Study to determine relevant health outcome measures in opioid use disorder: Multicriteria decision analysis. / Estudio para la determinación de medidas de resultados en salud relevantes en el trastorno por consumo de opiáceos. Análisis de decisión multicriterio.

The aim of the current study was to establish the most relevant health outcomes to assess opioid substitution treatment programmes (OSP) in patients with opioid use disorder (OUD) in Spain. A multicriteria decision analysis was applied in 3 phases: 1) concepts and criteria definitions; 2) criteria screening and weighting by means of a discrete choice experiment; 3) deliberative process. Criteria established in phase 1 were: substance use (opioids, alcohol, tobacco, stimulants and cannabis), other mental disorders (affective/anxiety disorder, psychosis, attention deficit hyperactivity disorder, borderline personality disorder, antisocial personality disorder, gambling disorder and other impulse control disorders), level of disability, adherence, medical illnesses (medical comorbidities, risk behaviours, infectious and sexually transmitted diseases), psychosocial aspects (hostile and/or violent behaviour and work problems), functional disability (quality of life, treatment and service satisfaction, social functionality). In phase 2, the most relevant factors in OSP were determined, and subsequently assessed in the deliberative process: remission of substance use (opioids, alcohol and stimulants), improvement of other mental disorders (psychosis and borderline personality disorder), improvement in comorbidity management, and improvement in social functionality, with a weighting of 56.5%, 21.9%, 11.0%, and 10.7%, respectively. The current analysis defines the main health outcomes in OSP in patients with OUD in Spain, supporting decision making and socio-health management of existing resources.

El objetivo fue establecer los resultados en salud con mayor relevancia en la evaluación de programas de tratamiento de sustitución de opiáceos (PTSO) en pacientes con trastorno por consumo de opiáceos (TCO) en España. Se realizó un análisis de decisión multicriterio con 3 fases: 1) definición de conceptos y criterios a evaluar; 2) cribado y ponderación de criterios mediante un experimento de elecciones discretas; 3) proceso deliberativo. Los criterios de la fase 1 fueron: consumo de sustancias (opiáceos, alcohol, tabaco, estimulantes y cannabis), trastornos mentales (trastorno afectivo ansioso, psicosis, trastorno por déficit de atención e hiperactividad, trastorno límite de personalidad, trastornos de personalidad antisocial, trastorno por juego y otras alteraciones del control de los impulsos), nivel de discapacidad, adherencia, enfermedades médicas (comorbilidades, conductas de riesgo, enfermedades infecciosas y de transmisión sexual), aspectos psicosociales (conducta hostil y/o violenta, presencia de problemas laborales), discapacidad funcional (calidad de vida, satisfacción con el tratamiento y servicio, funcionamiento social). En la fase 2 se determinaron los factores fundamentales en la elección de un PTSO, revisados en el proceso deliberativo: remisión del consumo de sustancias (opiáceos, alcohol y estimulantes), mejoría en el manejo de otros trastornos mentales (psicosis y trastorno límite de la personalidad), mejoría en manejo de comorbilidades médicas y mejoría en el funcionamiento social, con un peso del 56,5%, 21,9%, 11,0% 10,7% respectivamente. Este análisis define los resultados sanitarios más relevantes en PTSO en pacientes con TCO en España, favoreciendo la toma de decisiones y la gestión socio-sanitaria de los recursos existentes.

UWB-Based Self-Localization Strategies: A Novel ICP-Based Method and a Comparative Assessment for Noisy-Ranges-Prone Environments.

Ultra-Wide-Band (UWB) positioning systems are now a real option to estimate the position of generic agents (e.g., robots) within indoor/GPS-denied environments. However, these environments can comprise metallic structures or other elements which can negatively affect the signal transmission and hence the accuracy of UWB-based position estimations. Regarding this fact, this paper proposes a novel method based on point-to-sphere ICP (Iterative Closest Point) to determine the 3D position of a UWB tag. In order to improve the results in noise-prone environments, our method first selects the anchors' subset which provides the position estimate with least uncertainty (i.e., largest agreement) in our approach. Furthermore, we propose a previous stage to filter the anchor-tag distances used as input of the ICP stage. We also consider the addition of a final step based on non-linear Kalman Filtering to improve the position estimates. Performance results for several configurations of our approach are reported in the experimental results section, including a comparison with the performance of other position-estimation algorithms based on trilateration. The experimental evaluation under laboratory conditions and inside the cargo hold of a vessel (i.e., a noise-prone scenario) proves the good performance of the ICP-based algorithm, as well as the effects induced by the prior and posterior filtering stages.