Decision-support systems for ambulatory care, including pandemic requirements: using mathematically optimized solutions.

BACKGROUND: The healthcare sector poses many strategic, tactic and operational planning questions. Due to the historically grown structures, planning is often locally confined and much optimization potential is foregone. METHODS: We implemented optimized decision-support systems for ambulatory care for four different real-world case studies that cover a variety of aspects in terms of planning scope and decision support tools. All are based on interactive cartographic representations and are being developed in cooperation with domain experts. The planning problems that we present are the problem of positioning centers for vaccination against Covid-19 (strategical) and emergency doctors (strategical/tactical), the out-of-hours pharmacy planning problem (tactical), and the route planning of patient transport services (operational). For each problem, we describe the planning question, give an overview of the mathematical model and present the implemented decision support application. RESULTS: Mathematical optimization can be used to model and solve these planning problems. However, in order to convince decision-makers of an alternative solution structure, mathematical solutions must be comprehensible and tangible. Appealing and interactive decision-support tools can be used in practice to convince public health experts of the benefits of an alternative solution. The more strategic the problem and the less sensitive the data, the easier it is to put a tool into practice. CONCLUSIONS: Exploring solutions interactively is rarely supported in existing planning tools. However, in order to bring new innovative tools into productive use, many hurdles must be overcome.

Improving reconstructions in nanotomography for homogeneous materials via mathematical optimization.

Compressed sensing is an image reconstruction technique to achieve high-quality results from limited amount of data. In order to achieve this, it utilizes prior knowledge about the samples that shall be reconstructed. Focusing on image reconstruction in nanotomography, this work proposes enhancements by including additional problem-specific knowledge. In more detail, we propose further classes of algebraic inequalities that are added to the compressed sensing model. The first consists in a valid upper bound on the pixel brightness. It only exploits general information about the projections and is thus applicable to a broad range of reconstruction problems. The second class is applicable whenever the sample material is of roughly homogeneous composition. The model favors a constant density and penalizes deviations from it. The resulting mathematical optimization models are algorithmically tractable and can be solved to global optimality by state-of-the-art available implementations of interior point methods. In order to evaluate the novel models, obtained results are compared to existing image reconstruction methods, tested on simulated and experimental data sets. The experimental data comprise one 360° electron tomography tilt series of a macroporous zeolite particle and one absorption contrast nano X-ray computed tomography (nano-CT) data set of a copper microlattice structure. The enriched models are optimized quickly and show improved reconstruction quality, outperforming the existing models. Promisingly, our approach yields superior reconstruction results, particularly when only a small number of tilt angles is available.