Advanced Computational Methods for Radiation Dose Optimization in CT.

BACKGROUND: In planning radiotherapy treatments, computed tomography (CT) has become a crucial tool. CT scans involve exposure to ionizing radiation, which can increase the risk of cancer and other adverse health effects in patients. Ionizing radiation doses for medical exposure must be kept "As Low As Reasonably Achievable". Very few articles on guidelines for radiotherapy-computed tomography scans are available. This paper reviews the current literature on radiation dose optimization based on the effective dose and diagnostic reference level (DRL) for head, neck, and pelvic CT procedures used in radiation therapy planning. This paper explores the strategies used to optimize radiation doses, and high-quality images for diagnosis and treatment planning. METHODS: A cross-sectional study was conducted on 300 patients with head, neck, and pelvic region cancer in our institution. The DRL, effective dose, volumetric CT dose index (CTDIvol), and dose-length product (DLP) for the present and optimized protocol were calculated. DRLs were proposed for the DLP using the 75th percentile of the distribution. The DLP is a measure of the radiation dose received by a patient during a CT scan and is calculated by multiplying the CT dose index (CTDI) by the scan length. To calculate a DRL from a DLP, a large dataset of DLP values obtained from a specific imaging procedure must be collected and can be used to determine the median or 75th-percentile DLP value for each imaging procedure. RESULTS: Significant variations were found in the DLP, CTDIvol, and effective dose when we compared both the standard protocol and the optimized protocol. Also, the optimized protocol was compared with other diagnostic and radiotherapy CT scan studies conducted by other centers. As a result, we found that our institution's DRL was significantly low. The optimized dose protocol showed a reduction in the CTDIvol (70% and 63%), DLP (60% and 61%), and effective dose (67% and 62%) for both head, neck, and pelvic scans. CONCLUSIONS: Optimized protocol DRLs were proposed for comparison purposes.

Quantifying holistic capacity response and healthcare resilience in tackling COVID-19: Assessment of country capacity by MCDM.

The resilience of a country during the COVID-19 pandemic was determined based in whether it was holistically prepared and responsive. This resilience can only be identified through systematic data collection and analysis. Historical evidence-based response indicators have been proven to mitigate pandemics like COVID-19. However, most databases are outdated, requiring updating, derivation, and explicit interpretation to gain insight into the impact of COVID-19. Outdated databases do not show a country's true preparedness and response capacity, therefore, it undermines pandemic threat. This study uses up-to-date evidence-based pandemic indictors to run a cross-country comparative analysis of COVID-19 preparedness, response capacity, and healthcare resilience. PROMETHEE-a multicriteria decision making (MCDM) technique-is used to quantify the strengths (positive) and weaknesses (negative) of each country's COVID-19 responses, with full ranking (net) from best to least responsive. From 22 countries, South Korea obtained the highest net outranking value of 0.1945, indicating that it was the most resilient, while Mexico had the lowest (-0.1428). Although countries were underprepared, there was a robust response to the pandemic, especially in developing countries. This study demonstrates the performance and response capacity of 22 key countries to resist COVID-19, from which other countries can compare their statutory capacity ranking in order to learn/adopt the evidence-based responses of better performing countries to improve their resilience.

Quantitative Forecasting of Malaria Parasite Using Machine Learning Models: MLR, ANN, ANFIS and Random Forest.

Malaria continues to be a major barrier to socioeconomic development in Africa, where its death rate is over 90%. The predictive power of many machine learning models-such as multi-linear regression (MLR), artificial neural networks (ANN), adaptive neuro-fuzzy inference systems (ANFISs) and Random Forest classifier-is investigated in this study using data from 2207 patients. The dataset was reduced from the initial dataset of thirty-two criteria samples to fifteen. Assessment measures such as the root mean square error (RMSE), mean square error (MSE), coefficient of determination (R2), and adjusted correlation coefficient R were used. ANFIS, Random Forest, MLR, and ANN are among the models. After training, ANN outperforms ANFIS (97%), MLR (92%), and Random Forest (68%) with the greatest R (99%) and R2 (99%), respectively. The testing stage confirms the superiority of ANN. The paper also presents a statistical forecasting sheet with few errors and excellent accuracy for MLR models. When the models are assessed with Random Forest, the latter shows the least results, thus broadening the modeling techniques and offering significant insights into the prediction of malaria and healthcare decision making. The outcomes of using machine learning models for precise and efficient illness prediction add to an expanding body of knowledge, assisting healthcare systems in making better decisions and allocating resources more effectively.

A look at radiation detectors and their applications in medical imaging.

The effectiveness and precision of disease diagnosis and treatment have increased, thanks to developments in clinical imaging over the past few decades. Science is developing and progressing steadily in imaging modalities, and effective outcomes are starting to show up as a result of the shorter scanning periods needed as well as the higher-resolution images generated. The choice of one clinical device over another is influenced by technical disparities among the equipment, such as detection medium, shorter scan time, patient comfort, cost-effectiveness, accessibility, greater sensitivity and specificity, and spatial resolution. Lately, computational algorithms, artificial intelligence (AI), in particular, have been incorporated with diagnostic and treatment techniques, including imaging systems. AI is a discipline comprised of multiple computational and mathematical models. Its applications aided in manipulating sophisticated data in imaging processes and increased imaging tests' accuracy and precision during diagnosis. Computed tomography (CT), positron emission tomography (PET), and Single Photon Emission Computed Tomography (SPECT) along with their corresponding radiation detectors have been reviewed in this study. This review will provide an in-depth explanation of the above-mentioned imaging modalities as well as the radiation detectors that are their essential components. From the early development of these medical instruments till now, various modifications and improvements have been done and more is yet to be established for better performance which calls for a necessity to capture the available information and record the gaps to be filled for better future advances.

Assessment of UTI Diagnostic Techniques Using the Fuzzy-PROMETHEE Model.

Accurate diagnosis of urinary tract infections (UTIs) is important as early diagnosis increases treatment rates, reduces the risk of infection and disease spread, and prevents deaths. This study aims to evaluate various parameters of existing and developing techniques for the diagnosis of UTIs, the majority of which are approved by the FDA, and rank them according to their performance levels. The study includes 16 UTI tests, and the fuzzy preference ranking organization method was used to analyze the parameters such as analytical efficiency, result time, specificity, sensitivity, positive predictive value, and negative predictive value. Our findings show that the biosensor test was the most indicative of expected test performance for UTIs, with a net flow of 0.0063. This was followed by real-time microscopy systems, catalase, and combined LE and nitrite, which were ranked second, third, and fourth with net flows of 0.003, 0.0026, and 0.0025, respectively. Sequence-based diagnostics was the least favourable alternative with a net flow of -0.0048. The F-PROMETHEE method can aid decision makers in making decisions on the most suitable UTI tests to support the outcomes of each country or patient based on specific conditions and priorities.

COVID-19 Prediction Using Black-Box Based Pearson Correlation Approach.

The novel coronavirus (COVID-19), also known as SARS-CoV-2, is a highly contagious respiratory disease that first emerged in Wuhan, China in 2019 and has since become a global pandemic. The virus is spread through respiratory droplets produced when an infected person coughs or sneezes, and it can lead to a range of symptoms, from mild to severe. Some people may not have any symptoms at all and can still spread the virus to others. The best way to prevent the spread of COVID-19 is to practice good hygiene. It is also important to follow the guidelines set by local health authorities, such as physical distancing and quarantine measures. The World Health Organization (WHO), on the other hand, has classified this virus as a pandemic, and as a result, all nations are attempting to exert control and secure all public spaces. The current study aimed to (I) compare the weekly COVID-19 cases between Israel and Greece, (II) compare the monthly COVID-19 mortality cases between Israel and Greece, (III) evaluate and report the influence of the vaccination rate on COVID-19 mortality cases in Israel, and (IV) predict the number of COVID-19 cases in Israel. The advantage of completing these tasks is the minimization of the spread of the virus by deploying different mitigations. To attain our objective, a correlation analysis was carried out, and two distinct artificial intelligence (AI)-based models-specifically, an artificial neural network (ANN) and a classical multiple linear regression (MLR)-were developed for the prediction of COVID-19 cases in Greece and Israel by utilizing related variables as the input variables for the models. For the evaluation of the models, four evaluation metrics (determination coefficient (R2), mean square error (MSE), root mean square error (RMSE), and correlation coefficient (R)) were considered in order to determine the performance of the deployed models. From a variety of perspectives, the corresponding determination coefficient (R2) demonstrated the statistical advantages of MLR over the ANN model by following a linear pattern. The MLR predictive model was both efficient and accurate, with 98% accuracy, while ANN showed 94% accuracy in the effective prediction of COVID-19 cases.

A Multi-Criteria Decision Aid Tool for Radiopharmaceutical Selection in Tau PET Imaging.

The accumulation of pathologically misfolded tau is a feature shared by a group of neurodegenerative disorders collectively referred to as tauopathies. Alzheimer's disease (AD) is the most prevalent of these tauopathies. Immunohistochemical evaluation allows neuropathologists to visualize paired-helical filaments (PHFs)-tau pathological lesions, but this is possible only after death and only shows tau in the portion of brain sampled. Positron emission tomography (PET) imaging allows both the quantitative and qualitative analysis of pathology over the whole brain of a living subject. The ability to detect and quantify tau pathology in vivo using PET can aid in the early diagnosis of AD, provide a way to monitor disease progression, and determine the effectiveness of therapeutic interventions aimed at reducing tau pathology. Several tau-specific PET radiotracers are now available for research purposes, and one is approved for clinical use. This study aims to analyze, compare, and rank currently available tau PET radiotracers using the fuzzy preference ranking organization method for enrichment of evaluations (PROMETHEE), which is a multi-criteria decision-making (MCDM) tool. The evaluation is based on relatively weighted criteria, such as specificity, target binding affinity, brain uptake, brain penetration, and rates of adverse reactions. Based on the selected criteria and assigned weights, this study shows that a second-generation tau tracer, [18F]RO-948, may be the most favorable. This flexible method can be extended and updated to include new tracers, additional criteria, and modified weights to help researchers and clinicians select the optimal tau PET tracer for specific purposes. Additional work is needed to confirm these results, including a systematic approach to defining and weighting criteria and clinical validation of tracers in different diseases and patient populations.

Systematic Review on Diagnostic Reference Levels for Computed Tomography Examinations in Radiation Therapy Planning.

Background: In August 2017, the European Commission awarded the "European Study on Clinical Diagnostic Reference Levels (DRL) for X-ray Medical Imaging" project to the European Society of Radiology to provide up-to-date Diagnostic Reference Levels based on clinical indications. This work aimed to conduct an extensive literature review by analyzing the most recent studies published and the data provided by the National Competent Authorities to understand the current situation regarding Diagnostic Reference Levels based on clinical indications for Radiation Therapy Computed Tomography. Objective: To review the literature on established DRLs and methodologies for establishing Diagnostic reference levels in radiation therapy planning computed tomography (RTCT). Methods: Eligibility criteria: A cohort study (observational design) reporting DRLs in adult patients undergoing computed tomography (CT) for radiation therapy for the region head and neck or pelvis were included. The comprehensive literature searches for the relevant studies published between 2000 and 2021 were performed using PubMed, Scopus, CINHAL, Web of Science, and ProQuest. Results: Three hundred fifty-six articles were identified through an extensive literature search. Sixty-eight duplicate reports were removed. The title and abstract of 288 studies were assessed and excluded if they did not meet the inclusion criteria. Sixteen of 288 articles were selected for full-text screening (studies conducted between 2000 and 2021). Five articles were included in the review after the full-text screening. Conclusions: A globally approved standard protocol that includes scanning techniques, dose measurement method, and DRL percentile needs to be established to make a valuable and accurate comparison with international DRLs.

Mathematical Assessment of Machine Learning Models Used for Brain Tumor Diagnosis.

The brain is an intrinsic and complicated component of human anatomy. It is a collection of connective tissues and nerve cells that regulate the principal actions of the entire body. Brain tumor cancer is a serious mortality factor and a highly intractable disease. Even though brain tumors are not considered a fundamental cause of cancer deaths worldwide, about 40% of other cancer types are metastasized to the brain and transform into brain tumors. Computer-aided devices for diagnosis through magnetic resonance imaging (MRI) have remained the gold standard for the diagnosis of brain tumors, but this conventional method has been greatly challenged with inefficiencies and drawbacks related to the late detection of brain tumors, high risk in biopsy procedures, and low specificity. To circumvent these underlying hurdles, machine learning models have recently been developed to enhance computer-aided diagnosis tools for advanced, precise, and automatic early detection of brain tumors. This study takes a novel approach to evaluate machine learning models (support vector machine (SVM), random forest (RF), gradient-boosting model (GBM), convolutional neural network (CNN), K-nearest neighbor (KNN), AlexNet, GoogLeNet, CNN VGG19, and CapsNet) used for the early detection and classification of brain tumors by deploying the multicriteria decision-making method called fuzzy preference ranking organization method for enrichment evaluations (PROMETHEE), based on selected parameters, in this study: prediction accuracy, precision, specificity, recall, processing time, and sensitivity. To validate the results of our proposed approach, we performed a sensitivity analysis and cross-checking analysis with the PROMETHEE model. The CNN model, with an outranking net flow of 0.0251, is considered the most favorable model for the early detection of brain tumors. The KNN model, with a net flow of -0.0154, is the least appealing option. The findings of this study support the applicability of the proposed approach for making optimal choices regarding the selection of machine learning models. The decision maker is thus afforded the opportunity to expand the range of considerations which they must rely on in selecting the preferred models for early detection of brain tumors.

Computer-Aided Detection and Classification of Monkeypox and Chickenpox Lesion in Human Subjects Using Deep Learning Framework.

Monkeypox is a zoonotic viral disease caused by the monkeypox virus. After its recent outbreak, it has become clear that a rapid, accurate, and reliable diagnosis may help reduce the risk of a future outbreak. The presence of skin lesions is one of the most prominent symptoms of the disease. However, this symptom is also peculiar to chickenpox. The resemblance in skin lesions in the human subject may disrupt effective diagnosis and, as a result, lead to misdiagnosis. Such misdiagnosis can lead to the further spread of the disease as it is a communicable disease and can eventually result in an outbreak. As deep learning (DL) algorithms have recently been regarded as a promising technique in medical fields, we have been attempting to integrate a well-trained DL algorithm to assist in the early detection and classification of skin lesions in human subjects. This study used two open-sourced digital skin images for monkeypox and chickenpox. A two-dimensional convolutional neural network (CNN) consisting of four convolutional layers was applied. Afterward, three MaxPooling layers were used after the second, third, and fourth convolutional layers. Finally, we evaluated the performance of our proposed model with state-of-the-art deep-learning models for skin lesions detection. Our proposed CNN model outperformed all DL models with a test accuracy of 99.60%. In addition, a weighted average precision, recall, F1 score of 99.00% was recorded. Subsequently, Alex Net outperformed other pre-trained models with an accuracy of 98.00%. The VGGNet consisting of VGG16 and VGG19 performed least well with an accuracy of 80.00%. Due to the uniqueness of the proposed model and image augmentation techniques applied, the proposed CNN model is generalized and avoids over-fitting. This model would be helpful for the rapid and accurate detection of monkeypox using digital skin images of patients with suspected monkeypox.

Diagnostic AI and Cardiac Diseases.

(1) Background: The purpose of this study is to review and highlight recent advances in diagnostic uses of artificial intelligence (AI) for cardiac diseases, in order to emphasize expected benefits to both patients and healthcare specialists; (2) Methods: We focused on four key search terms (Cardiac Disease, diagnosis, artificial intelligence, machine learning) across three different databases (Pubmed, European Heart Journal, Science Direct) between 2017-2022 in order to reach relatively more recent developments in the field. Our review was structured in order to clearly differentiate publications according to the disease they aim to diagnose (coronary artery disease, electrophysiological and structural heart diseases); (3) Results: Each study had different levels of success, where declared sensitivity, specificity, precision, accuracy, area under curve and F1 scores were reported for every article reviewed; (4) Conclusions: the number and quality of AI-assisted cardiac disease diagnosis publications will continue to increase through each year. We believe AI-based diagnosis should only be viewed as an additional tool assisting doctors' own judgement, where the end goal is to provide better quality of healthcare and to make getting medical help more affordable and more accessible, for everyone, everywhere.

Applicability of American College of Radiology Appropriateness Criteria Decision-Making Model for Acute Appendicitis Diagnosis in Children.

Acute appendicitis is one of the most common causes of abdominal pain in the emergency department and the most common surgical emergency reason for children younger than 15 years of age, which could be enormously dangerous when ruptured. The choice of radiological approach is very important for the diagnosis. In this way, unnecessary surgery is avoided. The aim of this study was to examine the validity of the American College of Radiology appropriateness criteria for radiological imaging in diagnosing acute appendicitis with multivariate decision criteria. In our study, pediatric patients who presented to the emergency department with abdominal pain were grouped according to the Appendicitis Inflammatory Response (AIR) score and the choice of radiological examinations was evaluated with fuzzy-based Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) and with the fuzzy-based Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) model for the validation of the results. As a result of this study, non-contrast computed tomography (CT) was recommended as the first choice for patients with low AIR score (where Φnet=0.0733) and with high AIR scores (where Φnet=0.0702) while ultrasound (US) examination was ranked third in patients with high scores. While computed tomography is at the forefront with many criteria used in the study, it is still a remarkable practice that US examination is in the first place in daily routine. Even though there are studies showing the strengths of these tools, this study is unique in that it provides analytical ranking results for this complex decision-making issue and shows the strengths and weaknesses of each alternative for different scenarios, even considering vague information for the acute appendicitis diagnosis in children for different scenarios.

The Capacity of Artificial Intelligence in COVID-19 Response: A Review in Context of COVID-19 Screening and Diagnosis.

Artificial intelligence (AI) has been shown to solve several issues affecting COVID-19 diagnosis. This systematic review research explores the impact of AI in early COVID-19 screening, detection, and diagnosis. A comprehensive survey of AI in the COVID-19 literature, mainly in the context of screening and diagnosis, was observed by applying the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Data sources for the years 2020, 2021, and 2022 were retrieved from google scholar, web of science, Scopus, and PubMed, with target keywords relating to AI in COVID-19 screening and diagnosis. After a comprehensive review of these studies, the results found that AI contributed immensely to improving COVID-19 screening and diagnosis. Some proposed AI models were shown to have comparable (sometimes even better) clinical decision outcomes, compared to experienced radiologists in the screening/diagnosing of COVID-19. Additionally, AI has the capacity to reduce physician work burdens and fatigue and reduce the problems of several false positives, associated with the RT-PCR test (with lower sensitivity of 60-70%) and medical imaging analysis. Even though AI was found to be timesaving and cost-effective, with less clinical errors, it works optimally under the supervision of a physician or other specialists.

Clinical Modelling of RVHF Using Pre-Operative Variables: A Direct and Inverse Feature Extraction Technique.

Right ventricular heart failure (RVHF) mostly occurs due to the failure of the left-side of the heart. RVHF is a serious disease that leads to swelling of the abdomen, ankles, liver, kidneys, and gastrointestinal (GI) tract. A total of 506 heart-failure subjects from the Faculty of Medicine, Cardiovascular Surgery Department, Ege University, Turkey, who suffered from a severe heart failure and are currently receiving support from a ventricular assistance device, were involved in the current study. Therefore, the current study explored the application of both the direct and inverse modelling approaches, based on the correlation analysis feature extraction performance of various pre-operative variables of the subjects, for the prediction of RVHF. The study equally employs both single and hybrid paradigms for the prediction of RVHF using different pre-operative variables. The visualized and quantitative performance of the direct and inverse modelling approach indicates the robust prediction performance of the hybrid paradigms over the single techniques in both the calibration and validation steps. Whereby, the quantitative performance of the hybrid techniques, based on the Nash-Sutcliffe coefficient (NC) metric, depicts its superiority over the single paradigms by up to 58.7%/75.5% and 80.3%/51% for the calibration/validation phases in the direct and inverse modelling approaches, respectively. Moreover, to the best knowledge of the authors, this is the first study to report the implementation of direct and inverse modelling on clinical data. The findings of the current study indicates the possibility of applying these novel hybridised paradigms for the prediction of RVHF using pre-operative variables.

Fuzzy-Based PROMETHEE Method for Performance Ranking of SARS-CoV-2 IgM Antibody Tests.

Antibody tests, widely used as a complementary approach to reverse transcriptase-polymerase chain reaction testing in identifying COVID-19 cases, are used to measure antibodies developed for COVID-19. This study aimed to evaluate the different parameters of the FDA-authorized SARS-CoV-2 IgM antibody tests and to rank them according to their performance levels. In the study, we involved 27 antibody tests, and the analyzes were performed using the fuzzy preference ranking organization method for the enrichment evaluation model, a multi-criteria decision-making model. While criteria such as analytical sensitivity, specificity, positive predictive value, and negative predictive value were evaluated in the study, the ranking was reported by determining the importance levels of the criteria. According to our evaluation, Innovita 2019-nCoV Ab Test (colloidal gold) was at the top of the ranking. While Cellex qSARS-CoV-2 IgG/IgM Rapid Test and Assure COVID-19 IgG/IgM Rapid Tester ranked second and third on the list, the InBios-SCoV 2 Detect Ig M ELISA Rapid Test Kit was determined as the least preferable. The fuzzy preference ranking organization method for enrichment evaluation, which has been applied to many fields, can help decision-makers choose the appropriate antibody test for managing COVID-19 in controlling the global pandemic.

Breast Cancer Screening Based on Supervised Learning and Multi-Criteria Decision-Making.

On average, breast cancer kills one woman per minute. However, there are more reasons for optimism than ever before. When diagnosed early, patients with breast cancer have a better chance of survival. This study aims to employ a novel approach that combines artificial intelligence and a multi-criteria decision-making method for a more robust evaluation of machine learning models. The proposed machine learning techniques comprise various supervised learning algorithms, while the multi-criteria decision-making technique implemented includes the Preference Ranking Organization Method for Enrichment Evaluations. The Support Vector Machine, having achieved a net outranking flow of 0.1022, is ranked as the most favorable model for the early detection of breast cancer. The net outranking flow is the balance between the positive and negative outranking flows. This indicates that the higher the net flow, the better the alternative. K-nearest neighbor, logistic regression, and random forest classifier ranked second, third, and fourth, with net flows of 0.0316, -0.0032, and -0.0541, respectively. The least preferred alternative is the naive Bayes classifier with a net flow of -0.0766. The results obtained in this study indicate the use of the proposed method in making a desirable decision when selecting the most appropriate machine learning model. This gives the decision-maker the option of introducing new criteria into the decision-making process.

The Systematic Review of Artificial Intelligence Applications in Breast Cancer Diagnosis.

Several studies have demonstrated the value of artificial intelligence (AI) applications in breast cancer diagnosis. The systematic review of AI applications in breast cancer diagnosis includes several studies that compare breast cancer diagnosis and AI. However, they lack systematization, and each study appears to be conducted uniquely. The purpose and contributions of this study are to offer elaborative knowledge on the applications of AI in the diagnosis of breast cancer through citation analysis in order to categorize the main area of specialization that attracts the attention of the academic community, as well as thematic issue analysis to identify the species being researched in each category. In this study, a total number of 17,900 studies addressing breast cancer and AI published between 2012 and 2022 were obtained from these databases: IEEE, Embase: Excerpta Medica Database Guide-Ovid, PubMed, Springer, Web of Science, and Google Scholar. We applied inclusion and exclusion criteria to the search; 36 studies were identified. The vast majority of AI applications used classification models for the prediction of breast cancer. Howbeit, accuracy (99%) has the highest number of performance metrics, followed by specificity (98%) and area under the curve (0.95). Additionally, the Convolutional Neural Network (CNN) was the best model of choice in several studies. This study shows that the quantity and caliber of studies that use AI applications in breast cancer diagnosis will continue to rise annually. As a result, AI-based applications are viewed as a supplement to doctors' clinical reasoning, with the ultimate goal of providing quality healthcare that is both affordable and accessible to everyone worldwide.

Optimization of Dental Devices and Tools Used on Teeth.

Taking decisions is important in every aspect of life. Decision-making has become a difficult problem in any situation where there are multiple criteria. The application of multicriteria decision-making methods that can bring mathematical and logical solutions to the problem from an analytical perspective has experienced considerable growth recently. It provides great benefits in solution and subsequent stages. Medical equipment selection is also a challenging, complex, and difficult problem for the decision-maker, due to the requirements of conflicting criteria, which must be taken into account simultaneously. In this context, the aim of this study implicates the principle of multicriteria decision-making theories on various types of instruments used in dentistry. Since the data used in this study are not numeric but linguistic, the Fuzzy PROMETHEE decision-making method is used. In this research, six dental tools most commonly used by professionals to perform operations on patients are compared and evaluated. Fuzzy PROMETHEE decision-making method investigations show that the dental mirror is the most effective tool among all compared tools, followed by dental suction, dental air abrasion, dental handpiece, dental laser, and dental X-ray, consequently, basing on the selected criteria and the importance weight given to each criterion. Using this technique, one can obtain more specific ranking results based on a specific preference level.

Comparative Evaluation of the Treatment of COVID-19 with Multicriteria Decision-Making Techniques.

Objectives: The outbreak of coronavirus disease 2019 (COVID-19) was first reported in December 2019. Until now, many drugs and methods have been used in the treatment of the disease. However, no effective treatment option has been found and only case-based successes have been achieved so far. This study aims to evaluate COVID-19 treatment options using multicriteria decision-making (MCDM) techniques. Methods: In this study, we evaluated the available COVID-19 treatment options by MCDM techniques, namely, fuzzy PROMETHEE and VIKOR. These techniques are based on the evaluation and comparison of complex and multiple criteria to evaluate the most appropriate alternative. We evaluated current treatment options including favipiravir (FPV), lopinavir/ritonavir, hydroxychloroquine, interleukin-1 blocker, intravenous immunoglobulin (IVIG), and plasma exchange. The criteria used for the analysis include side effects, method of administration of the drug, cost, turnover of plasma, level of fever, age, pregnancy, and kidney function. Results: The results showed that plasma exchange was the most preferred alternative, followed by FPV and IVIG, while hydroxychloroquine was the least favorable one. New alternatives could be considered once they are available, and weights could be assigned based on the opinions of the decision-makers (physicians/clinicians). The treatment methods that we evaluated with MCDM methods will be beneficial for both healthcare users and to rapidly end the global pandemic. The proposed method is applicable for analyzing the alternatives to the selection problem with quantitative and qualitative data. In addition, it allows the decision-maker to define the problem simply under uncertainty. Conclusions: Fuzzy PROMETHEE and VIKOR techniques are applied in aiding decision-makers in choosing the right treatment technique for the management of COVID-19.