Background: fact Boxes are decision support tools that can inform about treatment effects. Objectives: to test whether Fact Box decision support tools impacted decisional conflict, knowledge and preferences about the use of antibiotics and artificial hydration in advanced dementia. Design: randomized controlled trial. Setting: Swiss-German region of Switzerland. Subjects: two hundred thirty-two participants (64 physicians, 100 relatives of dementia patients, 68 professional guardians) randomly allocated to intervention (N = 114) or control (N = 118). Intervention: two-page Fact Box decision support tools on antibiotics for pneumonia and artificial hydration in advanced dementia (at 1-month). Methods: participants were mailed questionnaires at baseline and one month later that asked questions about treatments based on hypothetical scenarios. The primary outcome was change in decisional conflict (DCS-D; range 0 < 100) about treatment decisions. Secondary outcomes included knowledge about treatments (range 0 < 7) and preferences to forego treatments. Results: participants were: mean age, 55.6 years; female, 62.8%. Relative to control participants, intervention participants experienced less decisional conflict about using antibiotics (unstandardized beta (b) = −8.35, 95% Confidence Interval (CI), −12.43, −4.28) and artificial hydration (b = −6.02, 95% CI, −9.84, −2.20) at 1-month compared to baseline. Intervention participants displayed greater knowledge about the use of antibiotics (b = 2.24, 95% CI, 1.79, 2.68) and artificial hydration (b = 3.01, 95% CI, 2.53, 3.49), and were significantly more likely to prefer to forego antibiotics (odds ratio, 2.29, 95% CI, 1.08, 4.84) but not artificial hydration. Conclusions: fact Box decision support tools reduced decisional conflict, increased knowledge and promoted preferences to forego antibiotics in advanced dementia among various decision-makers. Trial registration: FORSbase (12091).

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Graphical models are omnipresent in the software engineering field, but most current graphical modeling languages do not scale with the increasing size and complexity of today's systems. The navigation in the diagrams becomes a major problem especially if different aspects of the system are scattered over multiple, only loosely coupled diagrams. In this paper we present the hierarchical navigation capabilities of the Adora modeling tool. The user of this tool can freely control the level of detail in different parts of the model to reduce the size and complexity of the diagrams being displayed. Our fisheye visualization technique makes it possible to integrate all modeling aspects (structure, data, behavior, etc.) in one coherent model while keeping the size and complexity of the diagrams within reasonable limits. Tool Support for the Navigation in Graphical ModelsTobias Reinhard, Silvio Meier, Reinhard Stoiber, Christina Cramer, Martin Glinz Department of Informatics University of Zurich, Switzerland {reinhard | smeier | stoiber | cramer | glinz} @ifi.uzh.ch ABSTRACTGraphical models are omnipresent in the software engineering field, but most current graphical modeling languages do not scale with the increasing size and complexity of today's systems. The navigation in the diagrams becomes a major problem especially if different aspects of the system are scattered over multiple, only loosely coupled diagrams.In this paper we present the hierarchical navigation capabilities of the Adora modeling tool. The user of this tool can freely control the level of detail in different parts of the model to reduce the size and complexity of the diagrams being displayed. Our fisheye visualization technique makes it possible to integrate all modeling aspects (structure, data, behavior, etc.) in one coherent model while keeping the size and complexity of the diagrams within reasonable limits.

Hierarchical decomposition is an important means for organizing and understanding large requirements and design models. Fisheye zoom visualization is an attractive means for viewing, navigating and editing such hierarchical models, because local detail and its surrounding global context can be displayed in a single view. However, existing fisheye view approaches have deficiencies in terms of layout stability when model nodes are zoomed-in and zoomed-out. Furthermore, most of them do not support model editing (moving, adding and deleting nodes) well.In this paper, we present an improved fisheye zoom algorithm which supports viewing and manipulating hierarchical models. Our algorithm solves the problem of having a user-editable layout which is nevertheless stable under multiple zooming operations. Furthermore, it supports multiple focal points, and runs in real-time.

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