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Robust Psychiatric Decision Support Using Surrogate Numbers

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Intelligent Software Methodologies, Tools and Techniques (SoMeT 2015)

Abstract

Decision analytical methods have been utilized and demonstrated to be of use for a broad range of applications in medical contexts, from regular diagnostic strategies and treatment to the evaluation of diagnostic tests and prediction models and benefit-risk assessments. However, a number of issues still remain to be clarified, for instance ease of use, realism of the input data, long-term outcomes and integration into routine clinical work. In particular, many people are unaccustomed or unwilling to express input information with the preciseness and correctness most methods require, i.e., the values need to be “true” in some sense. The common lack of complete information naturally increases this problem significantly and several attempts have been made to resolve this issue. This is not least the case within psychiatric emergency care where the information available often is of a highly qualitative nature. In this article we suggest the use of so called surrogate numbers that have proliferated for a while in the form of ordinal ranking methods for multi-criteria and show how they can be adapted for use in probability elicitation.

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Notes

  1. 1.

    For various cognitive and methodological aspects of imprecision in decision making, see, e.g., (Danielson et al. 2007, 2013) and various others by the same authors.

  2. 2.

    We will, unless otherwise stated, presume that decision problems are modelled as simplexes S x generated by x 1 > x 2 > … > x N , Σx i  = 1, and 0 ≤ x i .

  3. 3.

    We assume a standard one-level probability tree with a decision node followed by alternatives of action. For each alternative, there is a set of exhaustive and mutually exclusive events which the decision-maker is asked to rank with respect to the probabilities of occurrence. The results are easy to generalise to multi-level trees.

  4. 4.

    Note that these are only suggestions for illustrative purposes. This paper does not intend to discuss problems with eliciting verbal probability statements and their conversion to numerical data. The cardinal information is rather in an actual implementation of the method considered to be input using graphical sliders in a software tool.

  5. 5.

    In order to simplify the presentation, we use p i to represent the probability p(c i ).

  6. 6.

    For simplicity in generation procedures, but without loss of generality, assume that the events in all alternatives have the same number of consequences, N.

  7. 7.

    A second success measure we used is the matching of the three highest ranked alternatives (“podium”), the number of times the three highest evaluated alternatives using a particular method all coincide with the true three highest alternatives. A third set generated is the matching of all ranked alternatives (“overall”), the number of times all evaluated alternatives using a particular method coincide with the true ranking of the alternatives. The two latter sets correlated strongly with the first and are not shown in this paper.

  8. 8.

    The standard deviations between sets of 10 runs were around 0.2–0.3 per cent.

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Correspondence to Love Ekenberg .

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Appendix

Appendix

See Fig. 1

Fig. 1.
figure 1

The complete decision model of the Anna case

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Danielson, M., Ekenberg, L., Sygel, K. (2015). Robust Psychiatric Decision Support Using Surrogate Numbers. In: Fujita, H., Guizzi, G. (eds) Intelligent Software Methodologies, Tools and Techniques. SoMeT 2015. Communications in Computer and Information Science, vol 532. Springer, Cham. https://doi.org/10.1007/978-3-319-22689-7_44

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  • DOI: https://doi.org/10.1007/978-3-319-22689-7_44

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