Research Article | Open Access
Necla Öztürk, Hakan Tozan, "A Fuzzy-Based Decision Support Model for Selecting the Best Dialyser Flux in Haemodialysis", Journal of Healthcare Engineering, vol. 6, Article ID 694901, 22 pages, 2015. https://doi.org/10.1260/2040-2218.104.22.1683
A Fuzzy-Based Decision Support Model for Selecting the Best Dialyser Flux in Haemodialysis
Decision making is an important procedure for every organization. The procedure is particularly challenging for complicated multi-criteria problems. Selection of dialyser flux is one of the decisions routinely made for haemodialysis treatment provided for chronic kidney failure patients. This study provides a decision support model for selecting the best dialyser flux between high-flux and low-flux dialyser alternatives. The preferences of decision makers were collected via a questionnaire. A total of 45 questionnaires filled by dialysis physicians and nephrologists were assessed. A hybrid fuzzy-based decision support software that enables the use of Analytic Hierarchy Process (AHP), Fuzzy Analytic Hierarchy Process (FAHP), Analytic Network Process (ANP), and Fuzzy Analytic Network Process (FANP) was used to evaluate the flux selection model. In conclusion, the results showed that a high-flux dialyser is the best option for haemodialysis treatment.
- U. H. Inan, Kalite yönetim sistemlerinde tetkik performansının bulanık mantık ile analitik hiyerarşi süreci ve bulanık analitik ağ süreci ve bulanık analitik ağ süreci kullanılarak ölçülmesi [Ph.D. thesis], Yıldız Technical University, 2008.
- L. Yanar and H. Tozan, “A fuzzy hybrid decision support system for interceptor baywatch boat propulsion system selection,” Tehnički Vjesnik, vol. 19, no. 2, pp. 407–413, 2012.
- C. Ronco and S. Bowry, “Nanoscale modulation of the pore dimensions, size distribution, and structure of a new polysulfone-based high-flux dialysis membrane,” The International Journal of Artificial Organs, vol. 24, no. 10, pp. 726–735, 2001.
- F. Locatelli, F. Valderrabano, N. Hoenich, J. Bommer, K. Leunissen, and V. Cambi, “Progress in dialysis technology: membrane selection and patient outcome,” Nephrology Dialysis Transplant, vol. 15, no. 8, pp. 1133–1139, 2000.
- C. Ronco and A. R. Nissenson, “Does Nanotechnology Apply to Dialysis?” Blood Purification, vol. 19, no. 4, pp. 347–352, 2001.
- I. Uhlenbush-Körwer, E. Bonnie-Schorn, A. Grassman, and J. Vienken, Understanding membranes and dialysers, Pabst Science Publishers, Lengerich, 2004.
- T. L. Saaty and Y. Wind, “Marketing Applications of the Analytic Hierarchy Proces,” Management Science, vol. 26, no. 7, pp. 641–658, 1980.
- O. S. Vaidya and S. Kumar, “Analytic Hierarchy Process: An overview of Applications,” European Journal of Operational Research, vol. 169, no. 1, pp. 1–29, 2006.
- L. A. Zadeh, “Fuzzy Sets,” Information and Control, vol. 8, pp. 338–353, 1965.
- E. Cakir, H. Tozan, and O. Vayvay, “A method for selecting third party logistic service provider using fuzzy AHP,” Journal of Science and Engineering, vol. 5, no. 3, pp. 38–54, 2009.
- C. Kahraman, U. Cebeci, and D. Ruan, “Multi-attribute Comparison of Catering Service Companies Using Fuzzy AHP: The Case of Turkey,” International Journal of Production Economics, vol. 87, no. 2, pp. 171–184, 2004.
- D. Y. Chang, “Applications of the Extent Analysis Method on Fuzzy AHP,” European Journal of Operations Research, vol. 95, no. 3, pp. 649–655, 1996.
- S. M. Chen, “Evaluating Weapon Systems using Fuzzy Arithmetic Operations,” Fuzzy Sets and Systems, vol. 77, no. 3, pp. 265–276, 1996.
- R. H. Sprague, “A framework for the development of decision support systems,” MIS Quarterly, vol. 4, no. 4, pp. 1–26, 1980.
- G. Schönweiss, High-Flux-Dialyse in Dialyse Fibel, Abakiss Verlag, Bad Kissingen, 2nd edition, 1996.
- C. Ronco, P. M. Ghezzi, N. A. Hoenich, and P. Delfino, “Computerized Selection of Membranes and Hemodialyzers,” in Dialysis, Dialyzers and Sorbents. Where are we going? C. Ronco and J. F. Winchester, Eds., vol. 133, pp. 119–130, Karger, Basel, 2001.
- Fresenius Medical Care, “ESRD patients in 2010: a global perspective, 2010,” Accessed September 15, 2014, http://vision-fmc.com/files/pdf/ERSD%20Patients%20in%202010.pdf.
- Turkish Society of Nephrology Registry, “Registry of the nephrology, dialysis, and transplantation in Turkey, 2012,” Accessed September 15, 2014, http://www.tsn.org.tr/folders/file/tsn_registry_2011.pdf.
- S. K. Bowry, E. Gatti, and J. Vienken, “Contribution to polysulfone membranes to the success of convective dialysis therapies,” Contributions to Nephrology, vol. 173, pp. 110–118, 2011.
- R. M. Hakim, R. L. Wingard, L. Husni, R. A. Parker, and T. F. Parker, “The effect of membrane biocompatibility on plasma beta-2-microglobulin parameters in chronic haemodialysis patients,” Journal of American Society of Nephrology, vol. 7, no. 3, pp. 472–478, 1996.
- J. Hartmann, H. Fricke, and H. Schiffl, “Biocompatible membranes preserve residual renal function in patients undergoing regular haemodialysis,” American Journal of Kidney Disease, vol. 30, no. 3, pp. 366–373, 1997.
- J. C. Hornberger, M. Chernew, J. Petersen, and A. M. Garber, “A multivariate analysis of mortality and hospital admissions with high-flux dialysis,” Journal of American Society of Nephrology, vol. 3, no. 6, pp. 1227–1237, 1992.
- T. F. Parker, R. L. Wingard, L. Husni, T. A. Ikizler, R. A. Parker, and R. M. Hakim, “Effect of the membrane biocompatibility on nutritional parameters in chronic haemodialysis patients,” Kidney International, vol. 49, no. 2, pp. 551–556, 1996.
- N. R. Skroeder, S. H. Jacobson, L. E. Lins, and C. M. Kjellstrand, “Biocompatibility of dialysis membranes is of no importance for objective or subjective symptoms during or after Haemodialysis,” American Society for Artificial Internal Organs, vol. 36, no. 3, pp. 637–639, 1990.
- G. Asci, H. Toz, M. Ozkahya et al., “The impact of membrane permeability and dialysate purity on cardiovascular outcomes,” Journal of American Society of Nephrology, vol. 24, no. 6, pp. 1014–1023, 2013.
- E. Ok, G. Asci, H. Toz et al., “Mortality and cardiovascular events in online haemodiafiltration (OL-HDF) compared with high-flux dialysis: results from the Turkish OL-HDF Study,” Nephrology Dialysis Transplantation, vol. 28, no. 1, pp. 192–202, 2013.
- R. Vanholder, A. Davenport, T. Tannedouche et al., “Reimbursement of dialysis: a comparison of seven countries,” Journal of American Society Nephrology, vol. 23, no. 8, pp. 1291–1298, 2012.
- J. Z. Ma, J. Ebben, H. Xia, and A. L. Collins, “Hematocrit levels and associated mortality in hemodialysis patients,” Journal of American Society of Nephrology, vol. 10, no. 3, pp. 610–619, 1999.
- N. Ofsthun, J. LaBreque, E. Lacson, M. Keen, and J. M. Lazarus, “The effects of higher hemoglobin levels on mortality and hospitalization in hemodialysis patients,” Kidney International, vol. 63, no. 5, pp. 1908–1914, 2003.
- H. Xia, J. Ebben, J. Z. Ma, and A. L. Collins, “Hematocrit levels and hospitalization risks in hemodialysis patients,” Journal of American Society of Nephrology, vol. 10, no. 6, pp. 1309–1316, 1999.
- E. W. Young, “Dialysis dose, membrane type, and anemia control,” American Journal of Kidney Disease, vol. 6, no. 4, pp. 157–160, 1998.
- S. K. Bowry and E. Gatti, “Impact of hemodialysis therapy on anemia of chronic kidney disease: the potential mechanisms,” Blood Purification, vol. 32, no. 3, pp. 210–219, 2011.
- D. Ayli, M. Ayli, A. Azak et al., “The effect of high flux hemodialysis on renal anemia,” Journal of Nephrology, vol. 17, no. 5, pp. 701–706, 2004.
- A. Schneider, C. Drechsler, V. Krane et al., “The Effect of High-Flux Hemodialysis on Hemoglobin Concentrations in Patients with CKD: Results of the MINOXIS Study,” Clinical Journal of American Society of Nephrology, vol. 7, no. 1, pp. 52–59, 2012.
- D. De Jager, D. C. Grootendorst, K. J. Jager et al., “Cardiovascular and non-cardiovascular mortality among patients starting dialysis,” Journal of American Medical Association, vol. 302, no. 16, pp. 1782–1789, 2009.
- H. Klinkmann, H. Ebbighausen, I. Uhlenbusch, and J. Vienken, “High-flux dialysis, dialysate quality and backtransport,” Contributional Nephrology, vol. 103, pp. 89–97, 1993.
- P. Urena, A. Herbelin, J. Zingraff et al., “Permeability of cellulosic and non-cellulosic membranes to endotoxin sub units and cytokine production during in-vitro hemodialysis,” Nephrology Dialysis Transplantation, vol. 7, no. 1, pp. 16–28, 1992.
- H. Schiffl, “High-Flux Dialyzers, Backfiltration, and Dialysis Fluid Quality,” Seminars in Dialysis, vol. 24, no. 1, pp. 1–4, 2011.
- U. Baurmeister, J. Vienken, and V. Daum, “High-Flux Dialysis Membranes: Endotoxin Transfer by Back Filtration can be a Problem,” Nephrology Dialysis Transplantation, vol. 4, Suppl, pp. 89–93, 1989.
- G. Bonforte, P. Grillo, S. Zerbi, and M. Surian, “Improvement of anemia in hemodialysis patients treated by hemodiafiltration with high-volume On-Line-prepared substitution fluid,” Blood Purification, vol. 20, no. 4, pp. 357–363, 2002.
- F. Locatelli, A. Martin-Malo, T. Hannedouche et al., “Effect of membrane permeability on survival of hemodialysis patients,” Journal of American Society of Nephrology, vol. 20, no. 3, pp. 645–654, 2009.
- L. A. Pedrini, V. D. Cristofaro, M. Comelli et al., “Long-term effects of high-efficiency on-line haemodiafiltration on uraemic toxicity. A multicentre prospective randomized study,” Journal of Nephrology Dialysis Transplant, vol. 26, no. 8, pp. 2617–2624, 2011.
- T. M. Pickett, A. Cruickshank, R. N. Greenwood, D. Taube, A. Davenport, and K. Farrington, “Membrane flux not biocompatibility determines beta-2-microglobulin levels in hemodialysis patients,” Blood Purification, vol. 20, no. 2, pp. 161–166, 2001.
- J. Tattersall, B. Canaud, H. Heimburger, L. Pedrini, D. Schneditz, and W. Van Biesen, “High-flux or low-flux dialysis: a position statement following publication of the Membrane Permeability Outcome study,” Nephrology Dialysis Transplant, vol. 25, no. 4, pp. 1230–1232, 2010.
- P. J. Blankestijn, I. Ledebo, and B. Canaud, “Hemodiafiltration: clinical evidence and remaining questions,” Kidney International, vol. 77, no. 7, pp. 581–587, 2010.
- K. Ishida, M. Hirose, K. Fujiwara, H. Tsuruta, and N. Ikeda, “Analysis of Medical Equipment Management in Relation to the Mandatory Medical Equipment Safety Manager (MESM) in Japan,” Journal of Healthcare Engineering, vol. 5, no. 3, pp. 329–346, 2014.
- R. Snyder, N. Huynh, B. Cai, and A. Tavakoii, “Evaluation of medication administration process: Tools and techniques,” Journal of Healthcare Engineering, vol. 2, no. 4, pp. 527–538, 2011.
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