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Analytical Techniques to Support Hospital Case Mix Planning
Authors:
Robert L Burdett,
Paul corry,
David Cook,
Prasad Yarlagadda
Abstract:
This article introduces analytical techniques and a decision support tool to support capacity assessment and case mix planning (CMP) approaches previously created for hospitals. First, an optimization model is proposed to analyse the impact of making a change to an existing case mix. This model identifies how other patient types should be altered proportionately to the changing levels of hospital…
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This article introduces analytical techniques and a decision support tool to support capacity assessment and case mix planning (CMP) approaches previously created for hospitals. First, an optimization model is proposed to analyse the impact of making a change to an existing case mix. This model identifies how other patient types should be altered proportionately to the changing levels of hospital resource availability. Then we propose multi-objective decision-making techniques to compare and critique competing case mix solutions obtained. The proposed techniques are embedded seamlessly within an Excel Visual Basic for Applications (VBA) personal decision support tool (PDST), for performing informative quantitative assessments of hospital capacity. The PDST reports informative metrics of difference and reports the impact of case mix modifications on the other types of patient present. The techniques developed in this article provide a bridge between theory and practice that is currently missing and provides further situational awareness around hospital capacity.
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Submitted 31 July, 2023;
originally announced August 2023.
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Multicriteria Optimization Techniques for Understanding the Case Mix Landscape of a Hospital
Authors:
Robert L Burdett,
Paul Corry,
Prasad Yarlagadda,
David Cook,
Sean Birgan
Abstract:
Various medical and surgical units operate in a typical hospital and to treat their patients these units compete for infrastructure like operating rooms (OR) and ward beds. How that competition is regulated affects the capacity and output of a hospital. This article considers the impact of treating different patient case mix (PCM) in a hospital. As each case mix has an economic consequence and a u…
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Various medical and surgical units operate in a typical hospital and to treat their patients these units compete for infrastructure like operating rooms (OR) and ward beds. How that competition is regulated affects the capacity and output of a hospital. This article considers the impact of treating different patient case mix (PCM) in a hospital. As each case mix has an economic consequence and a unique profile of hospital resource usage, this consideration is important. To better understand the case mix landscape and to identify those which are optimal from a capacity utilisation perspective, an improved multicriteria optimization (MCO) approach is proposed. As there are many patient types in a typical hospital, the task of generating an archive of non-dominated (i.e., Pareto optimal) case mix is computationally challenging. To generate a better archive, an improved parallelised epsilon constraint method (ECM) is introduced. Our parallel random corrective approach is significantly faster than prior methods and is not restricted to evaluating points on a structured uniform mesh. As such we can generate more solutions. The application of KD-Trees is another new contribution. We use them to perform proximity testing and to store the high dimensional Pareto frontier (PF). For generating, viewing, navigating, and querying an archive, the development of a suitable decision support tool (DST) is proposed and demonstrated.
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Submitted 31 July, 2023;
originally announced August 2023.
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The Efficacy of Utility Functions for Multicriteria Hospital Case-Mix Planning
Authors:
Robert L Burdett,
Paul Corry,
Prasad Yarlagadda,
David Cook,
Sean Birgan
Abstract:
A new approach to perform hospital case-mix planning (CMP) is introduced in this article. Our multi-criteria approach utilises utility functions (UF) to articulate the preferences and standpoint of independent decision makers regarding outputs. The primary aim of this article is to test whether a utility functions method (UFM) based upon the scalarization of aforesaid UF is an appropriate quantita…
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A new approach to perform hospital case-mix planning (CMP) is introduced in this article. Our multi-criteria approach utilises utility functions (UF) to articulate the preferences and standpoint of independent decision makers regarding outputs. The primary aim of this article is to test whether a utility functions method (UFM) based upon the scalarization of aforesaid UF is an appropriate quantitative technique to, i) distribute hospital resources to different operating units, and ii) provide a better capacity allocation and case mix. Our approach is motivated by the need to provide a method able to evaluate the trade-off between different stakeholders and objectives of hospitals. To the best of our knowledge, no such approach has been considered before in the literature. As we will later show, this idea addresses various technical limitations, weaknesses, and flaws in current CMP. The efficacy of the aforesaid approach is tested on a case study of a large tertiary hospital. Currently UF are not used by hospital managers, and real functions are unavailable, hence, 14 rational options are tested. Our exploratory analysis has provided important guidelines for the application of these UF. It indicates that these UF provide a valuable starting point for planners, managers, and executives of hospitals to impose their goals and aspirations. In conclusion, our approach may be better at identifying case mix that users want to treat and seems more capable of modelling the varying importance of different levels of output. Apart from finding desirable case mixes to consider, the approach can provide important insights via a sensitivity analysis of the parameters of each UF.
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Submitted 31 July, 2023;
originally announced August 2023.
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Developing A Personal Decision Support Tool for Hospital Capacity Assessment and Querying
Authors:
Robert L Burdett,
Paul Corry,
David Cook,
Prasad Yarlagadda
Abstract:
This article showcases a personal decision support tool (PDST) called HOPLITE, for performing insightful and actionable quantitative assessments of hospital capacity, to support hospital planners and health care managers. The tool is user-friendly and intuitive, automates tasks, provides instant reporting, and is extensible. It has been developed as an Excel Visual Basic for Applications (VBA) due…
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This article showcases a personal decision support tool (PDST) called HOPLITE, for performing insightful and actionable quantitative assessments of hospital capacity, to support hospital planners and health care managers. The tool is user-friendly and intuitive, automates tasks, provides instant reporting, and is extensible. It has been developed as an Excel Visual Basic for Applications (VBA) due to its perceived ease of deployment, ease of use, Office's vast installed userbase, and extensive legacy in business. The methodology developed in this article bridges the gap between mathematical theory and practice, which our inference suggests, has restricted the uptake and or development of advanced hospital planning tools and software. To the best of our knowledge, no personal decision support tool (PDST) has yet been created and installed within any existing hospital IT systems, to perform the aforementioned tasks. This article demonstrates that the development of a PDST for hospitals is viable and that optimization methods can be embedded quite simply at no cost. The results of extensive development and testing indicate that HOPLITE can automate many nuanced tasks. Furthermore, there are few limitations and only minor scalability issues with the application of free to use optimization software. The functionality that HOPLITE provides may make it easier to calibrate hospitals strategically and/or tactically to demands. It may give hospitals more control over their case-mix and their resources, helping them to operate more proactively and more efficiently.
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Submitted 31 July, 2023;
originally announced August 2023.
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Characterization of cough sounds using statistical analysis
Authors:
Naveenkumar Vodnala,
Pratap Reddy Lankireddy,
Padmasai Yarlagadda
Abstract:
Cough is a primary symptom of most respiratory diseases, and changes in cough characteristics provide valuable information for diagnosing respiratory diseases. The characterization of cough sounds still lacks concrete evidence, which makes it difficult to accurately distinguish between different types of coughs and other sounds. The objective of this research work is to characterize cough sounds w…
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Cough is a primary symptom of most respiratory diseases, and changes in cough characteristics provide valuable information for diagnosing respiratory diseases. The characterization of cough sounds still lacks concrete evidence, which makes it difficult to accurately distinguish between different types of coughs and other sounds. The objective of this research work is to characterize cough sounds with voiced content and cough sounds without voiced content. Further, the cough sound characteristics are compared with the characteristics of speech. The proposed method to achieve this goal utilized spectral roll-off, spectral entropy, spectral flatness, spectral flux, zero crossing rate, spectral centroid, and spectral bandwidth attributes which describe the cough sounds related to the respiratory system, glottal information, and voice model. These attributes are then subjected to statistical analysis using the measures of minimum, maximum, mean, median, and standard deviation. The experimental results show that the mean and frequency distribution of spectral roll-off, spectral centroid, and spectral bandwidth are found to be higher for cough sounds than for speech signals. Spectral flatness levels in cough sounds will rise to 0.22, whereas spectral flux varies between 0.3 and 0.6. The Zero Crossing Rate (ZCR) of most frames of cough sounds is between 0.05 and 0.4. These attributes contribute significant information while characterizing cough sounds.
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Submitted 6 August, 2023;
originally announced August 2023.
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ViNet: Pushing the limits of Visual Modality for Audio-Visual Saliency Prediction
Authors:
Samyak Jain,
Pradeep Yarlagadda,
Shreyank Jyoti,
Shyamgopal Karthik,
Ramanathan Subramanian,
Vineet Gandhi
Abstract:
We propose the ViNet architecture for audio-visual saliency prediction. ViNet is a fully convolutional encoder-decoder architecture. The encoder uses visual features from a network trained for action recognition, and the decoder infers a saliency map via trilinear interpolation and 3D convolutions, combining features from multiple hierarchies. The overall architecture of ViNet is conceptually simp…
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We propose the ViNet architecture for audio-visual saliency prediction. ViNet is a fully convolutional encoder-decoder architecture. The encoder uses visual features from a network trained for action recognition, and the decoder infers a saliency map via trilinear interpolation and 3D convolutions, combining features from multiple hierarchies. The overall architecture of ViNet is conceptually simple; it is causal and runs in real-time (60 fps). ViNet does not use audio as input and still outperforms the state-of-the-art audio-visual saliency prediction models on nine different datasets (three visual-only and six audio-visual datasets). ViNet also surpasses human performance on the CC, SIM and AUC metrics for the AVE dataset, and to our knowledge, it is the first network to do so. We also explore a variation of ViNet architecture by augmenting audio features into the decoder. To our surprise, upon sufficient training, the network becomes agnostic to the input audio and provides the same output irrespective of the input. Interestingly, we also observe similar behaviour in the previous state-of-the-art models \cite{tsiami2020stavis} for audio-visual saliency prediction. Our findings contrast with previous works on deep learning-based audio-visual saliency prediction, suggesting a clear avenue for future explorations incorporating audio in a more effective manner. The code and pre-trained models are available at https://github.com/samyak0210/ViNet.
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Submitted 7 August, 2021; v1 submitted 11 December, 2020;
originally announced December 2020.
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Tidying Deep Saliency Prediction Architectures
Authors:
Navyasri Reddy,
Samyak Jain,
Pradeep Yarlagadda,
Vineet Gandhi
Abstract:
Learning computational models for visual attention (saliency estimation) is an effort to inch machines/robots closer to human visual cognitive abilities. Data-driven efforts have dominated the landscape since the introduction of deep neural network architectures. In deep learning research, the choices in architecture design are often empirical and frequently lead to more complex models than necess…
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Learning computational models for visual attention (saliency estimation) is an effort to inch machines/robots closer to human visual cognitive abilities. Data-driven efforts have dominated the landscape since the introduction of deep neural network architectures. In deep learning research, the choices in architecture design are often empirical and frequently lead to more complex models than necessary. The complexity, in turn, hinders the application requirements. In this paper, we identify four key components of saliency models, i.e., input features, multi-level integration, readout architecture, and loss functions. We review the existing state of the art models on these four components and propose novel and simpler alternatives. As a result, we propose two novel end-to-end architectures called SimpleNet and MDNSal, which are neater, minimal, more interpretable and achieve state of the art performance on public saliency benchmarks. SimpleNet is an optimized encoder-decoder architecture and brings notable performance gains on the SALICON dataset (the largest saliency benchmark). MDNSal is a parametric model that directly predicts parameters of a GMM distribution and is aimed to bring more interpretability to the prediction maps. The proposed saliency models can be inferred at 25fps, making them suitable for real-time applications. Code and pre-trained models are available at https://github.com/samyak0210/saliency.
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Submitted 10 March, 2020;
originally announced March 2020.