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Дисертації з теми "Systèmes d'aide à la décision – Dissertation universitaire":
Robert, Laurine. "Contextualisation des effets indésirables liés aux médicaments à type d’hyperkaliémie et d’insuffisance rénale aiguë chez les personnes âgées." Thesis, Lille 2, 2019. http://www.theses.fr/2019LIL2S028.
The prevention of adverse drug reactions (ADR) in older patients is a major public health issue due to their clinical and economic impacts. Studies that aimed at preventing these ADR focus mainly on so-called inappropriate prescriptions, i.e. with a negative benefit-risk ratio (validated standards). However, more than half of ADR are due to appropriate prescriptions, i.e. those that meet the recommendations of good practice, and are well tolerated by the patient.The objective of this thesis is to describe the mechanisms by which appropriate and tolerated chronic prescriptions are the source of ADR in older patients during intercurrent situations.This thesis is based on a historical cohort of more than 14,000 hospital stays in older patients (≥ 75 years old), established during the European PSIP project. Risk situations secondary to medication were automatically detected and then read back via the Scorecards® interface (independent double proofreading). We describe the results of 3 studies: (1) analysis of hospital hyperkalemia secondary to drugs; (2) analysis of community acute kidney injury secondary to drugs; (3) creation of risk profiles of hyperkalemia secondary to drugs for integration into a computerized decision support system
Briard, Tristan. "Des données captées aux créations de valeurs : Proposition d’une méthode outillée pour structurer la conception amont des produits intelligents et connectés." Electronic Thesis or Diss., Paris, HESAM, 2023. http://www.theses.fr/2023HESAE095.
Recent advances in information and communication technologies and data science have led to the development of smart connected products. These products have new capabilities that create value for both the user and the manufacturer. These developments are leading to a major paradigm shift. To take full advantage of the potential of smart connected products, manufacturers need to adopt new processes, especially in the design phase. Indeed, the choice of data that can be captured by the product at the design stage defines the potential value creation for the rest of its life cycle. The aim of this thesis is therefore to formalise a methodological structure to guide designers in the integration of value creation based on captured data. In order to propose a relevant and effective method, we first explore the challenges related to design and captured data. Based on the challenges identified, a method is then constructed. It is structured in two phases, each supported by a dedicated tool. The first phase is a creativity phase that systematically generates potential value creation based on captured data. The second phase is a decision-making phase in which the previously generated value creations are systematically ranked according to sustainability criteria. Experiments have validated the relevance and effectiveness of the proposed methodology. Through the method and its tools, this thesis work contributes to scientific and industrial research supporting the paradigm shift brought by digital technologies in product design
Achour, Benharrats Soumeya Lydia. "Environnement d'acquisition des connaissances pour la création de systèmes d'aide à la décision médicale : application à la prescription transfusionnelle." Paris 5, 2001. http://www.theses.fr/2001PA05CD03.
Occelli, Florent. "Systèmes d’Information Géographique et Lien Environnement – Santé (SIGLES) : contribution au développement d'outils cartographiques d'aide à la décision face aux risques sanitaires liés à l'environnement." Thesis, Lille 2, 2014. http://www.theses.fr/2014LIL2S043/document.
Environmental and social inequalities in health (ESIH) over territories are related to two cumulative dimensions: populations exposed to their living poor quality environment and the vulnerability of these populations to the environmental risk factors, which can affect health. This research deals with the Geographic Information Systems (GIS) applied to the field of environmental health. General purposes are the characterization of environmental media quality and the assessment of ESIH.Achieving these objectives requires a first step of harvest, genesis and formatting spatialized environmental databases. Such data are resulting from physico-chemical monitoring and biomonitoring. They were then mapped using GIS tools, including geostatistical spatial interpolation methods. On the over hand, spatial variability in the incidence of diseases were investigated using disease mapping methods (Standardized Incidence Ratios: SIR) and the detection of atypical clusters of events (scan statistics), which are based on disease registries. Finally, geographical ecological studies are developed to associate the environmental maps generated to health and socio-economic status. Thus, this work aims to answer the question \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\"do people with poor state of health live in a poor quality environment?\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\" This question has been studied through three main researches.The first relates the characterization of trace elements burdens in the environment and the assessment of ESIH on neighborhood scale, over three territories in the Nord-Pas de Calais (NPdC) region. This research is conducted from measurements of biological burdens performed both in epiphytic lichens and humans and from a localized index of deprivation. The measured metals were considered individually, but also holistically by developing an integrated multimetallic index, in order to describe the general status of environmental pollution by metals. Environmental inequalities were observed on neighborhood scale in Dunkerque. Our results assume that trace elements burdens in populations are affected by environmental burdens.In our second research we revealed spatial disparities in the incidence of end stage renal disease (ESRD) on small area in the NPdC. Unlike other factors (diabetes, cardiovascular disease, medical practices), we highlighted the role of socio-economic status in the occurrence of such disparities. Only a part of the ESRD variability is currently explained. It is therefore necessary to focus on the environmental hypothesis.The third research focuses on the spatial and spatio-temporal analysis of groundwater contamination by trace elements, in order to identify potential environmental risk factors in the incidence of chronic inflammatory bowel disease.This work is based on several collaborations with the REIN network, the EPIMAD registry, and several research teams (EA4483 and EA2694 Université Lille 2, TVES EA4477 ULCO).Following this thesis, the research prospects are to pursue the development of integrated indicators to assess population exposure to the multiple environmental media contamination. The results also indicate a lack of information in environmental databases compared to health registries. A work is thus needed to define the content of such databases. These are necessary to characterize the environmental quality and to help the assessment of interaction between the populations and their living environment
Bouam, Samir. "Aide à la décision pour la surveillance des infections nosocomiales et la sélection de l'antibiothérapie empirique : adaptation d'un modèle conceptuel pour l'implémentation et l'évaluation d'un système intégré au SIH." Paris 5, 2002. http://www.theses.fr/2002PA05CD10.
Marcilly, Romaric. "Towards a usability knowledge base to support health information technology design and evaluation : Application to Medication Alerting Systems." Thesis, Lille 2, 2014. http://www.theses.fr/2014LIL2S037/document.
Health Information Technology (HIT) is increasingly implemented to improve healthcare quality and patient safety. However, some usability issues may reduce their impact and even induce new problems (including patient safety issues). To avoid those negative outcomes, amongst other actions, HIT usability must be improved. This action requires applying validated usability knowledge. However, usability knowledge applied to HIT is scattered across several sources, is not structured and is hardly usable. Moreover, its coverage regarding related usability flaws is not known. This work has two aims: (i) to participate in improving the accumulation of usability knowledge for HIT and (ii) to provide synthetic structured easy-to-use HIT usability knowledge with a clear coverage. Those aims are applied to medication alerting systems.Method.Two independent analyses of the literature have been performed. On the one hand, usability flaws and their consequences for the clinicians and the work system have been searched and organized; on the other hand, existing usability design principles specific to medication alerting systems have been synthesized. Results of both analyses have been matched together. Results.A systematic review identified 13 types of usability flaws in medication alerting systems. Consequences on the clinicians and the work system are varied: they greatly impede the clinicians and negatively impact the work system (e.g., alert fatigue, alert misinterpretation). Sixty-three usability design principles dedicated to medication alerting systems are identified. They represent six themes: improve the signal-to-noise ratio, fit clinicians’ workflow, support collaborative work, display relevant information, make the system transparent and provide useful tools. The matching between usability flaws and principles is quite good.Discussion.As a result of this work, a list of usability design principles illustrated by actual instances of their violation has been developed. It may help designers and Human Factors experts understand and apply usability design principles when designing and evaluating medication alerting systems. Usability applied to HIT is a recent research field that suffers from a deficit of structured knowledge. This work shows that it is possible to accumulate and structure usability knowledge. It could be carried on by developing a usability knowledge base dedicated to HIT in order to strive towards “evidence-based usability”
Bouguerra, Afef. "Optimisation et aide à la décision pour la programmation des opérations électives et urgentes." Electronic Thesis or Diss., Université de Lorraine, 2017. http://www.theses.fr/2017LORR0171.
The operating theater is one of the most critical and expensive hospital resources. Indeed, a high percentage of hospital admissions are due to surgical interventions. Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. This thesis is supported by the urban community of Sarreguemines-France and the region of Lorraine-France, and is carried out in collaboration with the Centre Hospitalier de Sarreguemines - Hôpital Robert Pax. In the first part of this work, we propose two mathematical programming models to help operating theater managers in developing an optimal operating rooms scheduling. We also propose a constructive heuristic to obtain near optimal results for realistic sizes of the problem. In the second part of our work, the whole scheduling process is modeled as a hybrid four-stage flow shop problem with RSb blocking constraint, and is solved by a genetic algorithm. The objective is to synchronize all the needed resources around the optimal daily schedule obtained with the proposed mathematical model. The last part of our work is dedicated to non-elective surgeries. We propose a decision support tool, guiding the operating room manager, to handle this unpredictable flow of patients. Non-elective patients are classified according to their medical priority. The main contribution of the proposed decision support tool is to provide online assignment strategies to treat each non elective patient category. Proposed assignments are riskless on patient’s health. According to non-elective surgery classes, the proposed adjusted schedule minimizes different criteria such as patient’s waiting time, deviation from the firstly scheduled starting time of a surgery and the amount of resulting overtime
Bouguerra, Afef. "Optimisation et aide à la décision pour la programmation des opérations électives et urgentes." Thesis, Université de Lorraine, 2017. http://www.theses.fr/2017LORR0171/document.
The operating theater is one of the most critical and expensive hospital resources. Indeed, a high percentage of hospital admissions are due to surgical interventions. Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. This thesis is supported by the urban community of Sarreguemines-France and the region of Lorraine-France, and is carried out in collaboration with the Centre Hospitalier de Sarreguemines - Hôpital Robert Pax. In the first part of this work, we propose two mathematical programming models to help operating theater managers in developing an optimal operating rooms scheduling. We also propose a constructive heuristic to obtain near optimal results for realistic sizes of the problem. In the second part of our work, the whole scheduling process is modeled as a hybrid four-stage flow shop problem with RSb blocking constraint, and is solved by a genetic algorithm. The objective is to synchronize all the needed resources around the optimal daily schedule obtained with the proposed mathematical model. The last part of our work is dedicated to non-elective surgeries. We propose a decision support tool, guiding the operating room manager, to handle this unpredictable flow of patients. Non-elective patients are classified according to their medical priority. The main contribution of the proposed decision support tool is to provide online assignment strategies to treat each non elective patient category. Proposed assignments are riskless on patient’s health. According to non-elective surgery classes, the proposed adjusted schedule minimizes different criteria such as patient’s waiting time, deviation from the firstly scheduled starting time of a surgery and the amount of resulting overtime