) in the school. The principle of partnership advocated by the South African Schools Act invites pupils to partake in and share responsibility for the governance, organising and funding of public schools. To participate in school management pupils have to be part of participative structures. Two such structures for pupil participation and representation exist in South African schools, namely SRC's and the governing body of the school. The aim of this research is to develop a model for pupil participation in the management of schools and specific attention was given to participative management of pupils on the SRC and governing body of the school. In order to operationalize the above mentioned aim an analysis of the nature of participative management by pupils was done on the basis of theoretical approaches to participative management. Participative management by pupils can only be successful if the following participative management techniques namely pupil participation, pupil empowerment, influence. participative decision-making, delegation, democracy, decentralization, committees and meetings are interwoven with the participative management process. Pupil participation can also be successful if the advantages of such participation is realised by all school interest groups. The structure and functioning of pupil participation in the management activities of the school is reviewed firstly by giving attention to the practices of pupil participation in the education systems of a few international countries. This is done by analizing the structure of each education system, the statutory directives for pupil participation and the structures for pupil participation in these education systems. Secondly the managerial involvement of pupils in the management activities of SRC's and the governing bodies of schools was reviewed, while certain lacunas that resulted from the lack of information were addressed by empirical research. As a result of the preceding criteria a model for pupil participation in school management was developed and certain findings and recommendations were derived from it. / Thesis (Ph.D.)--Potchefstroom University for Christian Higher Education, 2000
115

'n Model vir leerlingdeelname aan skoolbestuur / Jurgens Johannes Kok

Kok, Jurgens Johannes January 2000 (has links)
Since the democratic election in 1994 and the publishing of the SA Schools Act on the 16th of November 1996 the South African education system has undergone a fundamental transformation. Pupils are regarded as a specific interest group that stands in a partnership relationship with other interest groups (stakeholders) in the school. The principle of partnership advocated by the South African Schools Act invites pupils to partake in and share responsibility for the governance, organising and funding of public schools. To participate in school management pupils have to be part of participative structures. Two such structures for pupil participation and representation exist in South African schools, namely SRC's and the governing body of the school. The aim of this research is to develop a model for pupil participation in the management of schools and specific attention was given to participative management of pupils on the SRC and governing body of the school. In order to operationalize the above mentioned aim an analysis of the nature of participative management by pupils was done on the basis of theoretical approaches to participative management. Participative management by pupils can only be successful if the following participative management techniques namely pupil participation, pupil empowerment, influence. participative decision-making, delegation, democracy, decentralization, committees and meetings are interwoven with the participative management process. Pupil participation can also be successful if the advantages of such participation is realised by all school interest groups. The structure and functioning of pupil participation in the management activities of the school is reviewed firstly by giving attention to the practices of pupil participation in the education systems of a few international countries. This is done by analizing the structure of each education system, the statutory directives for pupil participation and the structures for pupil participation in these education systems. Secondly the managerial involvement of pupils in the management activities of SRC's and the governing bodies of schools was reviewed, while certain lacunas that resulted from the lack of information were addressed by empirical research. As a result of the preceding criteria a model for pupil participation in school management was developed and certain findings and recommendations were derived from it. / Thesis (Ph.D.)--Potchefstroom University for Christian Higher Education, 2000
116

Exploring effective decision-making of principals in secondary schools in the Free State province

Mokoena, Sello P. 30 November 2003 (has links)
In a democratic South Africa, a variety of factors are necessary to ensure effective school governance and management. One of these factors is shared decision-making (SDM). SDM is a process of making decisions in a collaborative manner at the school level. Those responsible for implementing a decision must be actively and legitimately involved in making the decision. In South African schools today, SDM is no longer an option. The new framework of SDM is embedded in the South African Schools Act (Act 84 of 1996). According to the Act, parents, learners and teachers should be given the opportunity of participating in decisions on educational matters. In this study, the researcher set out to investigate and explore effective decision-making of secondary school principals in the Thabo Mofutsanayana Education District (THMOED) of the Free State Province. In an endeavour to realize that end, an open-ended questionnaire, individual and focus group interviews were used to collect data. The main aim was to find out how teachers, learners, parents and principals experienced decision-making in their schools. The main findings of this research were that, decisions-making practices in the secondary schools in the THMOED still adhered to pre-democratic formal lines of authority. In other words, the locus of control and decision-making powers resided mainly with the principals, with minimum participation of other stakeholders. Consequently, there were dissatisfactions and concerns raised by the participants. The concerns were directed at the management and included lack of communication, lack of transparency, unacceptable disciplinary procedures, autocratic leadership styles and centralized decision-making. According to the findings, it would appear that democratic models of governance were insufficiently used or overlooked by the principals. Concerns raised by the respondents were a clear indication that much needed to be done to change the mind-set of the principals. / Educational Studies / D.Ed (Education Management)
117

The role of the principal in managing work-related stress among secondary school educators

Naicker, Soobramoney Govindsamy 11 1900 (has links)
Educator stress is a major problem worldwide. This study focuses on the role of the principal in the secondary school in providing support and assisting educators manage work-related stress, with particular reference to schools in Kwa-Zulu Natal, South Africa. The problem was investigated by means of a literature study and empirical investigation. The literature identified perspectives on educators' stress, the stress process of the educator and the principal, causes of work-related stress in educators and coping strategies. Furthermore, principals' leadership styles, theories of motivation and causes of principals' stress were discussed. A qualitative inquiry using focus group interviews was undertaken with a small sample of secondary school educators selected by purposeful sampling. Findings suggested that educator stress was caused by a lack of learner discipline; deterioration in educational standards; workload; policy changes; promotion procedures and the principal's leadership style. Based on the findings, recommendations were made for improvement of practice. / Educational Studies / M. Ed. (Education Management)
118

South African principals' perceptions of shared leadership and its relevance for school discipline

Mtsweni, Jim 06 1900 (has links)
This study focuses on the South African principals’ perceptions of shared leadership and its relevance for school discipline. In a mainly qualitative investigation, empirical data from ten secondary schools in the Nkangala District of the Mpumalanga Province were collected by means individual interviews and observation. These data were analyzed in accordance with accepted procedures for qualitative data processing. The preponderance of evidence collected in this study indicates that school principals indirectly contribute to school effectiveness and learner achievement through actions they take to influence what happens in the schools and classrooms. The skillful leadership of school principals is a key contributing factor when it comes to explaining successful change, school improvement, or school effectiveness. Schools should provide a stable, caring environment for all learners, irrespective of whether they are working with support or indifference of families. The role of the schools in relation to learners’ cultural and social differences should be supportive. Shared leadership is regarded as the state or quality of mutual influence in which team members disperse the leadership role through the group, participate in the decision-making processes, fulfill functions traditionally reserved for hierarchical leaders, and when appropriate, provide guidance to others to achieve group goals and objectives. The relevant stakeholders should work collaboratively in the education of learners. Principals and educators must understand that their traditional roles have changed and improved organizational teamwork will be fostered by all members of the learning community assuming decision-making roles. For the haul of school improvement school principals have to develop and expand their leadership repertoires. The collaborative process in shared school leadership should offer the opportunity for educators, learners, parents and the other stakeholders to study, to learn about shared leadership and also to share and to enact leadership. The management of discipline in schools is central to effective teaching and learning. A school that does not have an effective discipline policy (that includes strategies and support mechanisms that are available to all the members of the school community) and that does not maintain a climate of sound discipline, will not function as a centre for teaching and learning. The process of implementing a discipline policy should involve collaborative decision-making. All relevant stakeholders of the school community should have the opportunity to participate in the decision-making process. The study confirmed most of the views found in the existing body of knowledge on shared leadership and its relevance for school discipline. In the thesis, detailed attention is paid to the challenges those principals who were interviewed, experienced, and to the perceived origin of those challenges and suggested solutions. To conclude the study, a model for exercising sound school discipline through shared school leadership, including ten strategies to promote the implementation of shared school leadership in secondary schools, were proposed. / Educational Leadership and Management / D. Ed. (Education Management)
119

Prise de décision quant au devenir d’une grossesse compliquée par une anomalie fœtale sévère : facteurs impliqués, impacts et considérations éthiques

Taillefer, Catherine 06 1900 (has links)
No description available.
120

Data-based Therapy Recommender Systems

Gräßer, Felix Magnus 10 November 2021 (has links)
Für viele Krankheitsbilder und Indikationen ist ein breites Spektrum an Arzneimitteln und Arzneimittelkombinationen verfügbar. Darüber hinaus stellen Therapieziele oft Kompromisse zwischen medizinischen Zielstellungen und Präferenzen und Erwartungen von Patienten dar, um Zufriedenheit und Adhärenz zu gewährleisten. Die Auswahl der optimalen Therapieoption kann daher eine große Herausforderung für den behandelnden Arzt darstellen. Klinische Entscheidungsunterstützungssysteme, die Wirksamkeit oder Risiken unerwünschter Arzneimittelwirkung für Behandlungsoptionen vorhersagen, können diesen Entscheidungsprozess unterstützen und \linebreak Leitlinien-basierte Empfehlungen ergänzen, wenn Leitlinien oder wissenschaftliche Literatur fehlen oder ungeeignet sind. Bis heute sind keine derartigen Systeme verfügbar. Im Rahmen dieser Arbeit wird die Anwendung von Methoden aus der Domäne der Recommender Systems (RS) und des Maschinellen Lernens (ML) in solchen Unterstützungssystemen untersucht. Aufgrund ihres erfolgreichen Einsatzes in anderen Empfehlungssystemen und der einfachen Interpretierbarkeit werden zum einen Nachbarschafts-basierte Collaborative Filter (CF) an die besonderen Anforderungen und Herausforderungen der Therapieempfehlung angepasst. Zum anderen werden ein Modell-basierter CF-Ansatz (SLIM) und ein ML Algorithmus (GBM) erprobt. Alle genannten Ansätze werden anhand eines exemplarischen Therapieempfehlungssystems evaluiert, das auf die Behandlung der Autoimmunkrankheit Psoriasis abzielt. Um das Risiko der Empfehlung kontraindizierter oder gar gesundheitsgefährdender Medikamente zu reduzieren, werden Regeln aus evidenzbasierten Leitlinien und Expertenempfehlungen implementiert, um solche Therapieoptionen aus den Empfehlungslisten herauszufiltern. Insbesondere die Nachbarschafts-basierten CF-Algorithmen zeigen insgesamt kleine durchschnittliche Abweichungen zwischen geschätztem und tatsächlichem Therapie-Outcome. Auch die aus den Outcome-Schätzungen abgeleiteten Empfehlungen zeigen eine hohe Übereinstimmung mit der tatsächlich angewandten Behandlung. Die Modell-basierten Ansätze sind den Nachbarschafts-basierten Ansätzen insgesamt unterlegen, was auf den begrenzten Umfang der verfügbaren Trainingsdaten zurückzuführen ist und die Generalisierungsfähigkeit der Modelle erschwert. Im Vergleich mit menschlichen Experten sind alle untersuchten Algorithmen jedoch hinsichtlich Übereinstimmung mit der tatsächlich angewandten Therapie unterlegen. Eine objektive und effiziente Bewertung des Behandlungserfolgs kann als Voraussetzung für ein erfolgreiches ``Krankheitsmanagement'' angesehen werden. Daher wird in weiteren Untersuchungen für ausgwählten klinische Anwendungen der Einsatz von ML Methoden zur automatischen Quantifizierung von Gesunheitszustand und Therapie-Outcome erprobt. Zusätzlich, als weitere Quelle für Informationen über Therapiewirksamkeiten, wird der Einsatz von Sentiment Analysis Methoden zur Extraktion solcher Informationen aus Medikamenten-Bewertungen untersucht. / Under most medical conditions and indications, a great variety of pharmaceutical drugs and drug combinations are available. Beyond that, trade-offs need to be found between the medical requirements and the patients' preferences and expectations in order to support patients’ satisfaction and adherence to treatments. As a consequence, the selection of an optimal therapy option for an individual patient poses a challenging task to prescribers. Clinical Decision Support Systems (CDSSs), which predict outcome as effectiveness and risk of adverse effects for available treatment options, can support this decision-making process and complement guideline-based decision-making where evidence from scientific literature is missing or inappropriate. To date, no such systems are available. Within this work, the application of methods from the Recommender Systems (RS) domain and Machine Learning (ML) in such decision support systems is studied. Due to their successful application in other recommender systems and good interpretability, neighborhood-based CF algorithms are transferred to the medical domain and are adapted to meet the requirements and challenges of the therapy recommendation task. Moreover, a model-based CF method (SLIM) and a state of the art ML algorithm (GBM) are employed. All algorithms are evaluated in an exemplary therapy recommender system, targeting the treatment of the autoimmune skin disease Psoriasis. In order to reduce the risk of recommending contraindicated or even health-endangering drugs, rules derived from evidence-based guidelines and expert recommendations are implemented to filter such options from the recommendation lists. Especially the neighborhood-based CF algorithms show small average errors between estimated and observed outcome. Also, the recommendations derived from outcome estimates show high agreement with the ground truth. The performance of both model-based approaches is inferior to the neighborhood-based recommender. This is primarily assumed to be due to the limited training data sizes, which renders generalizability of the learned models difficult. Compared with recommendations provided by various experts, all proposed approaches are, however, inferior in terms of agreement with the ground truth. An objective and efficient assessment of treatment response can be regarded a prerequisite for successful ``disease management''. Therefore, the use of ML methods for the automatic quantification of health status and therapy outcome for selected clinical applications is investigated in further experiments. Moreover, as additional source of information about drug effectiveness, the use of Sentiment Analysis, in order to extract such information from drug reviews, is investigated.

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