Operations Research, Systems Engineering and Industrial Engineering Commons^™

Mathematical Modeling For Dental Decay Prevention In Children And Adolescents, Mahdiyeh Soltaninejad

Dissertations

The high prevalence of dental caries among children and adolescents, especially those from lower socio-economic backgrounds, is a significant nationwide health concern. Early prevention, such as dental sealants and fluoride varnish (FV), is essential, but access to this care remains limited and disparate. In this research, a national dataset is utilized to assess sealants' reach and effectiveness in preventing tooth decay, particularly focusing on 2nd molars that emerge during early adolescence, a current gap in the knowledge base. FV is recommended to be delivered during medical well-child visits to children who are not seeing a dentist. Challenges and facilitators in …

Mining High Impact Combinations Of Conditions From The Medical Expenditure Panel Survey, Arjun Mohan

Masters Theses

The condition of multimorbidity — the presence of two or more medical conditions in an individual — is a growing phenomenon worldwide. In the United States, multimorbid patients represent more than a third of the population and the trend is steadily increasing in an already aging population. There is thus a pressing need to understand the patterns in which multimorbidity occurs, and to better understand the nature of the care that is required to be provided to such patients.

In this thesis, we use data from the Medical Expenditure Panel Survey (MEPS) from the years 2011 to 2015 to identify …

Detecting Pathobiomes Using Machine Learning, Valerie Jackson, Valerie Jackson

Industrial Engineering Undergraduate Honors Theses

Machine learning is a field with high growth potential due to the overall continuous progressions, developments, advancements, and improvements caused by the way it is used to help interpret and use large amounts of data [1]. One type of data that can be collected and analyzed by these machine learning models is data that is associated with DNA and information that the DNA gives. The research will be focusing specifically on using machine learning technology to detect pathobiomes indicative of salmonella pork. The pathobiome associated with salmonella is very similar to others, and this causes a problem for classification/detection with …

A Machine Learning Approach For Predicting Clinical Trial Patient Enrollment In Drug Development Portfolio Demand Planning, Ahmed Shoieb

Masters Theses

One of the biggest challenges the clinical research industry currently faces is the accurate forecasting of patient enrollment (namely if and when a clinical trial will achieve full enrollment), as the stochastic behavior of enrollment can significantly contribute to delays in the development of new drugs, increases in duration and costs of clinical trials, and the over- or under- estimation of clinical supply. This study proposes a Machine Learning model using a Fully Convolutional Network (FCN) that is trained on a dataset of 100,000 patient enrollment data points including patient age, patient gender, patient disease, investigational product, study phase, blinded …

A Machine Learning Approach For Early Diagnosis Of Transthyretin Amyloid Cardiomyopathy Among Heart Failure Patients, Tanjim Ahmed

Graduate Theses, Dissertations, and Problem Reports

Transthyretin Amyloid Cardiomyopathy (ATTR-CM) is a rare, progressive, and fatal disease. Prevalence of ATTR-CM ranges from 4 to 17 per 100000 cases where the mean survival time is less than 4 years. It has a history of being underdiagnosed and misdiagnosed. The diagnosis delay has a weighted mean of 6.1 years for wild-type ATTR-CM. Low awareness, the necessity of invasive procedures, and lack of treatment are the key reasons for delayed diagnosis. But, with the introduction of non-invasive tests like nuclear scintigraphy with ^99mTC-PYP and the disease modifying drug Tafamidis, the diagnosis delay signifies a missed opportunity to increase …

Models And Algorithms For Trauma Network Design., Sagarkumar Dhirubhai Hirpara

Electronic Theses and Dissertations

Trauma continues to be the leading cause of death and disability in the US for people aged 44 and under, making it a major public health problem. The geographical maldistribution of Trauma Centers (TCs), and the resulting higher access time to the nearest TC, has been shown to impact trauma patient safety and increase disability or mortality. State governments often design a trauma network to provide prompt and definitive care to their citizens. However, this process is mainly manual and experience-based and often leads to a suboptimal network in terms of patient safety and resource utilization. This dissertation fills important …

Back And Shoulder Exoskeletons For Occupational Use: A Review, Erkan Ozan

Theses

Work-related musculoskeletal disorders (MSDs) account for a large portion of all work-related injuries according to OSHA. Back and shoulder-related disorders make the most of work-related MSDs according to the Bureau of Labor Statistics (BLS). Exoskeletons emerged in recent years with the potential to reduce the risks of work-related musculoskeletal disorders and injuries. Their use in occupational settings is increasing, and exoskeleton designs are rapidly evolving. This paper reviewed recent scientific articles (2015 and after) that evaluated back and shoulder-support passive industrial exoskeletons. The findings of these articles are summarized and analyzed to assess the benefits of passive upper-body exoskeletons by …

Improving Patient Safety, Patient Flow And Physician Well-Being In Emergency Departments, Vishnunarayan Girishan Prabhu

All Dissertations

Over 151 million people visit US Emergency Departments (EDs) annually. The diverse nature and overwhelming volume of patient visits make the ED one of the most complicated settings in healthcare to study. ED overcrowding is a recognized worldwide public health problem, and its negative impacts include patient safety concerns, increased patient length of stay, medical errors, patients left without being seen, ambulance diversions, and increased health system expenditure. Additionally, ED crowding has been identified as a leading contributor to patient morbidity and mortality. Furthermore, this chaotic working environment affects the well-being of all ED staff through increased frustration, workload, stress, …

Eagle Medical Tray Denesting & Debris Removal Process, Nicholas Allen Ungefug, Noah Chavez, Susana Shu-Lin Okhuysen, Michael Augustine Pennington

Industrial and Manufacturing Engineering

Eagle Medical Incorporated is a contract medical device packaging and sterilization company. The company purchases thermoformed medical packaging trays, which maintain the sterility of medical devices, from various manufacturers. To ensure packaging quality and to prevent cleanroom contamination, Eagle Medical inspects and sterilizes each blister tray that they order. This process is an essential non-value-added activity that creates a bottleneck. Cleanroom employees must stop packaging medical devices and attend to the processing of blister trays and packaging solutions. The blister trays arrive at Eagle’s facility in nested stacks. Vibration and movement during shipping further compresses the stacks, which makes separation …

Supplier Performance Scorecard Utilization In The Medical Device Manufacturing Healthcare Supply Chain, Justin Cardisco

Theses and Dissertations

The medical device manufacturing industry has a deficiency in determining how to improve supplier performance for the components and systems they purchase. Many complex medical devices require components from superb suppliers. But how does a medical device manufacturer (MDM) impartially assess supplier performance to know which suppliers to continuing with (or even boost purchase volumes) and which suppliers they should exit? This study describes which supplier-specific metrics are most important to medical device manufacturers (MDMs) so they can utilize this supplier performance scorecard backed by real-world inputs. This research will focus on five categories to measure MDM supplier performance (Quality, …

Examining The Impact Of Design Features Of Electronic Health Records Patient Portals On The Usability And Information Communication For Shared Decision Making, Rong Yin

All Dissertations

The use of the Electronic Health Records (EHR) patient portal has been shown to be effective in generating positive outcomes in patients’ healthcare, improving patient engagement and patient-provider communication. Government legislation also required proof of its meaningful use among patients by healthcare providers. Typical patient portals also include features such as health information and patient education materials. However, little research has examined the specific use of patient portals related to individuals with specific diseases such as inflammatory bowel diseases (IBDs). IBDs are life-long, not curable, chronic diseases that can impact the whole population. Individuals with IBDs may have higher needs …

Investigations Of External Resources And The Impact Of Imaging On Patient Flow In The Emergency Department, Marisa Shehan

All Theses

The problems associated with Emergency Department (ED) crowding are numerous, varied, and complex. Though overcrowded Emergency Departments are frequently attributed to overcrowded hospitals, crowding is also impacted by bottlenecks in patient flow. While discrete-event simulation (DES) is commonly used to model ED flow, external resources are typically excluded from these models due to their complexity and the limited amount of known information for these processes. Instead, external resources such as consults, labs, and imaging are modeled using estimation and/or educated guesswork. In this study, the impact of imaging on patient flow was assessed through data analysis of specific imaging factors, …

Decision-Analytic Models Using Reinforcement Learning To Inform Dynamic Sequential Decisions In Public Policy, Seyedeh Nazanin Khatami

Doctoral Dissertations

We developed decision-analytic models specifically suited for long-term sequential decision-making in the context of large-scale dynamic stochastic systems, focusing on public policy investment decisions. We found that while machine learning and artificial intelligence algorithms provide the most suitable frameworks for such analyses, multiple challenges arise in its successful adaptation. We address three specific challenges in two public sectors, public health and climate policy, through the following three essays. In Essay I, we developed a reinforcement learning (RL) model to identify optimal sequence of testing and retention-in-care interventions to inform the national strategic plan “Ending the HIV Epidemic in the US”. …

Evaluating The Military Medical Evacuation Dispatching And Delivery Problem Via Simulation And Self-Exciting Hawkes Process, Virbon B. Frial

Theses and Dissertations

The location, allocation, and utilization of military medical evacuation (MEDEVAC) resources significantly impact the quality and timeliness of medical care to injured troops. In 2009, Secretary of Defense Robert Gates introduced the Golden Hour mandate that entails the evacuation of critically-injured troops to military treatment facilities (MTFs) within an hour to prevent further complications. To develop high-quality policies that improve MEDEVAC system performance, several papers in the current literature assume that MTFs have both the capacity and capability of treating any patient, regardless of the type of injury. However, these assumptions are unrealistic when conducting high-intensity operations. While acknowledging MTF …

Assessing Patient Safety Culture In United States' Hospitals, Abdulmajeed Azyabi

Electronic Theses and Dissertations, 2020-

Patient safety is founded on continuous learning because there is an urgent need to report and learn from errors, accidents, near misses, and adverse events. The traditional approach to patient safety, based on forming mortality committees and investigating accidents, will no longer be effective. Frameworks, surveys, and assessment tools have been developed over the last decade to assist organizations in measuring and understanding their culture. This a retrospective cross-sectional study included 67,010 respondents from Agency for Health care Research and Quality (AHRQ) 2018 comparative database was analyzed using partial least squares structural equation modeling (PLS-SEM). This research explored whether the …

The Relationship Between First Case On-Time Starts, Turnover Times, And Operating Room Productivity, Rhafia Bucoy

Walden Dissertations and Doctoral Studies

Operating room (OR) managers struggle to manage day-to-day surgical operations while meeting and exceeding organizational productivity amid the COVID-19 pandemic. The deferral of surgeries contributes to millions of backlogs of surgical case volume and unintended negative consequences. Grounded in the proposition that first-case on-time starts (FCOTS) and turnover time (TOT) are correlates of OR productivity, the purpose of this quantitative correlational study was to examine the relationship between FCOTS, TOT, and OR productivity. Archival data from 136 electronic surgical records were collected from two free-standing ambulatory surgery centers and analyzed using multiple regression. The results of the one-service, eye-specialized, ambulatory …

Developing Artificial Intelligence Tools To Investigate The Phenotypes And Correlates Of Chronic Kidney Disease Patients In West Virginia, Marzieh Amiri Shahbazi

Graduate Theses, Dissertations, and Problem Reports

ABSTRACT

Developing Artificial Intelligence tools to investigate the phenotypes and correlates of Chronic Kidney Disease patients in West Virginia

Marzieh Amiri Shahbazi

Chronic kidney disease (CKD) is responsible for disrupting the lives of 37 million people just in the USA, which is about 1 in 7 adults. CKD results in a gradual loss of kidney function over time. Sometimes CKD doesn’t produce any significant symptoms until it reaches an advanced stage. On the other hand, acute kidney injury (AKI) accounts for a sudden decline in the kidney’s function. As a result, the kidneys fail to filter waste materials from the …

Examining Cognitive Empathy Elements Within Ai Chatbots For Healthcare Systems, Lamia Alam

Dissertations, Master's Theses and Master's Reports

Empathy is an essential part of communication in healthcare. It is a multidimensional concept and the two key dimensions: emotional and cognitive empathy allow clinicians to understand a patient’s situation, reasoning, and feelings clearly (Mercer and Reynolds, 2002). As artificial intelligence (AI) is increasingly being used in healthcare for many routine tasks, accurate diagnoses, and complex treatment plans, it is becoming more crucial to incorporate clinical empathy into patient-faced AI systems. Unless patients perceive that the AI is understanding their situation, the communication between patient and AI may not sustain efficiently. AI may not really exhibit any emotional empathy at …

Framework Of Big Data Analytics In Real Time For Healthcare Enterprise Performance Measurements, Ahmed Mohamed

Electronic Theses and Dissertations, 2020-

Healthcare organizations (HCOs) currently have many information records about their patients. Yet, they cannot make proper, faster, and more thoughtful conclusions in many cases with their information. Much of the information is structured data such as medical records, historical data, and non-clinical information. This data is stored in a central repository called the Data Warehouse (DW). DW provides querying and reporting to different groups within the healthcare organization to support their future strategic initiatives. The generated reports create metrics to measure the organization's performance for post-action plans, not for real-time decisions. Additionally, healthcare organizations seek to benefit from the semi-structured …

Multi-Stage Stochastic Optimization And Reinforcement Learning For Forestry Epidemic And Covid-19 Control Planning, Sabah Bushaj

Dissertations

This dissertation focuses on developing new modeling and solution approaches based on multi-stage stochastic programming and reinforcement learning for tackling biological invasions in forests and human populations. Emerald Ash Borer (EAB) is the nemesis of ash trees. This research introduces a multi-stage stochastic mixed-integer programming model to assist forest agencies in managing emerald ash borer insects throughout the U.S. and maximize the public benets of preserving healthy ash trees. This work is then extended to present the first risk-averse multi-stage stochastic mixed-integer program in the invasive species management literature to account for extreme events. Significant computational achievements are obtained using …

Stochastic Programming And Agent-Based Simulation Approaches For Epidemics Control And Logistics Planning, Xuecheng Yin

Dissertations

This dissertation addresses the resource allocation challenges of fighting against infectious disease outbreaks. The goal of this dissertation is to formulate multi-stage stochastic programming and agent-based models to address the limitations of former literature in optimizing resource allocation for preventing and controlling epidemics and pandemics. In the first study, a multi-stage stochastic programming compartmental model is presented to integrate the uncertain disease progression and the logistics of resource allocation to control a highly contagious infectious disease. The proposed multi-stage stochastic program, which involves various disease growth scenarios, optimizes the distribution of treatment centers and resources while minimizing the total expected …

Optimization Of Vaccine Supply Chains In Low- And Middle-Income Countries Utilizing Drones, Maximilian Kolter

Graduate Theses and Dissertations

Despite tremendous efforts from governments and humanitarian organizations, millions of children in low- and low-middle-income countries (LICs and LMICs) are still excluded from the benefits of immunization. The vaccine distribution in LICs and LMICs is challenging for several reasons, such as limited cold chain capacities, vaccine wastage, uncertain demand, and lack of access to immunization services. A promising avenue to address these issues is the utilization of drones for vaccine delivery. Drones can fly at high speed on direct paths and could enable on-demand deliveries to mitigate limited storage capacities. Further, their independence of road networks could allow them reaching …

Analysis And Modeling Of Strategic Interactions In Health Systems To Improve Patient Care Access, Jorge A. Acuña Melo

USF Tampa Graduate Theses and Dissertations

Affordable health care access that provides well-coordinated and high-quality services on time is a goal that governments and health organizations strive for. Regrettably, most countries deal with access problems that affect the population's health, such as long waiting lists for specialized medical services, overcrowding of emergency departments, and high health prices. In the present doctoral dissertation, I model and analyze the strategic interactions that inhabit the health system machinery to uncover possible structural problems that led to the aforementioned issues. The study involves operation research, data science, and game theory techniques to address the health care access predicament.

Each research …

The Discrete-Event Modeling Of Administrative Claims (Demac) System: Dynamically Modeling The U.S. Healthcare Delivery System With Medicare Claims Data To Improve End-Of-Life Care, Rachael Chacko

Dartmouth College Undergraduate Theses

The shift of the U.S. healthcare delivery system from the treatment of acute conditions to chronic diseases requires a new method of healthcare system analysis to properly assess end- of-life (EOL) quality throughout the country. In this paper, we propose the Discrete-Event Modeling of Administrative Claims (DEMAC) system, which relies on a hetero-functional graph theory and discrete event-driven framework to dynamically model EOL care on multiple levels. The heat map visualizations produced by the DEMAC system enable the elucidation of not only patient-specific EOL care but also broader treatment patterns among providers and hospitals. As a whole, the DEMAC system …

Strategies For Achieving The United States Health System's Quadruple Aim By Enhancing The Primary Care Level, Jennifer L. Mendoza-Alonzo

USF Tampa Graduate Theses and Dissertations

The quadruple aim is an approach to optimize the performance of the health system in the United States and consists of four dimensions. The main objective is to improve the population's health, followed by reducing cost, improving patients' experience, and increasing providers' satisfaction. In the present doctoral dissertation, I explore three strategies that help accomplish the quadruple aim at the primary care level. The analysis combines data science and operation research principles to address health system engineering questions.

Each strategy proposed in this document emphasizes one objective more than another; however, all of them in conjunction serve to attain the …

Regression Analysis Of Pacing When Running A Marathon, Hawkin Starke

Industrial Engineering Undergraduate Honors Theses

Regression analysis can be an effective way of examining performance in the marathon event. By splitting up the race into segments or in runner terminology “splits” the significance of each segment as it relates to the total finish time can be explored. Because the idea of splits is already ingrained into the minds of runners, it makes intuitive sense to use these as the metrics to define a race. Additionally, marathons generally make participant age and gender date publicly available which can then be used to find trends within specific demographics. This tailors trends to smaller groups of people, making …

Physicians And Their Patience: Redefining Healthcare Relationships Through Readability Optimization, Rachel V. Ball

Honors Undergraduate Theses

The present study takes legibility research and extends it to the medical setting. Internal Medicine Physicians from UCF developed six passages of medical text detailing a History of Present Illness (HPI) Report from an emergency department as well as comprehension questions for the purpose of our study. In our study, we first presented non-medical passages and comprehension questions in six common fonts to identify participants' individual fastest and slowest fonts. We then gave participants medical passages in both their best and worst fonts while measuring reading speed and comprehension. This study was delivered to a population of Amazon Mechanical Turk …

Nebulizer-Based Systems To Improve Pharmaceutical Aerosol Delivery To The Lungs, Benjamin M. Spence

Theses and Dissertations

Combining vibrating mesh nebulizers with additional new technologies leads to substantial improvements in pharmaceutical aerosol delivery to the lungs across therapeutic administration methods. In this dissertation, streamlined components, aerosol administration synchronization, and/or Excipient Enhanced Growth (EEG) technologies were utilized to develop and test several novel devices and aerosol delivery systems. The first focus of this work was to improve the poor delivery efficiency, e.g., 3.6% of nominal dose (Dugernier et al. 2017), of aerosolized medication administration to adult human subjects concurrent with high flow nasal cannula (HFNC) therapy, a form of continuous-flow non-invasive ventilation (NIV). The developed Low-Volume Mixer-Heater (LVMH) …

Survey Of Airflow Around A Heated Manikin As A Simulated Aeromedical Evacuation Patient On A Litter With Computational Fluid Dynamics Models, George P. Lemmer

Theses and Dissertations

Aeromedical Evacuations remain the predominant method used to transport patients from forward deployed areas of operations to secure locations with more robust medical infrastructure. Transportation of chemical warfare casualties and infectious patients require additional attention to prevent cross contamination. Specific airflow characteristics paired with environmental control system settings are a gap in scholarly literature. Based on the available literature computational fluid dynamics models were created to simulate the airflow around a patient represented by human geometry using commercially available software. In order to compare simulated and experimental results a heated manikin was placed in the MURPHEE aerosol exposure chamber and …

A Core Reference Hierarchical Primitive Ontology For Electronic Medical Records Semantics Interoperability, Ziniya Zahedi

Engineering Management & Systems Engineering Theses & Dissertations

Currently, electronic medical records (EMR) cannot be exchanged among hospitals, clinics, laboratories, pharmacies, and insurance providers or made available to patients outside of local networks. Hospital, laboratory, pharmacy, and insurance provider legacy databases can share medical data within a respective network and limited data with patients. The lack of interoperability has its roots in the historical development of electronic medical records. Two issues contribute to interoperability failure. The first is that legacy medical record databases and expert systems were designed with semantics that support only internal information exchange. The second is ontological commitment to the semantics of a particular knowledge …