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1.
Medicina (Kaunas) ; 57(1)2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33430427

RESUMEN

Background and objectives: Limited evidence exists exploring perceptions of which aspects of a pain management program are perceived as valuable and impactful. The aim of this study was to explore patient beliefs about which aspects of a pain management program were valued and/or had perceived impact. Materials and Methods: One-on-one structured interviews were conducted with 11 adults three months after their completion of the Spark Pain Program at Westmead Hospital, Sydney, Australia. Concepts in the transcripts were inductively identified and explored, utilizing thematic analysis to better understand their relevance to the study aim. Results: Four themes emerged: (1) "The program overall was positive, but…"; (2) "I valued my improved knowledge and understanding of pain, but…"; (3) "I valued the stretching/relaxation/pacing/activity monitoring"; and (4) "I valued being part of a supportive and understanding group". Participants reported that they liked being treated as an individual within the group. A lack of perceived personal relevance of key messages was identified in some participants; it appears that patients in pain programs must determine that changes in knowledge, beliefs, and attitudes are personally relevant in order for the changes to have a significant impact on them. Conclusions: This study provides new insights into aspects of a pain management program that were perceived as valuable and impactful, areas that "missed the mark", and hypotheses to guide the implementation of service delivery and program redesign.


Asunto(s)
Dolor Crónico/terapia , Terapia por Ejercicio , Conocimientos, Actitudes y Práctica en Salud , Ejercicios de Estiramiento Muscular , Manejo del Dolor/métodos , Educación del Paciente como Asunto , Terapia por Relajación , Adulto , Anciano , Actitud Frente a la Salud , Australia , Duración de la Terapia , Femenino , Objetivos , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Percepción , Solución de Problemas , Investigación Cualitativa
2.
Ambio ; 50(2): 393-399, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32885402

RESUMEN

Ecosystems around the world are increasingly exposed to multiple, often interacting human activities, leading to pressures and possibly environmental state changes. Decision support tools (DSTs) can assist environmental managers and policy makers to evaluate the current status of ecosystems (i.e. assessment tools) and the consequences of alternative policies or management scenarios (i.e. planning tools) to make the best possible decision based on prevailing knowledge and uncertainties. However, to be confident in DST outcomes it is imperative that known sources of uncertainty such as sampling and measurement error, model structure, and parameter use are quantified, documented, and addressed throughout the DST set-up, calibration, and validation processes. Here we provide a brief overview of the main sources of uncertainty and methods currently available to quantify uncertainty in DST input and output. We then review 42 existing DSTs that were designed to manage anthropogenic pressures in the Baltic Sea to summarise how and what sources of uncertainties were addressed within planning and assessment tools. Based on our findings, we recommend future DST development to adhere to good modelling practise principles, and to better document and communicate uncertainty among stakeholders.


Asunto(s)
Ecosistema , Solución de Problemas , Países Bálticos , Humanos , Incertidumbre
3.
Proc Natl Acad Sci U S A ; 117(47): 29302-29310, 2020 11 24.
Artículo en Inglés | MEDLINE | ID: mdl-33229515

RESUMEN

Many animals, and an increasing number of artificial agents, display sophisticated capabilities to perceive and manipulate objects. But human beings remain distinctive in their capacity for flexible, creative tool use-using objects in new ways to act on the world, achieve a goal, or solve a problem. To study this type of general physical problem solving, we introduce the Virtual Tools game. In this game, people solve a large range of challenging physical puzzles in just a handful of attempts. We propose that the flexibility of human physical problem solving rests on an ability to imagine the effects of hypothesized actions, while the efficiency of human search arises from rich action priors which are updated via observations of the world. We instantiate these components in the "sample, simulate, update" (SSUP) model and show that it captures human performance across 30 levels of the Virtual Tools game. More broadly, this model provides a mechanism for explaining how people condense general physical knowledge into actionable, task-specific plans to achieve flexible and efficient physical problem solving.


Asunto(s)
Modelos Psicológicos , Solución de Problemas/fisiología , Comportamiento del Uso de la Herramienta/fisiología , Cognición/fisiología , Simulación por Computador , Aprendizaje Profundo , Juegos Experimentales , Humanos , Imaginación/fisiología , Conocimiento
4.
Proc Natl Acad Sci U S A ; 117(47): 29390-29397, 2020 11 24.
Artículo en Inglés | MEDLINE | ID: mdl-33229557

RESUMEN

Observations abound about the power of visual imagery in human intelligence, from how Nobel prize-winning physicists make their discoveries to how children understand bedtime stories. These observations raise an important question for cognitive science, which is, what are the computations taking place in someone's mind when they use visual imagery? Answering this question is not easy and will require much continued research across the multiple disciplines of cognitive science. Here, we focus on a related and more circumscribed question from the perspective of artificial intelligence (AI): If you have an intelligent agent that uses visual imagery-based knowledge representations and reasoning operations, then what kinds of problem solving might be possible, and how would such problem solving work? We highlight recent progress in AI toward answering these questions in the domain of visuospatial reasoning, looking at a case study of how imagery-based artificial agents can solve visuospatial intelligence tests. In particular, we first examine several variations of imagery-based knowledge representations and problem-solving strategies that are sufficient for solving problems from the Raven's Progressive Matrices intelligence test. We then look at how artificial agents, instead of being designed manually by AI researchers, might learn portions of their own knowledge and reasoning procedures from experience, including learning visuospatial domain knowledge, learning and generalizing problem-solving strategies, and learning the actual definition of the task in the first place.


Asunto(s)
Imaginación/fisiología , Pruebas de Inteligencia , Aprendizaje Automático , Solución de Problemas/fisiología , Humanos , Modelos Psicológicos , Redes Neurales de la Computación , Procesamiento Espacial/fisiología , Percepción Visual/fisiología
5.
Eur Rev Med Pharmacol Sci ; 24(20): 10860-10866, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33155248

RESUMEN

OBJECTIVE: Social distancing, as experienced by the Italian population during the COVID-19 outbreak, generated the long-term activation of stress-response in individuals. This has been a crucial opportunity to study the coping strategies that people put in place to adapt their lives and habits to such a unique condition. For this reason, we have investigated both emotion-focused and problem-oriented coping strategies among the Italian population by relating them to other structural factors, such as social, economic and cultural conditions. MATERIALS AND METHODS: More than 140,000 online interviews were collected in Italy from March 22 to April 2, 2020. This large dataset was used to carry out multivariate statistical data analysis with the aim of creating behavioral profiles, starting from coping parameters and other information. This technique has produced an association, showing a good level of statistical significance, between coping strategies and reactions to social distancing, due to the health emergency, during the data collection phase. RESULTS: Two coping indicators - problem-oriented and focused on positive emotions coping strategies - were selected as objective variables in a "decision tree" modelling. The results have shown a link between individual factors (i.e., atmosphere at home) and educational and social factors (i.e., compliance with restrictions during the health emergency). CONCLUSIONS: The reduction of social interaction had quite a significant impact on people's behavior; furthermore, coping strategies have played a crucial role in facing this stressor. For both the selected coping indicators, the best predictor was the atmosphere perceived at home. Moreover, the respondents' previous experiences have played a relevant role in the acceptance of new rules imposed by the government. This information can be useful in planning future social policies, both at national and international level, during such peculiar times.


Asunto(s)
Adaptación Psicológica , Infecciones por Coronavirus/psicología , Neumonía Viral/psicología , Femenino , Humanos , Entrevistas como Asunto , Italia , Masculino , Pandemias , Solución de Problemas , Encuestas y Cuestionarios
7.
Rev. inf. cient ; 99(5): 468-477, tab
Artículo en Español | LILACS | ID: biblio-1139209

RESUMEN

RESUMEN Introducción: El egreso de un médico general competente demanda que desde el pregrado aprenda a solucionar los problemas de salud más prevalentes. Objetivo: Diseñar un sistema de tareas docentes que contribuya a que el estudiante de Medicina desarrolle la habilidad de solucionar problemas de salud de carácter urgente presentes en el paciente adulto. Método: En el curso escolar 2017-2018, en el servicio de Medicina Intensiva del Hospital General Docente "Dr. Agostinho Neto" se realizó un estudio de corte transversal y con enfoque cualitativo. Se utilizaron métodos teóricos, empíricos y matemático-estadísticos. Se hizo un pre-experimento en el que se aplicó un sistema de tareas docentes dirigido a satisfacer el objetivo que se declaró, en el que participaron 25 estudiantes seleccionados aleatoriamente. Resultados: La autoevaluación del estudiante y su examen de desempeño mostró que en el 64,0 % de ellos mejoró su preparación para este fin y logró el desarrollo de la habilidad. Conclusiones: Se fundamenta desde el punto de vista teórico que la solución de estos problemas de salud de carácter urgente adquiere el carácter de habilidad profesional para el médico dada su implicación en el modo de actuación profesional. Se diseña un sistema de tareas docentes que posibilita esta aspiración y se demuestra su viabilidad para su instrumentación en la práctica pedagógica.


ABSTRACT Introduction: The graduation of competent general practitioners demand from them the learning of skills to solve the most common urgent health issues from early stages of the undergraduate level. Objective: To design a system of teaching tasks aiming to the development of problem-solving skills in the medicine student regarding common urgent health problems in adult patients. Method: During the school year 2017-2018, a qualitative-focused cross-sectional study was undertaken in the intensive care service at the General Teaching Hospital ¨Dr. Agostinho Neto¨. In the research, theoretical, empirical and mathematical-statistical methods were used. A pre experiment was carried out, applying a system of teaching tasks aimed to the goals already set, in a group of 25 randomly-selected students. Results: Self-evaluation of the students, and their performance in the exams showed an improvement in 64.0% of them, and the development of the skills required. Conclusions: From a theoretical point of view, is obvious that the resolution of urgent health problems is a keystone skill in the practitioners, due to the importance it has in their career. On that path, a system of tasks is developed in order to show the students how to improve on these skills, and the viability to make this tasks into the current teaching program is proved.


Asunto(s)
Humanos , Aptitud , Solución de Problemas , Toma de Decisiones Clínicas , Estudiantes de Medicina , Estudios Transversales
8.
Sci Rep ; 10(1): 16728, 2020 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-33028930

RESUMEN

We aimed to develop a brief, preclinical test to screen the reduced hippocampal volume that is a marker of early dementia [Cognitive Quotient (CQ) test]. We performed an observational study of adult subjects who underwent brain MRI in seven institutions from February 2018 to May 2019. The CQ test consists of five components: (1) digits forward, (2) digits backward, (3) Stroop test, (4) simple calculation, and (5) mental rotation. The primary outcome measure was hippocampal volume. We separated the data into derivation (n = 322) and validation cohorts (n = 96). In the derivation cohort, we built two scoring systems using the results of CQ test (model 1 and 2). In the validation cohort, we validated the correlation of the scoring systems with hippocampal volume. In the derivation cohort, there was a moderate correlation between the scoring systems and hippocampal volume [e.g., correlation coefficient = 0.62 in model 1 (95% CI 0.44-0.75)]. Likewise, in the validation cohort, there was a moderate correlation between the scoring systems and hippocampal volume [e.g., correlation coefficient = 0.54 in model 2 (95% CI 0.38-0.67)]. In this analysis of 418 participants, the score of newly developed CQ test was correlated with hippocampal volume.


Asunto(s)
Cognición/fisiología , Hipocampo/diagnóstico por imagen , Solución de Problemas/fisiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Tamaño de los Órganos/fisiología
9.
Am J Orthod Dentofacial Orthop ; 158(6): 856-867, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33008708

RESUMEN

INTRODUCTION: During the decision-making process, physicians rely on heuristics that consist of simple, useful procedures for solving problems, intuitive shortcuts that produce reliable decisions based on limited information. In clinical situations characterized by a high degree of uncertainty such as those encountered in orthodontics, cognitive biases and judgment errors related to heuristics are not uncommon. This study aimed at promoting trust in the effective interface between the intuitive reasoning of the orthodontic practitioner and the computational heuristics emerging from simple statistical models. METHODS: We propose an integrative model based on the interaction between clinical reasoning and 2 computational tools, cluster analysis and fast-and-frugal trees, to extract a structured craniofacial representation of untreated subjects with Class III malocclusion and to forecast the worsening of the malocclusion over time. RESULTS: Cluster analysis of cephalometric values from 144 growing subjects with Class III malocclusion followed longitudinally (T1: mean age, 10.2 ± 1.9 years; T2: mean age, 13.8 ± 2.7 years) produced 3 morphologic subgroups with predominant sagittal, vertical, and slight maxillomandibular imbalances. Fast-and-frugal trees applied to different subgroups extracted heuristics that improved the prediction of key features associated with adverse craniofacial growth. CONCLUSIONS: Provided that cephalometric values are placed in the appropriate framework, the matching between simple and fast computational approaches and clinical reasoning could help the intuitive logic, perception, and cognitive inferences of orthodontic practitioners on the outcome of patients affected by Class III disharmony, decreasing errors associated with flawed judgments and improving the accuracy of decision making.


Asunto(s)
Heurística , Ortodoncia , Adolescente , Cefalometría , Niño , Toma de Decisiones , Humanos , Solución de Problemas
11.
Ugeskr Laeger ; 182(41)2020 10 05.
Artículo en Danés | MEDLINE | ID: mdl-33046185

RESUMEN

Transparency in modelling of the COVID-19 spread is necessary for enhanced understanding of the underlying logic and assumptions. In Denmark, the government relies on the expert advice given by Statens Serum Institut, whose model logic requires programming capabilities. This review demonstrates the importance in model transparency by setting up a system dynamics simulation model of the COVID-19 spread. The developed model can be applied to test intended interventions' effects and is promoted as a suitable approach for other equally complex problem solving in healthcare.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Neumonía Viral , Solución de Problemas , Betacoronavirus , Infecciones por Coronavirus/transmisión , Prestación de Atención de Salud , Humanos , Modelos Teóricos , Neumonía Viral/transmisión
12.
BMC Psychiatry ; 20(1): 463, 2020 09 24.
Artículo en Inglés | MEDLINE | ID: mdl-32972392

RESUMEN

BACKGROUND: Major depression (MDD) and social anxiety (SAD) disorders are debilitating psychiatric conditions characterized by disturbed interpersonal relationships. Despite these impairments in social relationships, research has been limited in simultaneously evaluating the dysfunction in MDD or SAD within two aspects of theory of mind (ToM): decoding mental states (i.e., Affective ToM) and reasoning mental states (i.e., cognitive ToM). Taking this into consideration, the current study assesses both decoding and reasoning mental states abilities in MDD, SAD, and healthy controls (HC). METHODS: Subjects included 37 patients with MDD, 35 patients with SAD, and 35 HCs. ToM was measured with the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Task, which assess decoding and reasoning mental states, respectively. RESULTS: Results revealed that in decoding of mental states, both the SAD and MDD groups had lower scores than the HC group; there was no significant difference between the SAD and MDD groups in decoding mental states. Conversely, in reasoning mental states, the SAD and HC groups had higher scores than the MDD group; no differences were found between the SAD and HC groups. CONCLUSIONS: Clinicians and researchers should further consider parsing generalized impairment in ToM into two aspects: decoding and reasoning of mental states by using the aforementioned measurements. By further understanding the two aspects, we can create a potentially new clinical profile for mental health disorders, such as in this context with both decoding and reasoning mental state impairment in MDD and just a decoding impairment in SAD.


Asunto(s)
Trastorno Depresivo Mayor , Fobia Social , Teoría de la Mente , Depresión , Trastorno Depresivo Mayor/diagnóstico , Humanos , Fobia Social/diagnóstico , Solución de Problemas
13.
CBE Life Sci Educ ; 19(3): ar42, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32870077

RESUMEN

We previously reported that students' concept-building approaches, identified a priori using a cognitive psychology laboratory task, extend to learning complex science, technology, engineering, and mathematics topics. This prior study examined student performance in both general and organic chemistry at a select research institution, after accounting for preparation. We found that abstraction learners (defined cognitively as learning the theory underlying related examples) performed higher on course exams than exemplar learners (defined cognitively as learning by memorizing examples). In the present paper, we further examined this initial finding by studying a general chemistry course using a different pedagogical approach (process-oriented guided-inquiry learning) at an institution focused on health science majors, and then extended our studies via think-aloud interviews to probe the effect concept-building approaches have on problem-solving behaviors of average exam performance students. From interviews with students in the average-achieving group, using problems at three transfer levels, we found that: 1) abstraction learners outperformed exemplar learners at all problem levels; 2) abstraction learners relied on understanding and exemplar learners dominantly relied on an algorithm without understanding at all problem levels; and 3) both concept-building-approach students had weaknesses in their metacognitive monitoring accuracy skills, specifically their postperformance confidence level in their solution accuracy.


Asunto(s)
Solución de Problemas , Estudiantes , Ingeniería , Humanos , Aprendizaje , Matemática
14.
CBE Life Sci Educ ; 19(3): ar41, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32870078

RESUMEN

Research in science, technology, engineering, and mathematics education supports a shift from traditional lecturing to evidence-based instruction in college courses, yet it is unknown whether particular evidence-based pedagogies are more effective than others for learning outcomes like problem solving. Research supports three distinct pedagogies: worked examples plus practice, productive failure, and guided inquiry. These approaches vary in the nature and timing of guidance, all while engaging the learner in problem solving. Educational psychologists debate their relative effectiveness, but the approaches have not been directly compared. In this study, we investigated the impact of worked examples plus practice, productive failure, and two forms of guided inquiry (unscaffolded and scaffolded guidance) on student learning of a foundational concept in biochemistry. We compared all four pedagogies for basic knowledge performance and near-transfer problem solving, and productive failure and scaffolded guidance for far-transfer problem solving. We showed that 1) the four pedagogies did not differentially impact basic knowledge performance; 2) worked examples plus practice, productive failure, and scaffolded guidance led to greater near-transfer performance compared with unscaffolded guidance; and 3) productive failure and scaffolded guidance did not differentially impact far-transfer performance. These findings offer insights for researchers and college instructors.


Asunto(s)
Aprendizaje , Psicología Educacional , Ingeniería , Humanos , Matemática , Solución de Problemas
15.
CBE Life Sci Educ ; 19(3): ar45, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32870080

RESUMEN

The creation and analysis of models is integral to all scientific disciplines, and modeling is considered a core competency in undergraduate biology education. There remains a gap in understanding how modeling activities may support changes in students' neural representations. The aim of this study was to evaluate the effects of simulating a model on undergraduates' behavioral accuracy and neural response patterns when reasoning about biological systems. During brief tutorials, students (n = 30) either simulated a computer model or read expert analysis of a gene regulatory system. Subsequently, students underwent functional magnetic resonance imaging while responding to system-specific questions and system-general questions about modeling concepts. Although groups showed similar behavioral accuracy, the Simulate group showed higher levels of activation than the Read group in right cuneal and postcentral regions during the system-specific task and in the posterior insula and cingulate gyrus during the system-general task. Students' behavioral accuracy during the system-specific task correlated with lateral prefrontal brain activity independent of instruction group. Findings highlight the sensitivity of neuroimaging methods for identifying changes in representations that may not be evident at the behavioral level. This work provides a foundation for research on how distinct pedagogical approaches may affect the neural networks students engage when reasoning about biological phenomena.


Asunto(s)
Lectura , Productos Biológicos , Encéfalo , Humanos , Modelos Biológicos , Solución de Problemas
16.
CBE Life Sci Educ ; 19(3): ar48, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32870088

RESUMEN

National calls to transform undergraduate classrooms highlight the increasingly interdisciplinary nature of science, technology, engineering, and mathematics (STEM). As biologists, we use principles from chemistry and physics to make sense of the natural world. One might assume that scientists, regardless of discipline, use similar principles, resources, and reasoning to explain crosscutting phenomena. However, the context of complex natural systems can profoundly impact the knowledge activated. In this study, we used the theoretical lens of framing to explore how experts from different disciplines reasoned about a crosscutting phenomenon. Using interviews conducted with faculty (n = 10) in biology, physics, and engineering, we used isomorphic tasks to explore the impact of item context features (i.e., blood or water) on how faculty framed and reasoned about fluid dynamics, a crosscutting concept. While faculty were internally consistent in their reasoning across prompts, biology experts framed fluid dynamics problems differently than experts in physics and engineering and, as a result, used different principles and resources to reach different conclusions. These results have several implications for undergraduate learners who encounter these cross-disciplinary topics in all of their STEM courses. If each curriculum expects students to develop different reasoning strategies, students may struggle to build a coherent, transferable understanding of crosscutting phenomena.


Asunto(s)
Solución de Problemas , Curriculum , Ingeniería , Humanos , Matemática , Estudiantes
17.
Artículo en Inglés | MEDLINE | ID: mdl-32932797

RESUMEN

In order to achieve sustainable development to protect the environment and society, an increasing number of scholars have conducted in-depth research on green marketing and green purchases. Although great achievements have been made in this field, there still is room for further progress. This study reviews 97 papers providing empirical research on green purchase behavior from 2015 to 2020. First, we review the widely used consumer theory and its extended application in recent years. Second, we divide the influencing factors of green purchase behavior into the following three categories and discuss them in detail: individual factors, product attributes and marketing, and social factors. Finally, we put forward the following possible directions for future research. (1) The authors can consider adjustment to the survey objects to weaken the subjectivity of the data. (2) Longitudinal research can be used to assess the impact of education and policies with a lagging effect on consumers. (3) The authors can broaden the research direction towards a cross-cultural background. (4) The behavior of various green products (such as recyclable tires, recycled glass containers, recycled paper) could be explored to enrich the research content. (5) It will be beneficial to combine a variety of consumer theories to explore the green purchase behavior of consumers and break through the existing linear hypothesis path to explore new research methods.


Asunto(s)
Conservación de los Recursos Naturales , Comportamiento del Consumidor , Mercadotecnía , Cultura , Humanos , Solución de Problemas , Encuestas y Cuestionarios , Desarrollo Sostenible
18.
PLoS One ; 15(9): e0236030, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32915801

RESUMEN

Previous experimental studies have regarded distraction, an emotional regulation strategy, as an attentional disengagement strategy and considered it to be maladaptive in the long term. This study intends to further examine the relationship between distraction and negative emotions by using a questionnaire and a multiple mediation model. A total of 723 college students completed the distraction, cognitive reappraisal and problem-solving subscales of the Measurement of Affect Regulation Styles, the Needs Satisfaction Questionnaire, the Meaningful Life Measure, and the Emotional Experience Questionnaire of Well-being. Structural equation modeling (SEM) was performed, and mediation effects were tested. The results showed that (1) distraction was used significantly more frequently than problem-solving and cognitive reappraisal, with a large effect size (partial η2 = 0.321 > 0.138), and (2) distraction had an effect on negative emotions through two multiple mediation paths, i.e., positive emotion-cognitive reappraisal-meaning in life, and positive emotion-problem-solving-needs satisfaction. Distraction reduces negative emotions by enhancing positive emotions and facilitating cognitive reappraisal, problem-solving, meaning in life and needs satisfaction. It is not a kind of avoidance but a temporary rest to strive for a better life.


Asunto(s)
Regulación Emocional , Solución de Problemas , Estudiantes , Adulto , Atención , China , Cognición , Emociones , Femenino , Humanos , Masculino , Adulto Joven
19.
PLoS One ; 15(9): e0238463, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32881919

RESUMEN

In a clinical decision support system, the purpose of case-based reasoning is to help clinicians make convenient decisions for diagnoses or interventional gestures. Past experience, which is represented by a case-base of previous patients, is exploited to solve similar current problems using four steps-retrieve, reuse, revise, and retain. The proposed case-based reasoning has been focused on transcatheter aortic valve implantation to respond to clinical issues pertaining vascular access and prosthesis choices. The computation of a relevant similarity measure is an essential processing step employed to obtain a set of retrieved cases from a case-base. A hierarchical similarity measure that is based on a clinical decision tree is proposed to better integrate the clinical knowledge, especially in terms of case representation, case selection and attributes weighting. A case-base of 138 patients is used to evaluate the case-based reasoning performance, and retrieve- and reuse-based criteria have been considered. The sensitivity for the vascular access and the prosthesis choice is found to 0.88 and 0.94, respectively, with the use of the hierarchical similarity measure as opposed to 0.53 and 0.79 for the standard similarity measure. Ninety percent of the suggested solutions are correctly classified for the proposed metric when four cases are retrieved. Using a dedicated similarity measure, with relevant and weighted attributes selected through a clinical decision tree, the set of retrieved cases, and consequently, the decision suggested by the case-based reasoning are substantially improved over state-of-the-art similarity measures.


Asunto(s)
Válvula Aórtica/cirugía , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Algoritmos , Válvula Aórtica/fisiología , Estenosis de la Válvula Aórtica/diagnóstico , Estenosis de la Válvula Aórtica/cirugía , Sistemas de Apoyo a Decisiones Clínicas , Prótesis Valvulares Cardíacas/tendencias , Implantación de Prótesis de Válvulas Cardíacas/métodos , Humanos , Selección de Paciente , Solución de Problemas , Diseño de Prótesis , Sensibilidad y Especificidad , Resultado del Tratamiento
20.
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