Main Decision Criteria Research Articles

A comparative configuration and decision of main restrictions of a renewable energy powered campus micro grid: A case study

Higher education institutes are representative of small cities. Availability of building level data enables categorizing the models according to load profile instead of developing one model for whole communities, which is a gap in literature.In this study, hourly electricity consumption data of 34 buildings measured in Selcuk University is utilized to develop optimum Zero energy campus (ZEC) model. ZEC models developed until now used data of whole campus. In this study, campus and building level ZEC models are compared using PV/Wind/Biomass/Hydropower with/without battery.Biomass is found as a good option for high annual electricity consumption (AEC) buildings whereas using more than two type of renewable systems was better for low AEC. Required system size was found to be smaller at campus level design. However, renewable factor (RF) was higher at building level design which decreased levelized cost of electricity (LCOE). Therefore, the main limitation of ZEC is found as electricity selling price. Campus level design will be cost effective in case of electricity selling price to be the same or more then purchasing price. As a result of this study hourly load profile and electricity selling/purchasing prices are found to be the main decision criteria’s on optimum HRES design.

Chronic rhinosinusitis with nasal polyposis and biological agents: the ARIA-ITALY Survey.

Background. Chronic rhinosinusitis (CRS) is an inflammatory disease that affects the nasal mucosa and the paranasal sinuses. CRS can be associated by nasal polyposis (CRSwNP phenotype) in up to 30% of patients and it is frequently associated with bronchial asthma. CRSwNP shows predominantly an underlying activation of type 2 inflammatory pathways with the involvement of eosinophils, IgE, interleukin (IL)-4, IL-5 and IL-13. Biological drugs that target these inflammatory cytokines are currently a therapeutic option recognized by guidelines for the treatment of uncontrolled form of the disease. Methods. As part of the activity of the "ARIA-Italy" working group, a panel of 255 Italian Ear, Nose and Throat (ENT) specialists, pneumologists and immuno-allergologists actively participated in this national survey and answered a series of questions geared toward understanding the main criteria for patient characterization and therapeutic decision, highlighting multidisciplinarity, and the implementation of the management of CRSwNP patients, as a part of the precision medicine concept and the appropriate use of the biologicals. Results. Two hundred and fifty-five experts and specialists participated in the survey. Conclusions. The results of this survey obtained from an extensive number of active specialists throughout Italy allow some important concluding remarks to be drawn. The main points of agreement were that multidisciplinary care teams provide many benefits but that, once the team is established, meetings and communication between members must be coordinated. Finally, the dissemination of national disease registries and the continuous updating of guidelines and position papers related to CRSwNP and comorbidities should be encouraged.

Invasiveness of decompression surgery affects modeled lumbar spine kinetics in patients with degenerative spondylolisthesis.

Introduction: The surgical treatment of degenerative spondylolisthesis with accompanying spinal stenosis focuses mainly on decompression of the spinal canal with or without additional fusion by means of a dorsal spondylodesis. Currently, one main decision criterion for additional fusion is the presence of instability in flexion and extension X-rays. In cases of mild and stable spondylolisthesis, the optimal treatment remains a subject of ongoing debate. There exist different opinions on whether performing a fusion directly together with decompression has a potential benefit for patients or constitutes overtreatment. As X-ray images do not provide any information about internal biomechanical forces, computer simulation of individual patients might be a tool to gain a set of new decision criteria for those cases. Methods: To evaluate the biomechanical effects resulting from different decompression techniques, we developed a lumbar spine model using forward dynamic-based multibody simulation (FD_MBS). Preoperative CT data of 15 patients with degenerative spondylolisthesis at the level L4/L5 who underwent spinal decompression were identified retrospectively. Based on the segmented vertebrae, 15 individualized models were built. To establish a reference for comparison, we simulated a standardized flexion movement (intact) for each model. Subsequently, we performed virtual unilateral and bilateral interlaminar fenestration (uILF, bILF) and laminectomy (LAM) by removing the respective ligaments in each model. Afterward, the standardized flexion movement was simulated again for each case and decompression method, allowing us to compare the outcomes with the reference. This comprehensive approach enables us to assess the biomechanical implications of different surgical approaches and gain valuable insights into their effects on lumbar spine functionality. Results: Our findings reveal significant changes in the biomechanics of vertebrae and intervertebral discs (IVDs) as a result of different decompression techniques. As the invasiveness of decompression increases, the moment transmitted on the vertebrae significantly rises, following the sequence intact ➝ uILF ➝ bILF ➝ LAM. Conversely, we observed a reduction in anterior-posterior shear forces within the IVDs at the levels L3/L4 and L4/L5 following LAM. Conclusion: Our findings showed that it was feasible to forecast lumbar spine kinematics after three distinct decompression methods, which might be helpful in future clinical applications.

A Hybrid Fuzzy Model To The Ranking Problem of Companies Operating R&D Activities in Technology Innovation Centers

Technology innovation centers where universities share information with industry collaborations and institutions and have a wide range of companies in its field. Developing technology and competition have forced to make innovations, the companies in technology innovation centers operating Research and Development (R&D) activities have tried to prove themselves by proposing different projects to industrial organizations and making innovations and they are still working since they may get some promotions from the government. A decision for ranking companies has a number of criteria, which range from financial incentives and infrastructure to R&D activities. Most of the criteria are based on linguistic terms that decision makers can express with fuzzy statements. For this reason, in this study, the problem for ranking the companies operating R&D activities is solved by using a hybrid model, combining the Fuzzy Analytic Hierarchy Process and Fuzzy TOPSIS methods. Four different main decision criteria, 16 sub-criteria and three random companies were considered for this study. A network was formed, and surveys were carried out with the opinions of the experts on R&D activities and including experts from some technology development zones of Turkey. The proposed hybrid model was applied successfully to a case study for the ranking the companies operating R&D activities in Çukurova University Technology Development Zone in Turkey. Using actual data, it is showed the applicability of the proposed approach and compare the best alternative obtained by the proposed method for three companies in Çukurova University Technology Development Zone in Turkey.

La gestione del paziente con rinosinusite cronica e poliposi nasale in Italia: expert opinion sul percorso diagnostico-terapeutico

Chronic rhinosinusitis (CRS) is an inflammatory disease that affects the nasal mucosa and the paranasal sinuses; it can be characterized by nasal polyposis (CRSwNP) in up to 30% of cases. CRSwNP is frequently associated with bronchial asthma and patients affected show a greater severity of clinical disease with a significantly worse quality of life. CRSwNP shows predominantly an underlying activation of type 2 inflammatory pathways with the increase of eosinophils, IgE, interleukin (IL)-4, IL-5 and IL-13. Biological drugs that target inflammatory molecules are currently a therapeutic option recognized by guidelines for the treatment of uncontrolled form of the disease. The correct definition of the target patient, the type of biological drug to be used and the timing of intervention are crucial to guarantee a personalized therapy and optimize the cost/effectiveness of the treatment. A panel of Italian pneumologists, allergologists, immunologists and ear, nose and throat specialists discussed in a series of virtual expert meetings the main criteria for patient characterization and therapeutic decision, highlighting multidisciplinarity, the constant dialogue between doctor and patient, the organization in networks and the use of registries as strategies to implement the management of CRSwNP patients, to reach the personalization of the treatment and the best use of the biological drug(s).

General public's view on opt-in, opt-out, and mandated choice organ donation policies: a qualitative study involving Swiss French-speaking citizens favourably disposed towards organ donation.

All over the world, patients die while waiting for a transplant. Facing this difficulty, countries struggle to find efficient procedures and policies. One policy that has recently been enforced in many countries is the presumed consent (opt-out) system for organ donation. In such a system, every individual is considered as a potential organ donor except in cases of expressed refusal during her or his lifetime. Based on the input of a citizen's initiative, the Swiss parliament has made a proposal for a soft presumed consent policy.It was accepted by both chambers at the national level, but will possibly be challenged by a referendum, and give rise to a public vote. Ahead of the democratic debate, our aim was to sound out what issues are perceived as relevant by ordinary citizens when they evaluate different policies regulating organ donation. What are their main worries and decision criteria? We conducted semi-structured taped interviews with ordinary citizens during which we asked their views on three different systems: the current opt-in system, the opt-out presumed consent system described in a soft and in a hard version, and the mandatory decision system. We analysed transcripts by coding, and grouping code families up to four levels. We achieved saturation with fifteenth interviews. All our participants happened to be favourably disposed towards organ donation. Participants considered it important to choose a policy that contributes to overcoming the current shortage of organs, but not by any means. They were mostly concerned about individual rights and liberties, and more specifically about the importance of respecting the deceased's will and to promote lifetime advanced directives on organ donation. The role and rights of relatives were recurrent topics on which participants expressed divergent opinions. Participants often concluded that no legal system is perfect and spent much time discussing elements that were relevant to organ donation in general but not specifically linked to a given legal system. This study provides useful information about citizens' concerns regarding organ donation. In preparation of public debates on an opt-out policy, our results reveal what issues are likely to tilt the public opinion.

Estimating maturity by measuring pH, sugar, dry matter, water and vitamin C content of cashew apple (Anacardium occidentale) from remote spectral reflectance data using neural network

In agricultural sector, maturity is the main decision criterion for starting the harvest. This criterion is usually revealed by a number of parameters such as pH, sugar, dry matter, water and vitamin C, which are informative but technically tedious to measure. The cashew apple is the hypertrophied peduncle which is attached to the cashew nut. It is a nutritious (very juicy fruit (85 to 90% water), sweet (7 to 13% carbohydrates), acidic and vitamin C content) fruit with high therapeutic and medicinal properties. The cashew apple is used as a raw material for many industrial applications (juice and alcohol). This research was conducted as a preliminary step towards the development of a real-time remote sensing technique for assessing the quality of tropical fruits. Spectral acquisitions were carried out from intact cashew apple using optical system composed reflector coupled with spectrometer USB 4000 FL from Ocean Optics (350-1100 nm). Immediately after spectral acquisition, the samples were analyzed by using chemical methods (sugar content, dry matter content, water content, vitamin C and pH). Preprocessing treatment method, bootstrap method was required to create statistical new samples and to increase the number of samples required. This method was used to improve the predictive performance of calibration model. Statistical models of prediction were developed using an artificial neural network (ANN) method. The results obtained from the models built by ANN showed strong relationships between predicted and experimental values: (Rsquare = 0.9870, RMSE= 0.0262) for pH, (Rsquare=0.9869, RMSE=0.1392) for Sugar, (Rsquare=0.9726, RMSE=0.3333) for water content, (Rsquare=0.9703, RMSE=0.3464) for vitamin C and (Rsquare=0.9922, RMSE= 5.0304, RMSE=5.0304) for dry matter. These results confirm the potential of visible spectroscopy to predict quality parameters of cashew apples remotely and make decisions about best harvest time

Analysis on the library service quality with analytic hierarchy process model

Library service is a significant factor for a university to give the public a glimpse on the university education quality. An excellent library can provide a comfortable study environment for the students to concentrate on their learning. Besides that, library should also be a source that the students can easily search for the plenty of updated information that they need. As a result, a conceptual framework based on Analytic Hierarchy Process model is proposed to identify the priority of the main decision criteria and sub-criteria toward the library service quality among the undergraduate students. The results show that information control is the most influential decision criterion, followed by library as place and affect of service. Moreover, the top five most influential sub-criteria are desk and seating availability, Internet/WIFI facilities, cleanliness and beauty, temperature setting, and finally online journal collection. The findings of this study can provide an insight to the library to improve the services in order to satisfy the students’ expectations and needs in the future. This study is significant because AHP model is proposed to determine the quality of the library service with the consideration of the important decision criteria.

Technology for developing expert modules and DSS comprehensive platform for reliability and risks monitoring in the Oil and Gas Engeneering

The paper describes the proposed technology for the development of expert modules and DSS for integrated reliability and risk control systems for oil and gas industry, as part of a complex of intelligent technological management of reliability and efficiency of oil and gas systems developed at TIU. All stages of the development of system modules for controlling technical risks, the features of the structure of the decision-making model for DSS, and the components of a static and dynamic expert system for transport and storage of hydrocarbons are considered. The features of creating decision support systems are described, their main functions and decision criteria and their main provisions. As an example, one of the modules of intelligent neural network engineering control for predicting halos of thawing soil in the vicinity of the pipeline and passing communications, and buildings is shown, a model for visualizing processing results is proposed.

Integrated Fuzzy AHP-TOPSIS for selecting the best color removal process using carbon-based adsorbent materials: multi-criteria decision making vs. systematic review approaches and modeling of textile wastewater treatment in real conditions

ABSTRACT Here, Fuzzy AHP-TOPSIS methodology proposed for selecting the best colour treatment process using carbon-based adsorbent materials. Cost, safety, accessibility, reuse and adsorption capacity were identified as the main criteria for decision making. The priority of the criteria based on the experts’ opinions ordered as accessibility, reuse, adsorption capacity, environment safety, human safety, material cost, equipment cost with BNP = 0.250, 0.217, 0.172, 0.144, 0.105, 0.070 and 0.049, respectively. The consistency ratio was found 0.7% (less than 10%), which was acceptable to prioritise the criteria results. Fuzzy TOPSIS decision matrix with respect to criteria for evaluating the performance of eight carbon-based adsorbent materials in colour removal was formed and adsorbents ranked according to the NCCi as powder activated carbon>granular activated carbon >carbon nano tube >graphene oxide > graphene >reduced graphene oxide >graphite>coal. Finally, the effect of key factors in the treatment of real textile wastewater using PAC was investigated and optimised with RSM-CCF modelling. The optimal value of the parameters for the best productivity (81.60%) were as follows: pH: 3, PAC dose: 9.99 g L−1 and contact time: 83.19 min, respectively. The adsorption equilibrium and kinetic data were fitted with the Langmuir monolayer isotherm model (qmax: 127.431 ADMI/g, R2: 0.999) and Pseudo-first-order kinetics (R2: 0.998). Thermodynamic parameters, i.e. R2 > 0.995, ΔH°> 0, ΔS°> 0 and ΔG°< 0 also indicated colour adsorption are feasible, spontaneous and endothermic in nature.

Fragrances' luxury brand extension: consumer behaviour and influences

PurposeThis article aims to understand the influences surrounding the consumption of fragrances, especially if these products fit as a brand extension of luxury brands. More specifically, it aims at identifying the main reasons behind the process of buying fragrances and the main features associated with the consumption of fragrances.Design/methodology/approachThis research adopts a qualitative approach in the form of 15 in-depth interviews with consumers of fragrances, seeking to assess attitudes and influences in the consumption of fragrances as a brand extension of luxury brands.FindingsThis research shows that the emotional use of fragrances as a luxury product is much more important than their functionality, the relationship between the studied consumers and fragrances depends on the occasion of consumption (season of the year; day or night) and the aroma and the durability of the aroma is the main decision criterion for the purchase of fragrances. Respondents have also mentioned comfort, elegance and sophistication as attributes to choose a fragrance as a luxury product.Originality/valueThis article adds to the current knowledge on the topics of luxury brand management and buying behaviour by providing a better understanding of attitudes and influences towards the use of fragrances. This research recognizes the importance of a brand extension strategy for luxury brands, especially in the case of fragrances.

Selecting an airport ground access mode using novel fuzzy LBWA-WASPAS-H decision making model

Airports are critical in ensuring a fast way of transporting people and goods. Choosing a reliable, fast and comfortable access mode to the airport is vital to ensure a seamless aviation system. The aim of this study is to select the best transport mode for Istanbul’s newly constructed Istanbul Airport. One of the largest airports in the world with 150,000 passenger capacity per year, Istanbul Airport is located in the northern part of Istanbul, outside the city. However, the access to the new airport resulted in many controversies about the selection of the best mode. Underground metro, bus rapid transit (BRT), light rail transit (LRT) and premium bus services are put forward as alternative ground access modes. These alternatives are evaluated based on 4 main decision criteria including financial aspects, operating features, project characteristics and environmental sustainability, which are broken down into 14 sub-criteria. In this paper, the importance weights of the criteria are determined by novel fuzzy Level Based Weight Assessment (LBWA) which is capable of modelling human thinking. Afterwards, the traditional Weighted Aggregated Sum Product Assessment (WASPAS) method is enhanced by the integration of the fuzzy Weighted Heronian Mean (WHM) and fuzzy Weighted Geometric Heronian Mean (WGHM) functions. A hybrid fuzzy multi-criteria decision making method based on LBWA-WASPAS-H model is used to solve this ground access mode selection problem. The results show that an underground metro is the most optimal mode, followed by LRT, BRT, and premium bus services.

PNS178 ISPOR 2019 TOP 10 HEOR TRENDS: BRAZILIAN DECISION MAKERS' PERSPECTIVE

We conducted a survey related to the ISPOR 2019 Top 10 HEOR Trends to Brazilian decision makers during the Healthcare Regulation Forum in Minas Gerais, Brazil. Our objective was to analyze their perspectives in relation to five trends that shaped the field in 2019: (i) Drug budgets and health system affordability; (ii) Use of real-world data (RWD) in healthcare decision making; (iii) Solutions to the challenges facing health professionals; (iv) Value-driven healthcare; and (v) Main criteria for healthcare decision making. We conducted a digital and behavioral survey oriented to action directives with 99 Forum participants and 20 speakers after each roundtable discussion. The response rate was over 60%. The sample was diverse in terms of academic background (53.0% nurse auditors), type of work institution (24 different institutions), and geographical region of origin (15 different cities). This survey identified five insights: (i) The best way to provide health outcomes for patients without bankrupting the healthcare system is to limit the use of new technologies by guideline development (46.2%); (ii) Although RWD are accessible, health institutions are not prepared to convert RWD into real-world evidence for healthcare decision making (60.0%); (iii) In addition to concerns over the number of professionals to meet health demands in the near future, health decision makers consider that Brazilian professionals need to improve patient care qualification (63.2%); (iv) Brazilian healthcare institutions have noticed a shift towards a value-driven healthcare system for the de-hospitalization of patients with a view to patient well-being, risk protection and reduced health costs (53.3%); and (v) the most important criterion used to decide which new technology to include in a benefits package is the trial evidence (89.5%). This study provides a understanding of healthcare decision making in Brazil. It is essential to continue monitoring trends that will affect decision makers in healthcare institutions.

Investment preferences of Iran's mineral extraction sector with a focus on the productivity of the energy consumption, water and labor force

Mines and mining industries provide many employment opportunities and generate economic growth. Mining is an important way to reach sustainable development and investing in this sector creates suitable economics added value. Huge resources of the various mineral types have held Iran as one of the most-rich mineral countries. Making a proper strategic vision and investment preference for this vital economic sector without considering the internal restrictions (such as energy and water resources) is impossible. Regarding different limitations exist in the determination of appropriate investment opportunity, multi-attribute decision-making (MADM) methods can be applied. Although these methods have been widely used in the literature, studies in the investment preferences of the mineral resources are insufficient. This paper aims to study the investment preference of Iran's mineral types using hybrid MADM (HMADM) models. The productivity of energy consumption, water, and labor force are considered as the main decision criteria. The hybrid methods fuzzy-DEMATEL-TOPSIS and fuzzy-DEMATEL-PROMETHEE are applied to study the comparative advantages in Iran's mineral resource exploitation. Regarding the results of this study, the productivity of the consumed water and the value-added production have the highest importance in prioritizing the mineral resources of Iran. Moreover, gold, coal, copper, iron ore, kaolin and fireclay, and lead and zinc mineral types are prioritized, respectively.

Understanding the logistics centre location decision: what are the main decision criteria and evaluation methods

A logistics centre is the specific area where commercial operators carry out all activities dedicated to transport, logistics, and goods distribution - both for national and international transit. Selecting suitable logistics centre location is very important for obtaining optimal solutions for a country's logistics infrastructure. This may involve many various decision criteria to decide where each logistics centre should be established. Therefore, valid criteria should be identified and a proper methodology implemented. Given the importance of the topic, this study conducted a systematic literature survey to classify relevant articles. The systematic literature review was completed in two stages. First, the main decision criteria are considered in the evaluation process; second, the most common evaluation methods for the logistics centre location decision are examined. Last, the discussion is performed whether logistics centre location problem is still relevant.

Understanding the logistics centre location decision: what are the main decision criteria and evaluation methods

Understanding the logistics centre location decision: what are the main decision criteria and evaluation methods

Real-time quality monitoring and control system using an integrated cost effective support vector machine

The quality monitoring and control (QMC) has been an essential process in the manufacturing industries. With the advancements in data analytics, machine-learning based QMC has become popular in various manufacturing industries. At the same time, the cost effectiveness (CE) of the QMC is perceived as a main decision criterion that explicitly accounts for inspection efforts and has a direct relationship with the QMC capability. In this paper, the cost-effective support vector machine (CESVM)-based automated QMC system (QMCS) is proposed. Unlike existing models, the proposed CESVM explicitly incorporates inspection-related expenses and error types in the SVM algorithm. The proposed automated QMCS is verified and validated using an automotive door-trim manufacturing process. Next, we perform a design of experiment to assess the sensitivity analysis of the proposed framework. The proposed model is found to be effective and could be viewed as an alternative or complementary tool for the traditional quality inspection system.

PNS219 TARGETED LITERATURE REVIEW AND PAYERS' PERSPECTIVES ON THE CURRENT PROGRESS OF HTA SYSTEM IMPLEMENTATION IN THE MENA REGION

In the MENA region, the application of Health Technology Assessment (HTA) for access, pricing and reimbursement decisions, is less prominent compared to other countries where there is an established link between decisions and evidence. The objective of this research was to explore the progress made by countries in the MENA region (Egypt, Jordan, Kuwait, Lebanon, Oman, Saudi Arabia, Tunisia, United Arab Emirates) regarding the implementation of an official HTA agency since the ISPOR conference in Dubai, and to gather payer’s perceptions on progress. An open internet search using key words (HTA, cost-effectiveness, budget impact, clinical effectiveness, comparative effectiveness) was used to review publications in the scope markets from Sept-2018 to May-2019. In addition, payers/advisors from the region have been contacted about the main decision criteria for assessment, the value and expected challenges of implementing an HTA system, the timelines for implementation, as well as, the impact of HTA on the access of treatments using Ipsos Dimensions survey software. HTA agency has been established in Tunisia at a national level and Jordan at a local level. The remaining scope countries have not yet established an agency; however, Kuwait is discussing the integration of an HTA system, while Lebanon and the United Arab Emirates have started making use of HTA. Egypt and Saudi Arabia have included the development of HTA agency in their 2030 healthcare vision goals and are rolling out trainings. Data from the survey is being analysed and we expect this to provide additional insight on implementation progress and payer perceptions. The MENA region is moving towards utilising HTAs in funding decisions, however, progress is at different stages across the region. The timescale for implementation of HTA is unclear and varies between countries. Only Saudi Arabia and Egypt have established clear timelines for HTA agency development.

Understanding Investment Analysis for Farm Management

Investment decisions are among the most important decisions growers make. In many cases, those investments are in capital assets such as establishing a new orchard or purchasing a new piece of equipment. The process for evaluating those investments is called investment analysis or capital budgeting. This 4-page fact sheet written by Julio Cruz and Ariel Singerman and published by the UF/IFAS Food and Resource Economics Department reviews net present value and the internal rate of return, the two main criteria for decision making when evaluating a decision to invest in a capital asset. https://edis.ifas.ufl.edu/fe1060

Current Trends Among US Surgeons in the Identification, Treatment, and Time of Repair for Medial Meniscal Ramp Lesions at the Time of ACL Surgery.

Background:Given the potential hidden nature of medial meniscal ramp lesions and the controversy regarding treatment, it is important to understand the current trends regarding the identification and treatment strategies of meniscal ramp lesions by the leading surgeons and educators in the field of sports medicine.Purpose:To better understand the current trends in orthopaedic surgery regarding arthroscopic identification and treatment of medial meniscal ramp lesions at the time of anterior cruciate ligament (ACL) surgery.Study Design:Cross-sectional study.Methods:An electronic questionnaire was sent in a blinded fashion to 91 directors of orthopaedic sports medicine fellowship training programs in the United States. Participants’ email addresses were obtained through the American Orthopaedic Society for Sports Medicine directory of current fellowship program directors. Inclusion criteria were only those surgeons who currently performed ACL reconstruction surgery. Exclusion criteria were those surgeons who did not perform ACL reconstruction or who chose to opt out of the survey.Results:Overall, 19 surgeons opted out of the survey; 36 responded from the remaining 72 surveys (50%). The majority (n = 31, 86%) reported routinely checking for a medial meniscal ramp lesion via inspection of the posteromedial meniscocapsular junction during an ACL reconstruction. The most common repair technique cited was all-inside (n = 24, 66.7%), followed by inside-out (n = 8, 22.2%). Three (8%) surgeons indicated that they did not repair meniscal ramp lesions. Regarding surgical treatment (repair vs no treatment), the majority reported using the extent of the tear (89%; partial vs full thickness) and the stability of the tear upon probing (81%) as the main criteria for intraoperative decision making. Nineteen (52.8%) surgeons required a mean time of <15 minutes for meniscal ramp repair; 16 surgeons (44.4%), 15 to 30 minutes; and 1 surgeon (2.8%), 30 to 45 minutes.Conclusion:This study provides insight regarding meniscal ramp tear identification, treatment, and repair strategies from the fellowship directors of sports medicine orthopaedic surgery in the United States. Such information may be useful for current orthopaedic surgeons to advance their practice according to the current trends surrounding ACL reconstruction and medial meniscal ramp repair.