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Fulltext Using Machine Learning Algorithms to Develop a Clinical Decision-Making Tool for COVID-19 Inpatients

Vepa A, Saleem A, Rakhshan K, Daneshkhah A, Sedighi T, Shohaimi S, et al.

Int J Environ Res Public Health, 2021 06 09;18(12).
PMID: 34207560 DOI: 10.3390/ijerph18126228

BACKGROUND: Within the UK, COVID-19 has contributed towards over 103,000 deaths. Although multiple risk factors for COVID-19 have been identified, using this data to improve clinical care has proven challenging. The main aim of this study is to develop a reliable, multivariable predictive model for COVID-19 in-patient outcomes, thus enabling risk-stratification and earlier clinical decision-making.
METHODS: Anonymised data consisting of 44 independent predictor variables from 355 adults diagnosed with COVID-19, at a UK hospital, was manually extracted from electronic patient records for retrospective, case-control analysis. Primary outcomes included inpatient mortality, required ventilatory support, and duration of inpatient treatment. Pulmonary embolism sequala was the only secondary outcome. After balancing data, key variables were feature selected for each outcome using random forests. Predictive models were then learned and constructed using Bayesian networks.
RESULTS: The proposed probabilistic models were able to predict, using feature selected risk factors, the probability of the mentioned outcomes. Overall, our findings demonstrate reliable, multivariable, quantitative predictive models for four outcomes, which utilise readily available clinical information for COVID-19 adult inpatients. Further research is required to externally validate our models and demonstrate their utility as risk stratification and clinical decision-making tools.

Matched MeSH terms: Clinical Decision-Making
Fulltext Adolescent’s strategies and reverse influence in family food decision making

Othman, M., Boo, H.C., Wan Rusni, W.I.

International Food Research Journal, 2013;20(1):131-139.
MyJurnal

The role of adolescents in family decision making related to food consumption in Malaysia has received comparatively little or no attention by researchers although there were evidences of differences in influences found in other countries. This study addressed the research gap by testing adolescents’ bilateral strategies in influencing their family decision using family power theory. A survey of 500 adolescents from urban area was conducted to investigate their influence based on their involvement in family consumer tasks. Key findings include strong relationship between perception of influence and rewards thus indicate the existence of strategies in adolescents influence attempt.

Matched MeSH terms: Decision Making
Fulltext Changing trends in informed consent

Victor Lim

International e-Journal of Science, Medicine & Education, 2014;8(1):3-7.
MyJurnal

Consent is defined as the “voluntary agreement to or acquiescence in what another person proposes or desires”. In the context of medical practice it is now universally accepted that every human being of adult years and of sound mind has the right to determine what shall be done with his or her own body. Informed consent is now a central part of medical ethics and medical law. There has been a change in the public’s expectations of their role in medical decision making. The paternalistic approach by doctors is no longer acceptable. Today the patient has the right to receive and the doctor the obligation to give sufficient and appropriate information so that the patient can make an informed decision to accept or refuse a treatment option. This has led to higher standards of practice in the process of informed consent taking. Consent taking is both a legal and moral requirement. Failure to comply with standards of practice can result in criminal prosecution, civil litigation or disciplinary action by the relevant professional authority. Consent taking is a process and not merely a one-off affixation of the patient’s signature on consent form. It involves a continuous discussion to reflect the evolving nature of treatment from before the treatment is given to the post-operative or discharge period. The regulatory authorities in many countries have established standards for consent taking which would include the capacity of the patient, the person who should seek consent, the information to be provided and the necessary documentation.

Matched MeSH terms: Clinical Decision-Making
Fulltext Participation and empowerment: determining the healthcare organization’s success

Haidar, R.T., Ahmad Fareed, A.R., Jamsiah, M.

Malaysian Journal of Community Health, 2010;16(1):38-47.
MyJurnal

Introduction : An organization performs well with proper management methods. Participation is a process involving cooperation and collaboration within all levels of individuals, groups or community for the purpose of organization improvement. Empowerment brings the organization further by delegation of power and responsibilities to others for better result.
Methodology : This is a systematic review on various publications, articles and studies based on the findings and researches conducted by experts and scholars involved with participation and empowerment of organizations.
Results : Participation and empowerment are crucial in every organization including healthcare. Its success depends on factors such as proper planning, mutual understanding, regular training and continuous education. They contribute towards better outcome in goal setting, decision making, problem solving and organizational development. There are also various levels of empowerment and participation depending on the type of activities, organisation’s performance and level of authority.
Conclusion : The prerequisite for an organisation’s success is dependent upon holistic participation and appropriate empowerment. The benefits gained from these measures are indeed invaluable. It creates sense of ownership, increases motivation and satisfaction, optimizing resources, promote innovations, enhancing quality and improving efficiency.

Matched MeSH terms: Decision Making
Fulltext Clinical Impact of Education Provision on Determining Advance Care Planning Decisions among End Stage Renal Disease Patients Receiving Regular Hemodialysis in University Malaya Medical Centre

Hing Wong A, Chin LE, Ping TL, Peng NK, Kun LS

Indian J Palliat Care, 2016 Oct-Dec;22(4):437-445.
PMID: 27803566

Advance care planning (ACP) is a process of shared decision-making about future health-care plans between patients, health care providers, and family members, should patients becomes incapable of participating in medical treatment decisions. ACP discussions enhance patient's autonomy, focus on patient's values and treatment preferences, and promote patient-centered care. ACP is integrated as part of clinical practice in Singapore and the United States.

Matched MeSH terms: Decision Making
Fulltext Medical informatics for medical students and medical practitioners

Mohan, Jai

International e-Journal of Science, Medicine & Education, 2010;4(1):-.
MyJurnal

The importance of incorporating medical (or health) informatics into the education of medical students and medical practitioners is being increasingly recognised. The advances in information and communication technology and the pervasion of the Internet into everyday life have important implications for healthcare services and medical education. Students and practitioners should learn to utilise biomedical information for problem solving and decision making based on evidence. The extensive introduction of electronic health information systems into hospitals and clinics and at the enterprise level in Malaysia and elsewhere is driving a demand for health professionals who have at least basic skills in and appreciation of the use of these technologies. The essential clinical informatics skills have been identified and should be incorporated into the undergraduate medical curriculum. It is recommended that these be introduced in stages and integrated into existing programmes rather than taught as a separate module. At the same time, medical schools should support the integration of e-learning in the educational process in view of the numerous potential benefits.

Matched MeSH terms: Decision Making
Fulltext Should parental decision override best interest of a handicapped child? A case illustration in a Malaysian child with Down Syndrome

Fashiham Taib, Nur Arzuar Abdul Rahim, Mohd Rizal Mohd Zain, Mohamad Ikram Ilias, Nik Mohd Rizal Mohd Fakri, Zabidi Azhar Hussin

Education in Medicine Journal, 2015;7(1):67-71.
MyJurnal

The paper discusses on the complexity of the issues surrounding a patient with subluxation of cervical spine in a Down syndrome child. Several relevant issues are discussed including consent in a minor, conflicting decision making between parents and doctors, end-of-life issues, supporting handicapped child with minimal co-morbidities, community ethics, neglect of care by the caregiver and decision making after allowing zonal of parental discretion. Despite the difficulties surrounding parental actions, there are still ethical priorities which have to be considered individually to alleviate the suffering of the patients and the family members. Dealing with patients with chronic illnesses is a challenge for any medical doctors. The case warrants sensitive approach to allow appropriate respect for parental decision despite in disagreement with the clinical team. The term ‘zone of parental discretion’ refers to a controversial area of decision making; and has still many potential conflicts on day to day clinical cases, especially among the conservative society in the East Coast of Peninsular Malaysia.

Matched MeSH terms: Decision Making
Fulltext Autonomy to refuse: please doctor, I want to fast, I don't want my medications

Kumurasamy V, Ahmad Fairuz M, Taib F, Mat Pa MN, Mohd Nazri S, Norzila Z, et al.

Education in Medicine Journal, 2014;6(1):66-69.
MyJurnal

This paper discusses the ethical issues of patient autonomy based on a case of a patient who refused medication during Ramadhan fasting period. Issues on patient autonomy include the right of a patient to refuse medication, informed decision making, the importance of effective communication and the physician roles and responsibilities are discussed. In conclusion, patient autonomy must be respected and valued. However, the need of effective communication in facilitating informed decision making to improve doctor-patient relationship, should not be overlooked and compromised.

Matched MeSH terms: Decision Making
Fulltext Autonomy in refusing life saving interventions: religious and cultural misconceptions

van Rostenberghe H, Yong A, Mohd Zin F, Fuad MDF, Idris B, Tahir NA, et al.

Education in Medicine Journal, 2014;6(1):70-73.
MyJurnal

Autonomy is widely accepted to be the third pillar of medical ethics. However, if it comes to refusal of life saving treatments, some extra considerations are necessary, especially if decisions are made by surrogate decision makers. Four cases of problematic decision making are presented here, followed by a discussion about the cultural and religious misconceptions about the rights of surrogate decision makers.

Matched MeSH terms: Decision Making
Fulltext A review on criteria and decision-making techniques in solving landfill site selection problems

Nur Azriati Mat, Aida Mauziah Benjamin, Syariza Abdul-Rahman

Journal of Advanced Review on Scientific Research, 2017;37(1):14-32.
MyJurnal

The selection of landfill, which happens to be an environmental issue, has attracted
the attention of many researchers from the fields of waste management and
environmental sciences worldwide. Hence, in the attempt to overcome this problem,
some decision-making techniques, including Geographic Information Systems (GIS)
and Multi-Criteria Decision Analysis (MCDA), have been widely utilized in prior studies,
where multiple criteria, particularly in site selection process, have been employed.
With that, this article identifies the selection criteria for landfill selection and presents
a review concerning decision-making techniques that have been used in past studies
for two important phases involved during the process of site selection, namely, (1)
preliminary site screening, and (2) assessment of site suitability. As such, some 82
articles chosen from 34 peer-reviewed journals had been investigated in detail. The
results showed that 42.68% of the selected articles integrated GIS and MCDA
techniques to solve the problem of landfill site selection, and this is followed by
integrating GIS and fuzzy MCDA technique (18.29%). Both these techniques are indeed
powerful tools that can guide decision-makers to solve problems in making decisions
on the basis of various criteria under certainty and uncertainty results, mainly involving
environmental issues.

Matched MeSH terms: Decision Making
Fulltext The effect of SET pedagogical training style to low-skilled students in hockey game

Nathan, Sanmuga

Jurnal Sains Sukan & Pendidikan Jasmani, 2012;1(1):68-81.
MyJurnal

This quasi-experimental study examined the effectiveness of SET pedagogical style training that combined teaching style E (Inclusion style) from Mosston Spectrum of Teaching Styles (Mosston & Ashworth, 2002) with Teaching Games for Understanding (TGfU), in hockey. A total of n=25, Form One low-skilled students (LSS) secondary school boys were involved in this study using Physical Education class for the duration of nine weeks. The effectiveness of the SET pedagogical style of training on LSS in hockey was measured using speed and accuracy executing general hockey skills, acquisition of declarative and procedural hockey knowledge as well as ball control, decision making (passing, tackling, dribbling and scoring) and skill execution (passing, tackling, dribbling and scoring) in 3 vs 3 game play. The data was analysed using MANCOVA together with other two training styles, which was not disclosed in this article. Findings indicated there were significant improvements in speed and accuracy executing hockey general skills, declarative and procedural knowledge using SET pedagogical style of training. Findings too revealed the SET style was able to develop significantly game components of ball control, decision makng and skill execution in 3 vs 3 game plays at posttest among LSS group. Conclusion, further research has to be done to validate the SET pedagogical style of training across many invasion games.

Matched MeSH terms: Decision Making
Fulltext Using mathematics to quantify subjective decisions: application of analytic hierarchy process to risk assessment

Rabihah Md. Sum

Journal of Advanced Research Design, 2018;44(1):7-19.
MyJurnal

Risk management requires human judgements, from risk identification, assessment to response. Although automated tools are useful in handling large amounts of data and in performing complex calculations rapidly, humans undertake the entire risk management process. They bring to the process their intuitions, insights, previous experiences and skills. Therefore, creating a rich source of information of risks faced by an organisation. Ignoring human factors may impoverish information and limit risk management to only measurable factors. This study contributes to the field of decision-making and risk assessment by investigating and discussing in detail how to quantify subjective judgements using the Analytic Hierarchy Process (AHP). AHP is used to assess risk of an insurance company. It discusses how to do risk assessment by combining both intuition and analytic in the decision-making process. The study defines intuition as knowledge and experience, and analytic as the mathematics or quantitative analysis to derive the result. It demonstrates how Analytic Hierarchy Process (AHP) - a flexible multi-attribute or multi-criteria decision making tool, enables risk managers to use both intuition and analytic to do risk assessment. Risk assessment using AHP produces global priority weights representing the overall risk ranking of an insurance company. The study develops a risk assessment problem and uses AHP to organise and structure risks and sub-risks of the problem. It uses formative evaluation method with open-ended questionnaires to obtain feedbacks from risk managers on AHP. Three employees of a risk management department in a government agency assesses the risks using AHP. AHP strengths are easy to use and understand, improves risk assessment and useful for risk assessment problems that have scarce or no data. AHP limitation are the numbers and repetitiveness of the pairwise comparisons. The participants either ignore some of the pairwise questions or they answer randomly instead of deliberate judgements.

Matched MeSH terms: Decision Making
Fulltext The financial status and factors affecting personal well-‐being among urban poor in Kuala Lumpur

Moga Dass T, Sabri MF

Malaysian Journal of Social Sciences and Humanities, 2017;2(1):21-39.
MyJurnal

The main purpose of this study is to understand the financial status of urban poor community in Kuala Lumpur and factors affecting their personal well-being. The sampling size of this research is 1,064 respondents chosen by using systematic sampling method. The data was obtained by using selfadministered questionnaires and the data being analysed by descriptive analysis meanwhile and multi regression analysis. The results shows that the urban poor community in Kuala Lumpur are having a moderate level of financial literacy possess a less effective financial behaviour, experiencing a high financial strain and adapting a moderate level of personal well-being. Besides that, the results also indicates that the financial literacy has no influence on personal well-being of the urban poor community, meanwhile financial behaviour has a positive influence and financial strain has a negative influence on the personal well-being of the urban poor community. The findings of the study suggest the government and non-government organisation such as Economic Planning Unit ((EPU), Kuala Lumpur City Hall (KLCH or DBKL), Central Bank of Malaysia (BNM), Credit Counselling and Debt Management Agency (CCDM or AKPK), Federation of Consumer Association (FOMCA) to make an inclusive effort and approach to improve the personal well-being of the urban poor. By understanding more about the financial status of the urban poor community, it is hoped to help them to become financial prudence and in the long-run could lead them into a good decision making while facing conflicts in financial issues and maintain a good quality of life. It is important to ensure the urban poor consumers have better financial management skills which lead them to make the right decision in order to enhance their personal well-being.

Matched MeSH terms: Decision Making
Determination of potential fishing grounds of Rastrelliger kanagurta using satellite remote sensing and GIS Technique

Suhartono Nurdin, Muzzneena Ahmad Mustapha, Tukimat Lihan, Mazlan Abd Ghaffar

Sains Malaysiana, 2015;44:225-232.

Analysis of relationship between sea surface temperature (SST) and Chlorophyll-a (chl-a) improves our understanding on the variability and productivity of the marine environment, which is important for exploring fishery resources. Monthly level 3 and daily level 1 images of Moderate Resolution Imaging Spectroradiometer Satellite (MODIS) derived SST and chl-a from July 2002 to June 2011 around the archipelagic waters of Spermonde Indonesia were used to investigate the relationship between SST and chl-a and to forecast the potential fishing ground of Rastrelliger kanagurta. The results indicated that there was positive correlation between SST and chl-a (R=0.3, p<0.05). Positive correlation was also found between SST and chl-a with the catch of R. kanagurta (R=0.7, p<0.05). The potential fishing grounds of R. kanagurta were found located along the coast (at accuracy of 76.9%). This study indicated that, with the integration of remote sensing technology, statistical modeling and geographic information systems (GIS) technique were able to determine the relationship between SST and chl-a and also able to forecast aggregation of R. kanagurta. This may contribute in decision making and reducing search hunting time and cost in fishing activities.

Matched MeSH terms: Decision Making
Fulltext Kecerdasan emosi sosial kemahiran penyesuaian diri dalam kalangan pelajar sekolah menengah

Lailawati Madlan E, Abdul Adib A, Chua BS, Ferlis Bullare B, Jasmine Adela M, Rosnah I

Jurnal Psikologi Malaysia, 2018;32:47-57.

Social emotional intelligence, a combination between emotion and social intelligence, is a very important aspect of one's self. It is divided into five components which is intrapersonal, interpersonal, stress management, adaptation and general mood. Social emotional intelligence directly affects the behavior, emotion and decision making of an individual. Secondary school students are a group of early teenager and still in the process of identity formation. Therefore, it is important to know the social emotional intelligence of adaptability skills especially among school students as it has long-term impact on their performance. The main objective of this study is to examine the social emotional intelligence scores among high school students in Kota Kinabalu, Sabah. The sample in this study consisted of Form One to Form Six students from various schools around Kota Kinabalu. A set of questionnaire used in this study is The Emotional Quotient Inventory Youth Version (EQ-i: YV) designed by Bar-On and Parker (2000) contains 60 questions with four likert scale. The data obtained were analyzed using the IBM SPSS version 24.0. The results of this study showed that the social emotional intelligence as a whole is at a moderate level. Meanwhile, there are differences in adaptability skills between male and female students, where the mean score for male students is higher than female students. As for the implication, related parties such as ministries of education, parents and the community can obtain relevant information for the purpose of implementation of programs and activities to enhance emotional intelligence and adaptability skills that are appropriate to the current generation Z.

Matched MeSH terms: Decision Making
Fulltext Geospatial Tuberculosis Information System for Airborne Disease Management

Abdul Rauf Abdul Rasam, Noresah Mohd Shariff, Dony, Jiloris F., Saiful Aman Sulaiman

Jurnal Inovasi Malaysia, 2018;2(1):75-88.
MyJurnal

An innovative health information system can be used to support the control of tuberculosis (TB) in Malaysia. The existing system of MyTB has helped in the national TB information management and decision-making process. However, the system can be further enhanced by producing a prototype of Geospatial Tuberculosis Information System (GeoTBiS). It is a geospatial decision support system that was initially proposed in Shah Alam, Selangor. Geospatial data has spatio-temporal characteristics that can be used to understand the basic elements of TB aetiology, while geospatial operations are employed to collect, manage and disseminate the data in a geographical information system (GIS) environment. The disease map and epidemiological risk analysis are produced using a global positioning system (GPS), satellite imagery, geostatistical analysis and web mapping services. This GeoTBiS has demonstrated the geospatial capabilities in enhancing the current system functions, and several recommendations towards a practicable application.

Matched MeSH terms: Decision Making
Health Technology Assessment in Malaysia: Past, Present, and Future

Roza S, Junainah S, Izzuna MMG, Ku Nurhasni KAR, Yusof MAM, Noormah MD, et al.

Int J Technol Assess Health Care, 2019;35(6):446-451.
PMID: 30864531 DOI: 10.1017/S0266462319000023

OBJECTIVES: The aim of this study was to provide a comprehensive overview of the evolution of health technology assessment (HTA) in Malaysia over the past decade.
METHODS: We described the evolution of HTA program in Malaysia based on review of administrative data, publicly available information and quantitative description of impact evaluation.
RESULTS: Health Technology Assessment HTA was formalized in Malaysia in 1995 as a central structure within the Ministry of Health, Malaysia in 1995. Expansion of activities demonstrated over the years including Horizon Scanning of health technologies and implementation of evidence-based Clinical Practice Guidelines. Improvement on the processes in terms of types of report, quality, monitoring, and impact evaluation as well as accessibility was also carried out. Examples of impact/influence of the reports have also been demonstrated.
CONCLUSIONS: HTA program in Malaysia has evolved over the past decades. Its role in policy formulation and decision making of health technologies has become more significant over the years and is foreseen to be bigger in the future. As a trusted source of evidence, HTA in Malaysia will continue to strengthen the health system by advocating informed decision making and value-based medicine. As other countries in this region is trying to establish their own HTA processes and procedures, this review on the evolution of the HTA program in Malaysia might give some insights on developing a sustainable HTA program.

Matched MeSH terms: Decision Making
Fulltext Immune Biomarkers for Diagnosis and Treatment Monitoring of Tuberculosis: Current Developments and Future Prospects

Yong YK, Tan HY, Saeidi A, Wong WF, Vignesh R, Velu V, et al.

Front Microbiol, 2019;10:2789.
PMID: 31921004 DOI: 10.3389/fmicb.2019.02789

Tuberculosis (TB) treatment monitoring is paramount to clinical decision-making and the host biomarkers appears to play a significant role. The currently available diagnostic technology for TB detection is inadequate. Although GeneXpert detects total DNA present in the sample regardless live or dead bacilli present in clinical samples, all the commercial tests available thus far have low sensitivity. Humoral responses against Mycobacterium tuberculosis (Mtb) antigens are generally low, which precludes the use of serological tests for TB diagnosis, prognosis, and treatment monitoring. Mtb-specific CD4+ T cells correlate with Mtb antigen/bacilli burden and hence might serve as good biomarkers for monitoring treatment progress. Omics-based techniques are capable of providing a more holistic picture for disease mechanisms and are more accurate in predicting TB disease outcomes. The current review aims to discuss some of the recent advances on TB biomarkers, particularly host biomarkers that have the potential to diagnose and differentiate active TB and LTBI as well as their use in disease prognosis and treatment monitoring.

Matched MeSH terms: Clinical Decision-Making
Fulltext A goal programming model for portfolio optimisation problem in fuzzy environment

Mokhtar, M., Shuib, A., Mohamad, D.

Pertanika Journal of Science & Technology, 2017;25(2):593-606.
MyJurnal

Portfolio optimisation is one of the most crucial issues in investment decision-making and has received considerable attention from researchers and practitioners. Traditionally, the portfolio optimisation models are formulated based on the assumption that investors have complete information on the distribution of random returns. However, in real life case, this is not possible since decisions have to be made under uncertainty. This paper deals with a fuzzy portfolio optimisation problem in which returns and turnover rates of securities are represented by fuzzy variables. A goal programming model is proposed to optimise three objectives: maximisation of portfolio return, maximisation of liquidity and minimisation of the portfolio risk. The cardinality constraints, floor and ceiling constraints are also taken into consideration. Finally, a numerical experiment using real data is conducted to demonstrate the applicability of the model.

Matched MeSH terms: Decision Making
A Multinational Study of Patient Preferences for How Decisions Are Made in Their Care

Pines R, Sheeran N, Jones L, Pearson A, Pamoso AH, Jin YB, et al.

Med Care Res Rev, 2023 Apr;80(2):205-215.
PMID: 35815591 DOI: 10.1177/10775587221108749

Inadequate consideration has been given to patient preferences for patient-centered care (PCC) across countries or cultures in our increasingly global society. We examined what 1,698 participants from the United States, Hong Kong, Philippines, and Australia described as important when making health care decisions. Analysis of frequencies following directed content coding of open-ended questions revealed differences in patients' preferences for doctor behaviors and decision-making considerations across countries. Being well informed by their doctor emerged as most important in decision-making, especially in Hong Kong. Participants in Australia and the United States wanted their doctor to meet their emotional needs. The safety and efficacy of treatments were the most common consideration, especially for Hong Kong. Findings suggest that doctors should focus on information exchange and identifying patient concerns about efficacy, lifestyle impact, cost, and recovery speed. Rather than assuming patients prefer shared decision-making, doctors must assess patient's decision control preferences.

Matched MeSH terms: Decision Making

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