新的灰关联分析法在不同地区卫生监督质量综合评价中的应用

<正>对于多指标评价的卫生监督质量资料,综合评价方法的正确选择关乎评价结果是否客观准确。本文应用新的灰关联分析法对10个不同地区反映卫生监督质量评价指标的原始数据进行综合评价,并与改进的TOPSIS法[1]和联系数法[2]的排序结果相比较,以便为卫生监督质量的综合评价提供更多的有效的统计方法,为卫生监督质量的提高提供科学依据。现将结果报道如下。     

试用灰关联分析法综合评估学生预防保健相关指标

学生预防保健相关指标主要有９大类［１］。客观准确地综合评估这些指标对全面衡量学校预防保健工作质量,指导卫生监督工作具有重要意义。目前对这９类指标的综合评估大多采用计分法,而计分法中确定每一指标所占的比分具有主观性。灰关联分析法具有评价范围广、无需权重系数、计算比较简单等优点,现已运用于医疗卫生等多个领域［２４］。本文试用灰关联分析法对其进行综合评估以探索更为客观科学的评价方法。１　资料来源本文资料来源于大丰市１９９７年上半年８所学校五年级学生体检资料。体检人员为学校卫生专业人员和医务工作者,体检…     

模糊集对分析法在评价公共场所卫生质量中的应用

采用模糊集对分析方法对天津南开区 1996年 4所公共场所的卫生质量进行了综合评价。结果显示 ,该评价结果与灰色关联分析法所得的结果完全一致     

军队医院院科两级综合评价指标体系及评价方法探讨

目的 初步建立医院和科室两级综合评价指标体系,并探讨综合评价方法. 方法 利用5所军队医院2006年的统计、经济管理和财务数据,采用德尔菲法、离散趋势描述法、多元相关分析法、因子分析法、逐步回归法进行指标的筛选,使用系统聚类法进行指标的验证,运用灰色关联分析法和Topsis法对两级指标进行尝试性评价. 结果 我们分别从经营状况、资源消耗、医疗质量、效率水平、发展创新、为兵服务6个方面确立了医院层面评价指标体系,包括26项二级指标;并从科室建设发展的实际需要出发,在临床和医技科室两个层面确立了科室综合评价指标体系,包括11项临床科室指标,医技科室根据其特色分别设立评价指标.医院层面采用灰色关联分析法进行评价,科室层面采用Topsis法进行评价. 结论 完善院科两级综合评价体系和综合评价方法,可为军队医院管理提供决策依据.     

军队医院院科两级综合评价指标体系及评价方法探讨

目的 初步建立医院和科室两级综合评价指标体系,并探讨综合评价方法. 方法 利用5所军队医院2006年的统计、经济管理和财务数据,采用德尔菲法、离散趋势描述法、多元相关分析法、因子分析法、逐步回归法进行指标的筛选,使用系统聚类法进行指标的验证,运用灰色关联分析法和Topsis法对两级指标进行尝试性评价. 结果 我们分别从...     

应用新的灰关联分析法评价公共场所卫生监督工作质量

作者应用新的灰关联分析法对某市2003年公共场所卫生监督检测资料进行综合评价，并与功效系数法、改进的综合系数法和秩和比法的排序进行比较，为卫生监督工作质量的综合评价提供有效工具，为提高卫生监督质量奠定坚实的基础。     

因子分析法在某市各县市区医疗卫生资源配置及利用情况综合评价中的应用研究

目的:探讨因子分析法在地区卫生资源配置及利用情况综合评价中的应用。方法:用因子分析法对某市12个县市区的卫生资源配置及利用情况进行综合评价。结果:因子分析法得到了12个县市区卫生资源配置及利用情况综合评价排序结果,为进一步做好工作提供了理论依据。结论:因子分析法适宜于客观地综合评价地区卫生资源配置及利用情况,有的放矢地指导卫生工作。     

灰色综合评判法在食品卫生监督质量评价中的应用

将文献[1 ] 提出的灰色关联分析法经过改进 ,并赋予相应的权重 ,综合出灰色综合评判法。结果显示 ,改进的灰色综合评判法与传统的灰色综合评判法所得评价结果一致。研究表明 ,该方法是继模糊评判法后又一行之有效的综合评判方法 ,其原理简单、算法简捷、评价结果客观可靠 ,而且所得结果较模糊评判法分辨率高 ,有较强的实用性 ,为更客观地评价食品卫生监督质量提供了新的定量分析的方法和思路。     

功效系数法在餐厅环境质量综合评价中的应用

<正>餐厅环境卫生质量的高低,对维护餐饮从业人员和就餐者身心健康具有重要意义。但是,在卫生监督工作中,必须按照国家相关卫生标准,采用多指标体系评价餐厅环境质量,这就涉及到如何对监督监测资料进行综合评价问题。功效系数法是多目标决策中进行综合评价的一种统计方法,该方法通过对多评价指标的无量纲化处理,实现分指标评价值合成总评价值。作者曾经应用秩和比法[1]和集对分析[2]对     

一个新的综合评判方法及其在卫生管理中的应用

<正> 对多种因素影响的事物和现象从整体观念出发进行综合评判的问题在医疗、卫生管理的各个领域经常出现。选择一个计算简单、结果可靠的评判方法是管理人员普遍关注的问题。应用灰色系统理论的关联分析法进行综合评判是近几年来在评判方法上的一个创新。该方法不仅可以充分利用原始数据     

应用直觉模糊熵权法评价医疗质量

针对评价系统的复杂性,以信息论中的熵理论为基础,对评价值以直觉模糊数形式给出的多属性评价问题建立直觉模糊熵权评价方法,该方法计算简单,不仅包含了模糊综合法的特性,而且具有信息利用率高,评价结果可靠的优点。     

基于模糊多属性决策理论的学生综合测评方法

针对多属性决策的大学生综合测评问题,从模糊属性评价原理出发,利用AHM法客观为大学生综合测评指标赋权,运用加权法得到方案的综合属性值,并对大学生综合素质做出评价。     

Relative importance of attributes of drug benefit plans: Thai civil servants' perspective

BackgroundThe drug benefit plan of Thailand's Civil Servant Medical Benefit Scheme (CSMBS) must be amended to control increasing costs; to that end, it is important to gather the views of beneficiaries before making changes to the benefit plan.ObjectivesTo examine the relative importance of attributes of drug benefit plans from the perspective of CSMBS beneficiaries.MethodsAttributes and levels adopted from focus group discussions and a preliminary survey were used to develop a questionnaire concerning hypothetical drug benefit plans. A convenience sample of 650 CSMBS beneficiaries in Songkhla province was asked to rate the drug benefit plans. To determine the beneficiaries' decision models, judgment analysis was used. Policy-capturing analysis was used to examine the beneficiaries' preferences, and cluster analysis was conducted to explore the variability among judgment plans. Judgment policy insight was also examined.ResultsThe results of the study showed that the beneficiaries weighed on cost-sharing as their most important attribute. The results remained unchanged, although only data from the beneficiaries who used the compensatory model were analyzed. The results of the cluster analysis showed that the largest cluster of beneficiaries weighed mostly on the cost-sharing attribute. The judgment policy insight results not only supported the finding that most beneficiaries focused on the cost-sharing attribute but also revealed that they might have the least understanding of how the formulary attribute affected beneficiaries' decision making.ConclusionsCost-sharing was the most important attribute for the CSMBS beneficiaries. This study indicated that a possible preferred drug benefit plan should have no cost-sharing, permit access only to drugs listed in a closed formulary, allow beneficiaries to obtain 3 months of drugs, and allow them to obtain drugs from either a community pharmacy or a government hospital.     

Benefit–risk assessment: the use of clinical utility index

Importance of the field: Measurement of the tradeoff between efficacy and safety is rarely done in a quantitative fashion. The use of a clinical utility index (CUI) has been proposed as a tool to aid in this assessment. The methodology from multi-attribute decision analysis is in its early stage in drug development and can be used to understand the therapeutic index and the value relative to the competitive landscape.

Areas covered in this review: Different examples and applications of the use of CUI are reviewed and key steps involved in the development described. These include: i) characterization of the exposure–response of efficacy and safety end points; ii) definition of clinically meaningful parameters; iii) selection and weighting of important attributes and iv) sensitivity analysis and measurement of uncertainty.

What the reader will gain: An understanding of the value and limitations of CUI in drug development.

Take home message: The use of a CUI for quantitative assessment of benefit/risk is most useful when there are multiple attributes involved in a decision to better understand the relevance of each attribute and when differentiation from competitors is critical to the success of a compound. Although development of CUI may be time- and resource-consuming, it allows clear and transparent decision making.     

A weight of evidence approach for hazard screening of engineered nanomaterials

Hazard identification is an important step in assessing nanomaterial risk and is required under multiple regulatory frameworks in the US, Europe and worldwide. Given the emerging nature of the field and complexity of nanomaterials, multiple studies on even basic material properties often result in varying data pointing in different directions when data interpretation is attempted. Weight of evidence (WOE) evaluation has been recommended for nanomaterial risk assessment, but the majority of WOE frameworks are qualitative in nature and do not satisfy the growing needs for objectivity and transparency that are necessary for regulatory decision making. This paper implements a quantitative WOE framework that utilizes multi-criteria decision analysis methodology for integrating individual studies on nanomaterial hazard resulting from physico-chemical and toxicological properties of nanomaterials. For the first time, a WOE approach explicitly integrates expert evaluation of data quality of available information. Application of the framework is illustrated for titanium dioxide nanoparticles (nano-TiO₂), but the approach is designed to compare the relative hazard of several nanomaterials as well as emerging stressors in general.     

民用发动机状态混沌预测算法研究

摘 要：本文首先应用Haar和Db16小波对航空发动机排气温度的原始数据序列进行去噪处理,并且证明了处理后的数据序列具有混沌特征。其次应用混沌理论建立发动机状态预测算法,实现对排气温度的预测。通过检验排气温度预测值是否超过所规定的红线,以及该曲线是否平稳,从而进行发动机的健康状态排查。作为验证实例,文中使用一组某机型发动机实际飞行数据对预测算法进行了验证,并与加权一阶局域法和自回归滑动平均模型预测法进行了对比。结果表明,该组合模型算法精度优于加权一阶局域法和自回归滑动平均模型预测法,该方法可以为这种机型发动机故障预测提供决策依据。     

Applying decision analysis in therapeutic drug monitoring: using decision trees to interpret serum theophylline concentrations

In the second of a three-part series, decision analysis is applied to therapeutic drug monitoring decisions that affect individual patients, using theophylline concentration and toxicity data to illustrate general concepts. Likelihood ratios and conditional probability curves were developed. The curves were used to determine the probability of toxicity based on the clinician's assessment of patient status and a measured serum theophylline concentration. A decision tree to "rule in" or "rule out" toxicity was constructed. Selection of a serum concentration cutoff level for classifying patients as toxic or nontoxic depends on the probabilities of the possible outcomes of the decision process and the clinician's assessment of the value of each possible outcome; therefore, no single concentration value is best for classifying patients. A decision tree was also constructed for evaluating therapeutic options when the clinician is confronted with adverse effects that may be drug related. In three prototype cases, the expected utility for discontinuing theophylline, continuing the drug at the same dosage, or lowering the dosage was determined and used to evaluate the relative worth of each therapeutic option. A more comprehensive interpretation of the serum theophylline concentration is provided by decision-analysis techniques than by observation of pharmacologic effect alone, because other factors such as merit, risk, and consequences of alternative decisions are considered.