The coronavirus disease 2019 (COVID-19) has emerged as a worldwide pandemic since March 2020. Although most patients complain of moderate or severe pain, these symptoms are generally underestimated and appropriate treatment is not applied. This study aims to guide physicians in selecting and ranking various alternatives for the treatment of pain in COVID-19 patients. However, the choice of treatment for pain requires the consideration of many different conflicting criteria. Therefore, we have studied this problem as a multicriteria decision-making problem. Throughout the solution procedure, first, the criteria and subcriteria affecting the preferences are defined. Then, weight values are determined with respect to these criteria, as they have different degrees of importance for the problem. At this stage, hesitant fuzzy linguistic term sets (HFLTSs) are used, and thus, experts can convey their ideas more accurately. In this first phase of the study, an HFLTS integrated Analytic Hierarchy Process (AHP) method is utilized. Subsequently, possible treatment alternatives are evaluated by using the Vise Kriterijumska Optimizacija I Kompromisno Resenje (VIKOR) method. According to the results obtained by considering expert evaluations, the most preferred treatment is the administration of paracetamol, followed by interventional treatments, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs), respectively. With this study, it is ensured that a more accurate method is followed by eliminating possible mistakes due to the subjective evaluations of experts in the process of determining pain treatment. This method can also be used in different patient and disease groups.

Background: Chronic pain is one of the most common complaints of cancer patients. There are many pharmacological and non-pharmacological treatment modalities used for the treatment of pain. Nonetheless, non-pharmacological interventions are preferred because of potential side effects in cases resistant to medical therapy that require a dose increase or potent drug use. In most real-life situations, the decision on which technique to choose is based on the clinical but subjective decisions of the practitioners. This study aimed to find out the best non-pharmacological treatment option for patients with chronic cancer pain by following a rational and reasonable approach. Methods: Since the evaluation of treatment options requires to make a comparison between a number of alternatives in the light of certain criteria, we utilize the order relation analysis (G1-method) which is a method for determining the weights based on the improved Analytic Hierarchy Process (AHP). The method uses the relative importances on prioritizing the four criteria and eight sub-criteria defined by the experts of three pain physicians, one oncologist, and one oncologic surgeon. Four alternatives are then compared according to the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) using the verbal subjective judgments of the practitioners. Results:Obtained results indicate that the general medical condition of the patient and the stage of the cancer are the essential factors in the selection of the treatment method. It is followed by the extent of the pain and the level of evidence, respectively. According to the evaluations performed, spinal port and splanchnic nerve radiofrequency thermocoagulation treatments are the first and second priority methods for pain treatment, respectively, compared to lumbar epidural catheter and celiac plexus block. Conclusions: The results of this study emphasize the need to integrate critical criteria into the decision-making process objectively. This is the first study in which multi-criteria decision-making tools are used in the evaluation and selection of pain management methods in cancer patients.

No abstract

No abstract

ÖZBu çalışmada, tek makineli bir sistemde hız değiştirme faaliyeti (HDF) ile birlikte işlerin çizelgelenmesi üzerinde durulmaktadır. Bir HDF, makinenin üretim hızının orijinal durumuna getirilmesi için uygulanan bir bakım faaliyeti olarak tanımlanmaktadır. Bu açıdan bakıldığında, bir işin HDF'den önce veya sonra planlanması sonucunda, işlerin işlem zamanları farklı değerler almaktadır. Ele alınan problem, iş sırası ve bu iş sırası içindeki HDF konumunun belirlenmesidir. Çözüme yönelik olarak şebeke gösterimine dayalı, en kısa yol tabanlı bir yöntem oluşturulmuştur. Önerilen yöntemde, ilk aşamada En Kısa İşlem Zamanı algoritması ile elde edilmiş iş sıralamasına göre bir şebeke oluşturulmaktadır. Daha sonra ilgili şebeke üzerinde en kısa yolu veren HDF ataması doğrusal programlama kullanılarak aranmakta ve bulunan yolun değeri makine için toplam tamamlanma zamanını vermektedir. Bundan sonra yerel arama prosedürü uygulanarak, her adımda iş sıralamaları üzerinde swap operasyonu (ikili değişim) kullanılmakta ve elde edilen yeni çözümler üzerinde yapılan sürekli karşılaştırmalar sonucu son çözüm elde edilmektedir.Anahtar kelimeler: Makine çizelgeleme, hız değiştirme faaliyeti, en kısa yol algoritması, tam sayılı programlama ABSTRACT In this study, scheduling of jobs and a rate modifying activity (RMA) on a single machine system is considered. A RMA is defined as a maintenance activity applied to bring production speed of the machine back to its original state. From this point of view, when a job is planned before or after the RMA, processing times of the jobs become different. The problem addressed is determination of the job sequence and the position of the RMA in this sequence. A shortest path-based method which is based on network representation is developed for the solution. In the proposed method, a network is created in the first step according to the job sequence obtained by the Shortest Processing Time algorithm. RMA assignment that gives the shortest path on the network is then searched using linear programming and the value of the found path gives total completion time for the machine. After this, using local search procedure, swap operation (binary exchange) is applied on the job positions at each step and final solution is obtained as a result of continuous comparisons on new solutions obtained.