Ordinal Ranking Research Articles

Socioeconomic Characteristics of Communities With Primary Care Practices With Nurse Practitioners

Given the disparities in access to primary care and the growing nurse practitioner (NP) workforce, it is important to understand the distribution of primary care practices with NPs across communities of varying socioeconomic characteristics. To compare the socioeconomic characteristics of communities that have primary care practices with or without NPs. This secondary, cross-sectional analysis of 79 743 primary care practices used 4 merged data sources: the IQVIA 2023 OneKey database, the 2020 US biennial Census, the 2017-2022 American Community Survey, and the 2021 Area Deprivation Index (ADI). US Census Tracts and Divisions from 2023 were used to examine differences in socioeconomic characteristics across communities. Primary care practices with NPs vs without NPs. Socioeconomic characteristics of Census Tracts and Block Groups, including racial and ethnic composition, median household income, percentage below the federal poverty level, educational attainment, and the ADI (an ordinal percentile ranking of Census Block Groups from 1 to 100, with 1 being least disadvantaged and 100 being most disadvantaged). Of 79 743 primary care practices, 42 601 (53.4%) employed NPs in 2023. Practices with NPs, compared with those without, were significantly more likely to be in communities classified as low income (23.3% vs 17.0%; P < .001) and rural (11.9% vs 5.5%; P < .001). On average, these communities had a higher proportion of the population living below the federal poverty level (14.4% [95% CI, 14.3%-14.5%] vs 12.8% [95% CI, 12.7%-12.9%]; P < .001) and without a high school diploma (19.8% [95% CI, 19.7%-19.9%] vs 18.5% [95% CI, 18.4%-18.6%]; P < .001). Communities with practices with NPs also had significantly higher mean ADI percentiles than communities with practices without NPs (53.3% [95% CI, 53.1%-53.6%] vs 42.5% [95% CI, 42.2%-42.7%]; P < .001). As the number of primary care practices decreased in disadvantaged areas, the proportion of practices with NPs increased. In most US Census Divisions, there were more primary care practices with NPs than without, a difference that was marked in low-income communities. This cross-sectional study of primary care practices in the US found that primary care practices with NPs, compared with those without NPs, were more likely to be located in communities with lower income and educational attainment and greater levels of overall socioeconomic disadvantage. This finding suggests that NPs are key to ensuring access to primary care in communities with socioeconomic disadvantage.

Quality of life following complete clinical response to chemoradiotherapy for rectal cancer: Patient-reported outcomes.

120 Background: Complete clinical response (cCR) after neoadjuvant therapy (chemoradiotherapy/total neoadjuvant treatment) for rectal cancer may permit an organ-preserving approach with “watch and wait” (W&amp;W) surveillance. This confers comparable survival, while avoiding the sequelae of pelvic surgery. Data on quality of life (QOL) for this cohort are lacking. Methods: Patient-reported outcomes were collated for patients on W&amp;W following cCR in a single hospital network. Validated questionnaires evaluating surgical, radiation and chemotherapy-related QOL were completed, including Low Anterior Resection Syndrome (LARS) score, Functional Assessment of Chemotherapy: Colorectal (FACT-C), EORTC QLQ-CIPN20, EQ-5D-5L and a linear analogue and ordinal scale ranking self-perception of health. Results: From 2016-2023, 76 patients were enrolled on W&amp;W. Median follow-up is 37 months (IQR20-63). 12 patients (15.8%) had local regrowth, of whom 11 (92%) had salvage surgery. Five patients (6.5%) developed metastases at median 8 months (IQR3-12) from W&amp;W entry. Of 57 patients (75%) with sustained cCR on surveillance, 44 (77%) responded to structured questionnaires. Two with stomas were excluded from LARS. 74% of respondents had no LARS, 9% minor LARS and 17% major LARS. 43% reported faecal urgency and 33% faecal incontinence. 41% experienced functional impairment due to chronic chemotherapy-related side effects (Table). Median EORTC CIPN20 score was 23 (IQR20-28; possible range 19-76, high score = poor QOL). Median sensory score was 11 (IQR9-15.5, PR 9-36), median motor score 8 (IQR8-11, PR 8-32) and median autonomic score 4 (IQR3-6) for males (PR 3-12) and 2 (IQR2-2.5) for females (PR 2-8). 54% of men reported erectile dysfunction, of whom 62% experienced severe dysfunction (33% of all males). Median FACT-C score was 123.5 (IQR108-131; PR 0-136, high score = better QOL). Median overall health score was 80% (IQR70-95). 36% of patients reported difficulty with mobility, 27% with usual activities and 11% with self-care. 30% declared ongoing physical pain/discomfort, while 23% live with anxiety/depression related to their diagnosis. Overall, 86% of reported problems were mild/moderate and 14% severe/very severe. Conclusions: This study highlights self-reported QOL in patients on W&amp;W pathway following neoadjuvant treatment of rectal cancer. It provides important insight to side-effects of treatment escalation in hope of organ preservation, and presents vital information for the counselling of future patients. Patients (n=41) Upper limb paraesthesia 12 (29%) Lower limb paraesthesia 17 (41%) Difficulty with: - Walking/standing (foot drop or impaired sensation) 10 (24%) - Stairs/sit-to-stand (leg weakness) 11 (27%) - Hot/cold differentiation 4 (10%) - Holding pen/manipulating small objects/opening jar/bottle 12 (29%) Hearing impairment 13 (32%) Blurred vision 4 (10%)

What Dyadic Internet Street Fight Videos Can and Cannot Tell Us About the Ethological, Game Theoretic, and Sex-Differentiated Phenomenology of Human Physical Aggression.

Street fight videos on the internet may provide information about little known aspects of human physical aggression, but their reliability is unclear. Analyses of 100 dyadic fight videos addressing ethological, game theoretic and sex-differentiated questions derived from research on other animals found that prefight verbalizations or gestural signals of nonaggressive or aggressive intent loosely predicted who would strike first and who would win. The head is the preferred strike target. Ordinal severity rankings of different strikes ranged from 1 for spitting to 5 for choking. Half the videos showed briefer, unilateral assaults beginning with one or more high severity strikes, little evidence of escalation and fewer bystander interventions. A quarter of these were sneak attacks. The other videos showed longer fights with reciprocal strikes, some evidence of strike severity escalation and more bystander intervention. Both types were equally injurious. Winner/loser outcomes were reliably identified by postfight behaviors and/or signs of injury. Winners had advantageous prefight resource holding potential (RHP: greater height and/or vigor) significantly more often than losers. Consistent with tendencies for fights to occur between animals of the same sex, there were more male/male and female/female fights and fewer male/female fights than expected from random pairings of men and women in the videos. Female/female fights involved proportionally more hair-pulling, extended bouts of rapidly repeated strikes and longest durations. Bystanders intervened in over half the videos, attempting to separate fighters or help losers more often than they attacked the loser. Carefully selected internet street fight videos can provide important information.

Olive oil consumption, preferences and usage areas: the case of Hatay and Aydın provinces

Olive and olive oil are essential food sources for their health benefits and flavour. It is crucial in regions such as Aydın and Hatay, where olives are intensively grown. This research was conducted through focus group discussions, in-depth interviews, and a questionnaire survey to understand how olive oil is preferred in cooking and its different uses in health, carpentry, skincare, hair care, massage oil, and aromatherapy. The study's findings show that the versatile use of olive oil is widespread in Aydın and Hatay provinces. The results of this research can be used for olive oil producers and marketers to develop sales and marketing strategies and better understand the potential uses of olive oil. Local production and price were the determinants of consumers' olive oil preferences. The results of this study reveal the diversity of olive and olive oil use in Aydın and Hatay provinces and how consumers prefer the product in different areas. Within the scope of the research, a questionnaire survey was conducted in two regions, and a scale of 1-5 points was used to help the respondents give more precise answers to the statements in the form. The findings were analysed using ordinal ranking and one-factor multiple variance analysis MANOVA. The results of this research were used to develop sales and marketing strategies for olive oil producers, marketers and consumers and to understand the potential uses of olive oil better.

Two-stage group ordinal consensus optimization ranking approach considering multiple optimal consistency adjustment solutions

Two-stage group ordinal consensus optimization ranking approach considering multiple optimal consistency adjustment solutions

The geography of wild American ginseng in North Carolina, USA: a comparative study of four capability analysis methods

Wild American ginseng is the root component of a family of plants called Panax, and it grows mainly in the understory of the eastern deciduous forests in North America. The growing market for wild American ginseng in Asia along with the scarcity of this plant in the wild due to rising illegal harvest have been simultaneously pushing up the price of American ginseng in the market, increasing incentives further for illegal harvest of this soon-to-be-extinct species. This paper studies the geography of wild American ginseng to identify the spatial distribution of the suitable habitat of this plant in the wild and provides advice on what conditions are required and what regions are suitable for cultivating it in farms, introducing an alternative to the wild American ginseng to decrease the harvesting pressure on its wild counterpart. By employing four popular geospatial methods, including the Binary Screening method, the Ordinal Ranking method (both Graduated Screening and Addition-of-Factors methods), and the Weighted Linear Combination method, this paper carries out a capability analysis and mapping for wild American ginseng in North Carolina (NC). After building the models, they are validated by using the data of the known locations of wild American ginseng plants in NC. Developing these models helps in gaining a more comprehensive understanding of where the plant naturally grows and sheds light on how government agencies can more effectively and more efficiently plan for law enforcement activities to better protect this plant from illegal harvest. The general pattern of our results suggests that western NC counties such as Jackson, Haywood, Transylvania, Henderson, Cherokee, and Ash are some of the most suitable geographical areas for wild American ginseng to grow. The results of our model validation analysis, along with the comparison of our models' predictions to the observed occurrences of wild American ginseng in nature, indicate that the Binary Screening method’s predictions align with almost 96% of the reported observations in nature. This suggests that the influential natural factors necessary for wild American ginseng are more of complementary factors to each other than being substitutes, meaning that they all must exist in the environment for it to grow, and it could not be that the lack of one natural factor can be compensated by the abundance of another natural factor.

Developing a Situational Judgement Test to Assess Clinical Judgement in Fourth-Year Medical Students: A Pilot Study.

Introduction Assessing clinical judgement objectively and economically presents a challenge in academic medicine. The authors developed a situational judgement test (SJT) to measure fourth-year medical students' clinical judgement. Methods A knowledge-based, single-best-answer SJT was developed by a panel of subject matter experts (SMEs). The SJT included 30 scenarios, each with five response options ranked ordinally from most to least appropriate. A computer-based format was used, and the SJT was piloted by two cohorts of fourth-year medical students at California University of Science and Medicine in 2022 and 2023 upon completion of an internship preparation course. Subsequently, students completed an optional survey. Evaluated scoring methods included original ordinal ranking, dichotomous, dichotomous with negative correction, distance from SME best answer, and distance from SME best answer squared. Results The SJT was completed by 142 fourth-year medical students. Cronbach's alpha ranged from 0.39 to 0.85, depending on the scoring method used. The distance-from-SME-best-answer-squared method yielded the highest internal consistency, which was considered acceptable. Using this scoring method, the mean score was 72.89 (SD = 48.32, range = 26-417), and the standard error of measurement was 18.41. Item analysis found that seven (23%) scenarios were of average difficulty, 13 (43%) had a good or satisfactory discrimination index, and nine (30%) had a distractor efficiency of at least 66%. Most students preferred the SJT to a traditional multiple-choice exam (16; 62%) and felt it was an appropriate tool to assess clinical judgement (15; 58%). Conclusions The authors developed and piloted an SJT to assess clinical judgement among medical students. Although not achieving validation, subsequent development of the SJT will focus on expanding the SME concordance panel, improving difficulty and discrimination indices, and conducting parallel forms reliability and adverse impact analyses.

Usefulness of the Kansas University Standing Balance Scale in inpatient rehabilitation: a retrospective validation study.

Adequate balance assessment is essential for designing rehabilitation programs and preventing falls. This study aimed to report the cross-cultural adaptation of the Korean version of the Kansas University Standing Balance Scale (KUSBS), investigate its concurrent and predictive validities, and examine aging-related differences. The adaptation was performed using a standard protocol. In this retrospective study, 1179 patients were included and classified into adult, young-old, old-old, and oldest-old groups. Furthermore, we compared the concurrent, discriminant, and predictive validities of the KUSBS and Berg Balance Scale (BBS). Nonparametric analysis was also conducted. The Spearman rho test revealed strong correlation coefficients between the KUSBS and BBS (r s > 0.7; P < 0.001). At admission, the relationship was strong in the adult, young-old, and old-old groups (r s = 0.931, 0.913, and 0.914, respectively; P < 0.001) but not the oldest-old group (r s = 0.790; P < 0.001). At discharge, the correlation coefficients were above 0.9 in all groups. Additionally, the relationship between the changes in both scales was moderate-to-strong (r s > 0.68; P < 0.001). The predictive validity for independent walking of the KUSBS was strong (r s = 0.791; P < 0.001) and significantly lower than that of the BBS (r s = 0.833; P < 0.001; Z = -3.001; P = 0.003). Furthermore, the cutoff value of the KUSBS at admission to predict independent ambulatory walkers at discharge was 3.5 in ordinal ranking in all age groups. The KUSBS is a reliable and effective tool for measuring balance in patients in inpatient rehabilitation.

Branching-independent random utility model

Branching-independent random utility model

New method for assigning cardinal weights in multi-criteria decision-making: the constant weight ratio method

A new method is proposed to convert ordinal ranking of a number of criteria and an additional piece of information into numerical weights. A literature review of methods for assigning cardinal weights based on ordinal ranking is performed, as well as an analysis of their behaviour. The new method, called ‘constant weight ratio’ (CWR), enables better adjustment to the decision-maker’s preferences than purely ordinal ranking methods. It also solves the problem of the excessive decrease in the weight of the most important criterion (or criteria) when the total number of criteria is large and the weight of the most important criterion (or criteria) must be high. It is achieved via three simple steps and flexible input data. The additional piece of information may be: (i) the relative importance of the criteria, i.e., the weight ratio, (ii) the total weight of the most important set of criteria, or (iii) the weight of the most important criterion. The proposed method is applied to two case studies in the cultural sector to illustrate that the resulting weights are equivalent to other methods requiring more input data from the decision maker.

Modeling multi-behavior sequence via HyperGRU contrastive network for micro-video recommendation

Modeling multi-behavior sequence via HyperGRU contrastive network for micro-video recommendation

Testing the suitability of vector normalization procedure in topsis method: application to wheel loader selection

The object of the research consists of testing the suitability of the vector normalization procedure (NP) in the Technique for Order Preference by Similarity to the Ideal Solution (TOPSIS) method. One of the most problematic steps of the Multi-Criteria Decision Making (MCDM) process is related to the application of NPs by default to transform different measurement units of criteria into a comparable unit. This is because of the absence of a universal agreement that defines which NP is the most suitable for a given MCDM method. In the literature, there are thirty-one available NPs, each one of them has its strengths and weaknesses and, accordingly, can efficiently be applied to an MCDM method and even worst to another. Let’s note that many NPs (e. g., NPs of sum, max-min, vector, and max) have been used by default (i. e., without suitability study) in the TOPSIS method. Consequently, outcomes of multi-criteria evaluation and rankings of alternatives considered in the decision problems could have led to inconsistent solutions, and, therefore, decision-makers could have made irrational or inappropriate decisions. That’s why suitability studies of NPs become indispensable. Moreover, a description of the methodology, proposed in this research, is outlined as follows: 1) method of weighting based on an ordinal ranking of criteria and Lagrange multiplier (for determining criteria weights); 2) TOPSIS method (for ranking considered alternatives); 3) a statistical approach with 3-estimate (for comparing effects generated by the used NPs). In the research, twelve different NPs are compared to each other in the TOPSIS method via a numerical example, which deals with the wheel loader selection problem. The results of the comparison indicate that, amongst the twelve different NPs analyzed in this suitability study, vector NP has the lesser effect on the considered alternatives’ evaluation outcomes, when used with the TOPSIS method. The vector NP-TOPSIS approach can therefore be applied to solve multi-criteria decision problems. Its application further allows the decision-makers and users to better select efficient solutions and, consequently, to make conclusive decisions.

Exploration of a Potential DOOR Endpoint for Hospital-acquired Bacterial Pneumonia and Ventilator-associated Bacterial Pneumonia Using Six Registrational Trials for Antibacterial Drugs.

Desirability of outcome ranking (DOOR) is an innovative approach to clinical trial design and analysis that uses an ordinal ranking system to incorporate the overall risks and benefits of a therapeutic intervention into a single measurement. Here we derived and evaluated a disease-specific DOOR endpoint for registrational trials for hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP). Through comprehensive examination of data from nearly 4000 participants enrolled in six registrational trials for HABP/VABP submitted to the Food and Drug Administration (FDA) between 2005 and 2022, we derived and applied a HABP/VABP specific endpoint. We estimated the probability that a participant assigned to the study treatment arm would have a more favorable overall DOOR or component outcome than a participant assigned to comparator. DOOR distributions between treatment arms were similar in all trials. DOOR probability estimates ranged from 48.3% to 52.9% and were not statistically different. There were no significant differences between treatment arms in the component analyses. Although infectious complications and serious adverse events occurred more frequently in ventilated participants compared to non-ventilated participants, the types of events were similar. Through a data-driven approach, we constructed and applied a potential DOOR endpoint for HABP/VABP trials. The inclusion of syndrome-specific events may help to better delineate and evaluate participant experiences and outcomes in future HABP/VABP trials and could help inform data collection and trial design.

COLD Fusion: Calibrated and Ordinal Latent Distribution Fusion for Uncertainty-Aware Multimodal Emotion Recognition.

Automatically recognising apparent emotions from face and voice is hard, in part because of various sources of uncertainty, including in the input data and the labels used in a machine learning framework. This paper introduces an uncertainty-aware multimodal fusion approach that quantifies modality-wise aleatoric or data uncertainty towards emotion prediction. We propose a novel fusion framework, in which latent distributions over unimodal temporal context are learned by constraining their variance. These variance constraints, Calibration and Ordinal Ranking, are designed such that the variance estimated for a modality can represent how informative the temporal context of that modality is w.r.t. emotion recognition. When well-calibrated, modality-wise uncertainty scores indicate how much their corresponding predictions are likely to differ from the ground truth labels. Well-ranked uncertainty scores allow the ordinal ranking of different frames across different modalities. To jointly impose both these constraints, we propose a softmax distributional matching loss. Our evaluation on AVEC 2019 CES, CMU-MOSEI, and IEMOCAP datasets shows that the proposed multimodal fusion method not only improves the generalisation performance of emotion recognition models and their predictive uncertainty estimates, but also makes the models robust to novel noise patterns encountered at test time.

The existence and efficiency of PMMS allocations

The existence and efficiency of PMMS allocations

The Effect of Different Point Systems on European League Positions

The introduction of three points for a win in European football during the 1980s and 90s was intended to promote a more attacking style of play and thus more goal scoring and entertainment for viewers. However, subsequent studies showed that the change did not have the desired effect and led to unexpected outcomes such as a rise in foul play, as measured by the number of red cards. In this paper, we investigate the outcome of assigning points in alternate ways. We consider several modifications of both the current system (with 3 points awarded for a win and 1 point for a draw) and the original system (with 2 points awarded for a win and 1 point for a draw), including the effect of awarding bonus points for large margin victories and a deduction of points for large margin defeats. Combinations of these modifications led to 175 different systems being analyzed. Based on data from the top five European leagues, we conclude that solely modifying the point system does not have a significant impact on the standings, with the average change in the ordinal rankings ranging from 0.44 to 0.95 placings per season, and that the final ranking of the teams at the end of the season is largely independent of the point system and based on the relative playing strength of the teams. However, a much greater variation is seen once bonus and penalty points are added for large margin victories and defeats.

Evaluation of a Novel Objective Method for The Assessment of Nasal Symmetry Among Patients with Unilateral Cleft Lip.

This is a cross sectional study aimed to asses novel semi objectve compter assisted method to asses the symmetry amog unilateral cleft lip patients. using Standard inferior view nose photos that were uploaded to Digimizer© Version 4.6.1 (2005-2016 MedCalc Software) Image Analysis, symmetry percentage was calculated and compared between cleft and non-cleft neonates. This method was compared to two subjective methods of rating symmetry. This a cross sectional pilot study performed in the Univresity Medical Center using standard inferior views of unilateral cleft patients which were compared to non-cleft neonates. Photographs of 71 neonates with unilateral complete and incomplete cleft lip and 30 neonates without facial cleft, which were born at the university medical center, Beer Sheba, Israel, were analyzed in a standard manner to determine nasal symmetry. the novel method proposed produced a nominal value for percentage of symmetry. Using Pearson's correlation test we found intra-rater reliability of 91.2% (p < 0.001) and Inter-rater reliability of 82.9% (p < 0.001). The analysis correlated with the surgeons subjective scores in both the numerical ranking method at 73% (p < 0.001) and 72.6% (p < 0.001) and the Ordinal ranking method at 87.6% (p < 0.001) and 77.7% (p < 0.001). The ability of the method to discriminate healthy from Cleft Lip patients overall was 92.3% With high sensitivity and specificity. This method accurately distinguishes healthy patients from cleft lip patients. We have achieved High levels of inter and intra-rater reliability. Significant correlations were found between our semiobjective method and the subjective scores.

Two modes of social impressions and their effects on choice.

Our memories of other people shape how we interact with them. Yet, even when we forget exactly what others said or did, we often remember impressions that capture a general gist of their behavior-whether they were forthright, friendly, or funny. Drawing on fuzzy trace theory, we propose two modes of social impression formation: impressions formed based on ordinal gist ("more competent," "less competent") or categorical gist ("competent," "incompetent"). In turn, we propose that people gravitate toward the simplest representation available and that different modes of memory have distinct consequences for social decisions. Specifically, ordinal impressions lead people to make decisions based on an individual's standing relative to others, whereas categorical impressions lead people to make decisions based on discrete classifications that interpret behavior. In four experiments, participants learned about two groups of individuals who differed in their competence (Studies 1a, 2, and 3) or generosity (Study 1b). When participants encoded impressions as ordinal rankings, they preferred to hire or help a relatively good target from a low-performing group over a relatively bad target from a high-performing group, even though both targets behaved identically and accuracy was incentivized. However, when participants could use categorical boundaries to interpret behavior, this preference was eliminated. In a final experiment, changing the category participants used to encode others' generosity changed their impressions, even when accounting for memory for verbatim details. This work links social impressions to theories of mental representation in memory and judgment, highlighting how distinct representations support divergent patterns of social decision-making. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Time stationarity, shape and ordinal ranking bias of RCA indexes: a new set of measures

A new set of tools to measure the time stationarity, shape and ordinal ranking bias of Revealed Comparative Advantage (RCA) indexes is suggested. The aim is to help select the most consistent RCA index for a given set of countries, products and time periods, which is especially relevant for economic policy based on comparative advantages. The GMM estimation of an AR(1) process based on RCA indexes provides three measures of time stationarity that are more rational than the measures available in the literature. Furthermore, we revise the statistics that are commonly used to capture shape. Finally, with respect to ordinal ranking bias, we modify the use of Spearman’s rank correlation coefficient in Leromain and Orefice (Int Econ 139:48–70, 2014) and generalize the non-parametric measure of Stellian and Danna-Buitrago (J Appl Econ 22(1):349–379, 2019). We discuss different methods of ranking RCA indexes according to all proposed measures. An application to 33 RCA indexes, 67 trade areas and three product classifications shows that, on average, the most accurate RCA indexes are Contribution-to-the-Trade-Balance indexes, Revealed Competitiveness indexes and regression-based indexes.

Antidepressant and antipsychotic side-effects and personalised prescribing: a systematic review and digital tool development

Side-effects of psychiatric medication impair quality of life and functioning. Furthermore, they contribute to morbidity, mortality, stigma, and poor treatment concordance resulting in relapse of psychiatric illness. Guidelines recommend discussing side-effects with patients when making treatment decisions, but a synthesis of antidepressant and antipsychotic side-effects to guide this process is missing, and considering all side-effects is a complex, multidimensional process. We aimed to create comprehensive databases of antipsychotic and antidepressant side-effects, and a digital tool to support database navigation. To create the databases, we did an umbrella review of Embase, PsycINFO, and MEDLINE from database inception to June 26, 2023. We included meta-analyses of randomised controlled trials examining antipsychotic monotherapy in the treatment of schizophrenia or antidepressant monotherapy in the treatment of major depressive disorder. We included meta-analyses in adults (aged ≥18 years) that assessed drugs with a common comparator. The search was complemented by a review of national and international guidelines and consensus statements for the treatment of major depressive disorder and schizophrenia in adults. Effect sizes for antipsychotic and antidepressant side-effects were extracted from meta-analyses examining the largest number of drugs. In cases of incomplete meta-analytic coverage, data were imputed on the basis of guideline-derived ordinal rankings or, if imputation was not possible, ordinal scores were extracted. Both meta-analytic and ordinal outcomes were normalised to provide values between 0 and 1. We then constructed a digital tool, the Psymatik Treatment Optimizer, to combine the side-effect databases with side-effect concerns of an individual user, to enable users to select side-effects of concern and the relative degree of concern for each side-effect. Concern weightings and the side-effect databases are synthesised via a multicriteria decision analysis method (technique for order of preference by similarity to ideal situation, or TOPSIS). Of 3724 citations, 14 articles containing 68 meta-analyses of individual side-effects met inclusion criteria. After review of 19 guidelines, seven provided ordinal data. Antipsychotic data were extracted from five studies (11 meta-analyses, n=65 594 patients) and four guidelines, and antidepressant data were extracted from three guidelines. The resultant databases included data on 32 antipsychotics (14 side-effects) and 37 antidepressants (nine side-effects). The databases highlighted the clinical dilemma associated with balancing side-effects, with avoidance of one side-effect (eg, weight gain for antipsychotics) increasing the risk of others (eg, akathisia). To aid with this dilemma, the Psymatik Treatment Optimizer synthesises the side-effect databases with individual user-defined concern weights. After computing up to 5851 pairwise comparisons for antidepressants and 5142 pairwise comparisons for antipsychotics, Psymatik ranks treatments in order of preference for the individual user, with the output presented in a heatmap. By facilitating collaborative, personalised, and evidence-based prescribing decisions, the side-effect databases and digital application supports care delivery that is consistent with international regulatory guidance for the treatment of schizophrenia and depression, and it therefore has promise for informing psychiatric practice and improving outcomes. National Institute for Health and Care Research, Maudsley Charity, Wellcome Trust, Medical Research Council.