Improving quality of life measures by knowledge management methods

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6 Νοε 2013 (πριν από 3 χρόνια και 9 μήνες)

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1

Improving
quality of life measures by
knowledge management methods

Tamar Kakiashvili
1
,Waldemar W. Koczkodaj
1,3
, Duncan Matheson
1
,

Phyllis Mongomery
1
, Kalpdrum Passi
1
, Ryszard Tadeusiewicz
2


1


Laurentian University, Sudbury, Ontario, Canada

2
AGH University of Science and Technology, Poland

3
the corresponding author:
wkoczkodaj@cs.laurentian.ca


Presenter: Dr. Tengiz Bochorishvili, Academia Podlaska (University of Podlasie),
Siedlce, Poland


2

Outline


Medicine and health


measures and instruments



quality of life and WHOQOL



consistency
-
driven pairwise comparisons (CDPC) can be used
to improve WHOQOL measure



Our approach assumes that not all items in an instrument are
of equal importance or equally contribute to the total score



it is expected that computing new weights for each separate
item will contribute to the precision of WHOQOL

3

Outline

Let us look at WHOQOL web site:


http://www.who.int/substance_abuse/research
_tools/whoqolbref/en/

4

WHOQOL
-
BREF labels


Rate QoL


Q1

-

Your quality of life (self
-
assessment)


Q2

-

Health satisfaction


Q3

-

Pain prevents doing


Q4

-

Need medical treatment


Q5

-

Enjoy life


Q6

-

Life is meaningful


Q7

-

Concentrate


Q8

-

Safe in your daily life


Q9

-

Healthy physical environment


Q10

-

Energy for everyday life


Q11

-

Accept bodily appearance


Q12

-

Money to meet needs

5

WHOQOL
-
BREF variable labels


Q13

-

Information available


Q14

-

Opportunity for leisure activities


Q15

-

Able to get around


Q16

-

Sleep


Q17

-

Daily living activities


Q18

-

Capacity for work


Q19

-

Satisfied with yourself


Q20

-

Personal relationships


Q21

-

Sex life


Q22

-

Friends


Q23

-

Conditions of your living place

6


The quality of life definition proposed by World
Health Organization (WHO) is important because
of its universal acceptability.



It is a combined effort of 15 research centers who
jointly developed a quality of life instrument.



unfortunately both Canada and Poland are not
represented by their research teams but hopefully
not for long

WHOQOL

7

The pairwise comparisons preliminaries



Pairwise comparisons method creates a matrix (A) of
values (a
ij
) of the i
-
th object compared with its
corresponding (j
-
th) object (in our case, questionnaire
item)



PC matrix is reciprocal: (a
ij
) =1/(a
ji
) since i to j is (or at
least, is expected to be) the reciprocal of j to i.



A small scale [1/c,c] is used for for comparisons from 5
to 9 (in most practical applications)



inconsistency analysis is essential since it allows to
locate the most inconsistent input

8

Inconsistency analysis in brief



The first ever defined: in 1977 by Saaty as a deviation
of an eigenvalue of the pairwise comparing matrix.



Eigenvalue is a global characteristic of a matrix



It does not localizes inconsistency



In 1993, a localizing distance based inconsistency
definition was proposed by Koczkodaj

9

What is inconsistency?


It occurs when we have at least three object to compare.


For example taking into consideration their area, we may come to
the following input:

10

What is inconsistency?


The previous picture is fuzzy since our knowledge is
anearly always: fuzzy, inexact, incompletem, and
inaccurate



by looking at the above picture, one can even wrongly
conclude that if “a” is two times bigger than “b” and
“b” is three times bigger than “c” than “a” should be 6,
not 5, times bigger than “c”.



Why? Our input in undisputable! We really do not
know if 3 is correct or not (it could be 2.5) or 2 could
be 5/3!

11

What is inconsistency?


Our comparisons can be subjective and in the case of QOL, even
highly subjective. Often, we cannot be even sure of them. This is a
true case of “approximate reasoning” and “incomplete knowledge”



for a triad, we define inconsistency index as follows:

and it is the minimum distance from the nearest consistent triad


It is not the purpose of this presentation to explain “why” or even
“how” the above inconsistency index works but how to use it to
improve the QOL measure by using the inconsistency index

1,1
ij ik kj
ik kj ij
a a a
ii Min
a a a
 

  
 
 

 
12

Let us begin with a basic model:


Explanation: all WHOQOL items have been organized into
hierarchical structure

13

So let us do it by looking at several screen images:


This is a part of a model for WHOQOL measure since the full model
has not fit into the screen

14

screen images:


This is how we compare objects against each other starting
from the top level

15

screen images:


After a new value (for a pair or more) is entered, we close this
window and…

16

screen images:


We can check inconsistency by ANALYZE window selecting
“Show Max” here

17

screen images:


We can alter values of the most inconsistent triad (the dark
highlight)

18

screen images:


It brings us to this (previously shown) screen:

19

screen images:


We can check the inconsistency again:

20

screen images:


When we have inconsistency 1/3 or less (but do not even try to
get not zero since it is unrealistic for highly subjective values),
we obtain weights:

21

In conclusion…



Many health measures, including the
WHOQOL, do not have weights for items



Applying the pairwise comparisons method to
WHOQOLhelps to improve its precision as the
preliminary results show (slide or screen
image) shows.


There is very little dispute that pain is more
important for QOL than transportation

22

In conclusion…


It is a work
-
in
-
progress report



an initial undertaking is the examination of the
feasibility of CDPC method to improve the
precision of QOL



for the final results to be clinically applicable,
true assessments must be consulted with the
WHOQOL experts and it may not be easy

23

Professor Koczkodaj


will answer your questions now…