Evaluation of criteria and COVID-19 patients for intensive care unit admission in the era of pandemic: A multi-criteria decision making approach

Fuzzy APPSS: A novel method for quantifying COVID-19 impact in India under triangular spherical fuzzy environment

In the current scenario, decision-making models are essential for analyzing real-world problems. To address the dynamic nature of these problems, fuzzy decision-making models have been proposed by various researchers. However, an advanced technique is needed to assess uncertainty in real-time complex situations. Therefore, an association between preference and performance with satisfactory score (APPSS) method is introduced as a fuzzy decision-making method that incorporates two components: preference and performance. This method focuses on demonstrating a connection between preference and performance with a satisfactory measure. Preference analysis evaluates the significance of criteria, while performance analysis assesses the effectiveness of each alternative based on these criteria. Additionally, the satisfactory measure ensures the reliability of the outcomes. The applicability of the proposed method is demonstrated by analyzing the impact of COVID-19 on different age groups in India across various categories. The proposed method employs triangular spherical fuzzy numbers (TSFN), which is a mathematical model that extends beyond conventional fuzzy numbers by incorporating both triangular and spherical characteristics. Furthermore, a new scoring function for TSFN is developed using the graded mean integration method. The analysis reveals that the age group between 60-69 is highly vulnerable to COVID-19. The robustness of these outcomes is verified through sensitivity and comparative analyses. The findings also assist policymakers in more effectively assessing potential future health complications.

Intensive care unit admission criteria: a scoping review

Background

Effectively identifying deteriorated patients is vital to the development and validation of automated systems designed to predict clinical deterioration. Existing outcome measures used for this purpose have significant limitations. Published criteria for admission to high acuity inpatient areas may represent markers of patient deterioration and could inform the development of alternate outcome measures.

Objectives

In this scoping review, we aimed to characterise published criteria for admission of adult inpatients to high acuity inpatient areas including intensive care units. A secondary aim was to identify variables that are extractable from electronic health records (EHRs).

Data sources

Electronic databases PubMed and ProQuest EBook Central were searched to identify papers published from 1999 to date of search. We included publications which described prescriptive criteria for admission of adult inpatients to a clinical area with a higher level of care than a general hospital ward.

Charting methods

Data was extracted from each publication using a standardised data-charting form. Admission criteria characteristics were summarised and cross-tabulated for each criterion by population group.

Results

Five domains were identified: diagnosis-based criteria, clinical parameter criteria, organ-support criteria, organ-monitoring criteria and patient baseline criteria. Six clinical parameter-based criteria and five needs-based criteria were frequently proposed and represent variables extractable from EHRs. Thresholds for objective clinical parameter criteria varied across publications, and by disease subgroup, and universal cut-offs for criteria could not be elucidated.

Conclusions

This study identified multiple criteria which may represent markers of deterioration. Many of the criteria are extractable from the EHR, making them potential candidates for future automated systems. Variability in admission criteria and associated thresholds across the literature suggests clinical deterioration is a heterogeneous phenomenon which may resist being defined as a single entity via a consensus-driven process.

A historical review and analysis on MOORA and its fuzzy extensions for different applications

Multi-criteria decision-making (MCDM) methods have been widely used among researchers to provide a trade-off solution between best and worst, considering conflicting criteria and sets of preferences. An efficient and systematic literature review of these methods is needed to maintain their application in distinctive domains. To this end, this paper presents a comprehensive and systematic literature survey on "multi-objective optimization by ratio analysis" (MOORA) method and its fuzzy extensions developed and discussed in recent years. This review includes articles categorized based on the publication name, publishing year, journal name, type of applications, and type of fuzzy extensions. In addition, this review will enhance the understanding of practitioners and decision-makers on the MOORA method, its development, fuzzy hybridization, different application areas, and future work. The study revealed that the MOORA technique was predominantly used with the TOPSIS approach, followed by the AHP and COPRAS methods. Furthermore, 76.28 % use single and hybridization approaches among all MOORA studies, while 23.72 % use MOORA in a fuzzy environment.

An interpreter ranking index-based MCDM technique for COVID-19 treatments under a bipolar fuzzy environment

The entire world is currently fighting the severe and dangerous pandemic COVID-19, which is causing bodily suffering and mental distress due to the rapidly increasing number of infected patients and deaths worldwide. Many COVID-19 treatments are going on in India, and some treatments are under development for these patients. But, treatment selection for the COVID-19 patients is challenging in the present situation. Through the multi-criteria decision-making technique, they can select the COVID-19 treatments easily. Therefore, we have developed an MCDM technique to select COVID-19 treatments in India. This paper invented the value and ambiguity of bipolar fuzzy (BF) numbers. Additionally, some fundamental theorems and properties of BF-numbers are studied. A novel positive and negative interpreter ranking index of BF numbers has been introduced. In the present day, most human decision-making relies heavily on bipolar fuzzy information. Hence, we developed an MCDM technique with bipolar fuzzy details. A comprehensive range of human decisions for selecting COVID-19 treatments is based on positive and negative double-sided or bipolar judgemental thinking. To select COVID-19 treatments in India, we have applied the proposed MCDM technique with BTrF information. Moreover, to demonstrate the applicability of our proposed MCDM method, we have considered a numerical example with BF data. Finally, we give the comparison study to show the effectiveness of our proposed MCDM method with other existing decision-making methods.

Decision trees for early prediction of inadequate immune response to coronavirus infections: a pilot study on COVID-19

Introduction

Few artificial intelligence models exist to predict severe forms of COVID-19. Most rely on post-infection laboratory data, hindering early treatment for high-risk individuals.

Methods

This study developed a machine learning model to predict inherent risk of severe symptoms after contracting SARS-CoV-2. Using a Decision Tree trained on 153 Alpha variant patients, demographic, clinical and immunogenetic markers were considered. Model performance was assessed on Alpha and Delta variant datasets. Key risk factors included age, gender, absence of KIR2DS2 gene (alone or with HLA-C C1 group alleles), presence of 14-bp polymorphism in HLA-G gene, presence of KIR2DS5 gene, and presence of KIR telomeric region A/A.

Results

The model achieved 83.01% accuracy for Alpha variant and 78.57% for Delta variant, with True Positive Rates of 80.82 and 77.78%, and True Negative Rates of 85.00% and 79.17%, respectively. The model showed high sensitivity in identifying individuals at risk.

Discussion

The present study demonstrates the potential of AI algorithms, combined with demographic, epidemiologic, and immunogenetic data, in identifying individuals at high risk of severe COVID-19 and facilitating early treatment. Further studies are required for routine clinical integration.

Evaluation of the treatment options for COVID-19 patients using generalized hesitant fuzzy- multi criteria decision making techniques

The breakout of the pandemic COVID-19 has affected numerous countries and territories worldwide. As COVID-19 specific medicines yet to be invented, at present the treatment is case specific, hence identification and evaluation of different prevalent treatment options based on various criteria and attributes are very important not only from the point of view of present pandemic but also for futuristic pandemic preparedness. The present study focuses on identifying, evaluation and ranking of treatment options using Multi Criteria Decision Making (MCDM). In this regard, the existing literature, doctors and scientist were interviewed to know the current treatment options in vogue and the scale of their importance with respect to the criteria. The criteria taken are side effect, regime cost, treatment duration, plasma stability, plasma turnover, time of suppression, ease of application, drug-drug interaction, compliance, fever, pneumonia, intensive care, organ failure, macrophage activation syndrome, hemophagocytic syndrome, pregnancy, kidney problem, age. This study extended Hesitant Fuzzy Set (HFS) to Generalized Hesitant Fuzzy Sets (GHFS). Generalized Hesitant Pentagonal Fuzzy Number (GHPFN) is developed. The properties of GHPFN are demonstrated. Two types of GHPFN has been described. The GHPFN (2nd type) along with MCDM tool Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) has been applied to rank the treatment options. The result of the study ranked 'Hydroxychloroquine' as the first alternative followed by, 'Plasma Exchange', 'Tocilizumab', 'Remdesivir' and 'Favipravir'. To check the robustness and steadiness of the proposed methodology, comparative analysis and sensitivity analysis has been conducted.

Systematic review of MCDM approach applied to the medical case studies of COVID-19: trends, bibliographic analysis, challenges, motivations, recommendations, and future directions

When COVID-19 spread in China in December 2019, thousands of studies have focused on this pandemic. Each presents a unique perspective that reflects the pandemic's main scientific disciplines. For example, social scientists are concerned with reducing the psychological impact on the human mental state especially during lockdown periods. Computer scientists focus on establishing fast and accurate computerized tools to assist in diagnosing, preventing, and recovering from the disease. Medical scientists and doctors, or the frontliners, are the main heroes who received, treated, and worked with the millions of cases at the expense of their own health. Some of them have continued to work even at the expense of their lives. All these studies enforce the multidisciplinary work where scientists from different academic disciplines (social, environmental, technological, etc.) join forces to produce research for beneficial outcomes during the crisis. One of the many branches is computer science along with its various technologies, including artificial intelligence, Internet of Things, big data, decision support systems (DSS), and many more. Among the most notable DSS utilization is those related to multicriterion decision making (MCDM), which is applied in various applications and across many contexts, including business, social, technological and medical. Owing to its importance in developing proper decision regimens and prevention strategies with precise judgment, it is deemed a noteworthy topic of extensive exploration, especially in the context of COVID-19-related medical applications. The present study is a comprehensive review of COVID-19-related medical case studies with MCDM using a systematic review protocol. PRISMA methodology is utilized to obtain a final set of (n = 35) articles from four major scientific databases (ScienceDirect, IEEE Xplore, Scopus, and Web of Science). The final set of articles is categorized into taxonomy comprising five groups: (1) diagnosis (n = 6), (2) safety (n = 11), (3) hospital (n = 8), (4) treatment (n = 4), and (5) review (n = 3). A bibliographic analysis is also presented on the basis of annual scientific production, country scientific production, co-occurrence, and co-authorship. A comprehensive discussion is also presented to discuss the main challenges, motivations, and recommendations in using MCDM research in COVID-19-related medial case studies. Lastly, we identify critical research gaps with their corresponding solutions and detailed methodologies to serve as a guide for future directions. In conclusion, MCDM can be utilized in the medical field effectively to optimize the resources and make the best choices particularly during pandemics and natural disasters.

MEF: Multidimensional Examination Framework for Prioritization of COVID-19 Severe Patients and Promote Precision Medicine Based on Hybrid Multi-Criteria Decision-Making Approaches

Effective prioritization plays critical roles in precision medicine. Healthcare decisions are complex, involving trade-offs among numerous frequently contradictory priorities. Considering the numerous difficulties associated with COVID-19, approaches that could triage COVID-19 patients may help in prioritizing treatment and provide precise medicine for those who are at risk of serious disease. Prioritizing a patient with COVID-19 depends on a variety of examination criteria, but due to the large number of these biomarkers, it may be hard for medical practitioners and emergency systems to decide which cases should be given priority for treatment. The aim of this paper is to propose a Multidimensional Examination Framework (MEF) for the prioritization of COVID-19 severe patients on the basis of combined multi-criteria decision-making (MCDM) methods. In contrast to the existing literature, the MEF has not considered only a single dimension of the examination factors; instead, the proposed framework included different multidimensional examination criteria such as demographic, laboratory findings, vital signs, symptoms, and chronic conditions. A real dataset that consists of data from 78 patients with different examination criteria was used as a base in the construction of Multidimensional Evaluation Matrix (MEM). The proposed framework employs the CRITIC (CRiteria Importance Through Intercriteria Correlation) method to identify objective weights and importance for multidimensional examination criteria. Furthermore, the VIKOR (VIekriterijumsko KOmpromisno Rangiranje) method is utilized to prioritize COVID-19 severe patients. The results based on the CRITIC method showed that the most important examination criterion for prioritization is COVID-19 patients with heart disease, followed by cough and nasal congestion symptoms. Moreover, the VIKOR method showed that Patients 8, 3, 9, 59, and 1 are the most urgent cases that required the highest priority among the other 78 patients. Finally, the proposed framework can be used by medical organizations to prioritize the most critical COVID-19 patient that has multidimensional examination criteria and to promptly give appropriate care for more precise medicine.

The applications of MCDM methods in COVID-19 pandemic: A state of the art review

Likened to the economic calamity of World War Two, the COVID-19 pandemic has sparked fears of a deep economic crisis, killed more than six million people worldwide and had a ripple effect on all aspects of life. MCDM (multi-criteria decision making) methods have become increasingly popular in modeling COVID-19 problems owing to the multi-dimensionality of this crisis and the complexity of health and socio-economic systems. This paper is aimed to review 72 papers published in 37 leading peer-reviewed journals indexed in Web of Science that used MCDM methods in different areas of COVID-19 pandemic. In this paper, data retrieval follows the PRISMA protocol for systematic literature reviews. 35 countries have contributed to this multidisciplinary research and India is identified as the leading country in this field followed by Turkey and China. Also 36 articles, namely 50% of papers are presented in the form of international cooperation. "Applied Soft Computing" is the journal with the highest number of articles whereas "Journal of infection and public health" and "Operations Management Research" are ranked in the second place. The results indicate that AHP (including fuzzy AHP) is the most popular MCDM method applied in 37.5% of papers followed by TOPSIS and VIKOR. This review reveals that the use of MCDM methods is one of the most attractive research areas in the field of COVID-19. As a result, one of the main purposes of this work is to identify diverse applications of MCDM methods in the COVID-19 pandemic. Most studies i.e. 69% (49 papers) of the papers combined various fuzzy sets with MCDM methods to overcome the problem of uncertainty and ambiguity while analyzing information. Nevertheless, the main drawback of those papers has been the lack of theoretical justifications. In fact, fuzzy MCDM methods impose heavy computational load and there is no general consensus on the clear advantage of fuzzy methods over crisp methods in terms of the solution quality. We hope the researchers who applied fuzzy MCDM methods to COVID-19-related research understand the theoretical basis of MCDM methods and the serious challenges associated with basic operations of fuzzy numbers to avoid potential disadvantages. This paper contributes to the body of knowledge via suggesting a deep vision to critique the fuzzy MCDM methods from mathematical perspective.

Local Disproportions of Quality of Life and Their Influence on the Process of Green Economy Development in Polish Voivodships in 2010-2020

Voivodships are centres of economic, social, and cultural life-they gather economic and social activities. This research aimed to evaluate the spatial differentiation of the quality of life in voivodships in Poland with the use of a synthetic measure. To achieve the research objective, the research methods used were literature analysis, statistical analysis, and synthetic measure. The Technique for Order Preference by Similarity to an Ideal Solution method was used to build synthetic measures. The choice of variables in 2010-2020 was largely conditioned by the availability of data collected in the regional system at the level of voivodships at the Local Data Bank of the Central Statistical Office. As a result of the analysis of voivodships in Poland, based on the quality of life measure, four groups were distinguished (according to the value of quartiles). In the group of the best voivodeships there were: Pomerania, Masovia, Lower Silesia, and West Pomeranian in 2010, and Masovia, Pomerania, Greater Poland, Lower Silesia, and Lesser Poland in 2020, and in the IV, the weakest group: Lodz Province, Podlasie Province, Lubusz Province, and Holy Cross in 2010, and Lodz Province, Podlasie Province, Holy Cross, and Lublin Province in 2020. The synthetic quality of life ranged from 0.37 to 0.56 in 2010 and from 0.39 to 0.64 in 2020. Regional authorities, taking care to improve economic potential, cause increasing the attractiveness of the area and attracting new entrepreneurs, create new jobs, and improve the quality of life of the inhabitants. Quality of life is shaped by economic activity and working conditions, health, education, free time and social relations, economic and physical security, and the quality of the natural environment. The results of the research conducted allow local governments to make comparisons. The conclusions drawn may allow them to identify potential directions for developing policy optimization.

Benchmarking sustainable E-commerce enterprises based on evolving customer expectations amidst COVID-19 pandemic

The 2019 coronavirus disease (COVID-19) pandemic has seriously impacted the performance of all types of businesses. It has given a tremendous structural boost to e-commerce enterprises by forcing customers to online shopping over visiting physical stores. Moreover, customer expectations of the digital and operational capabilities of e-commerce firms are also increasing globally. Thus, it has become crucial for an e-commerce enterprise to reassess and realign its business practices to meet evolving customer needs and remain sustainable. This paper presents a comprehensive performance evaluation framework for e-commerce enterprises based on evolving customer expectations due to the COVID-19 pandemic. The framework comprises seven primary criteria, which are further divided into 25 sub-criteria, including two sustainability factors, namely, environmental sustainability and carbon emissions. The evaluation approach is then practically demonstrated by analyzing the case of three Indian e-commerce firms. The results are obtained using a multi-criteria decision-making (MCDM) method, namely, Fuzzy VIKOR, to capture the fuzziness of the inherent decision-making problem. Further, numerical analysis is conducted to evaluate and rank various e-commerce enterprises based on customer expectations and satisfaction benchmarks. The findings explain the most important criteria and sub-criteria for e-commerce businesses to ensure customer expectations along with their economic and environmental sustainability.

Automated Triage System for Intensive Care Admissions during the COVID-19 Pandemic Using Hybrid XGBoost-AHP Approach

The sudden increase in patients with severe COVID-19 has obliged doctors to make admissions to intensive care units (ICUs) in health care practices where capacity is exceeded by the demand. To help with difficult triage decisions, we proposed an integration system Xtreme Gradient Boosting (XGBoost) classifier and Analytic Hierarchy Process (AHP) to assist health authorities in identifying patients' priorities to be admitted into ICUs according to the findings of the biological laboratory investigation for patients with COVID-19. The Xtreme Gradient Boosting (XGBoost) classifier was used to decide whether or not they should admit patients into ICUs, before applying them to an AHP for admissions' priority ranking for ICUs. The 38 commonly used clinical variables were considered and their contributions were determined by the Shapley's Additive explanations (SHAP) approach. In this research, five types of classifier algorithms were compared: Support Vector Machine (SVM), Decision Tree (DT), K-Nearest Neighborhood (KNN), Random Forest (RF), and Artificial Neural Network (ANN), to evaluate the XGBoost performance, while the AHP system compared its results with a committee formed from experienced clinicians. The proposed (XGBoost) classifier achieved a high prediction accuracy as it could discriminate between patients with COVID-19 who need ICU admission and those who do not with accuracy, sensitivity, and specificity rates of 97%, 96%, and 96% respectively, while the AHP system results were close to experienced clinicians' decisions for determining the priority of patients that need to be admitted to the ICU. Eventually, medical sectors can use the suggested framework to classify patients with COVID-19 who require ICU admission and prioritize them based on integrated AHP methodologies.