INTRODUCTION Early physiological assessment of multiple injured patients is crucial for decision making and has relied on personal experience of trauma experts. We have developed a new visual analytics tool (Sankey diagram, Watson Trauma Health care tool) that includes known prognostic parameters for polytrauma patients to help guide assessment and treatment decisions for physicians involved in trauma care. METHODS A prospectively collected trauma database of a single level I trauma center (3655 patients) was used. INCLUSION CRITERIA age >16 years, an injury severity score (ISS) >16 and presence of a complete data set in the database. Data collected included admission values of patient age, injury scoring, shock classification, temperature, acid-base and hemostasis parameters. All of these parameters were collected daily as longitudinal parameters. Endpoints of the clinical course we considered were sepsis, SIRS and early in hospital mortality (<72 h). A proof of concept of the visualization was developed over a 2-year period in a cooperation between physicians and engineers. Statistically, the most predictive parameters were selected by binary logistic regression and ROC analysis. RESULTS A dynamic interactive multilayer Sankey diagram, based on cohort similarities, was developed in a collaboration between the University Hospital of Zurich, Department of Trauma and IBM, from August 2017 until January 2018. It is a modular tool and allows any user to add a new patient, or work with an existing case. The visualization used the data-driven documents (D3) interactive visualization library to create a responsive graphic. CONCLUSIONS This application summarizes the experience of 3655 polytrauma patients and might serve as a guide for clinical decisions and educative purposes, as well as new scientific questions for the polytrauma patient. LEVEL OF EVIDENCE IV.
In this paper, we start with a discussion of Software Development Governance (SDG), and clarify its relationships to management and process. We discuss how these organizational components are related and present our view on SDG and its concerns. Throughout the paper, we use the Linux open source development project where we show how SDG is used to achieve productive development in an environment which is often considered to have anarchic characteristics.
At its essence software development governance is about guiding the development organization so that it produces value that aligns with the needs of the business. As software development platforms mature they provide increasingly sophisticated capabilities for process measurement and guidance. These new capabilities in turn offer an excellent opportunity for governance tools to help guide the development. In this paper we discuss a model of the development organization that includes: roles, responsibilities, decisions, rights, artifacts and their lifecycles. We show how this model can be elicited and deployed as part of a governance solution to guide the development organization and provide a description of a prototype we have built to automate this process. We conclude with a discussion and important directions for future work in the area.
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