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218     Abdulrahman Albar, Ahmad Elshennawy, Mohammed Basingab et al.

                          The final fuzzy rules for subsystem IV are provided in Appendix D. These rules will
                       become an essential part of the knowledge base for subsystem IV.
                          The results presented in this section are a critical component of this research, as they
                       provide validation for the design intent of the framework, and show that the consensus
                       rates for rule assessments are good, necessitating only seven re-evaluations among the
                       initial 137 rules. The average consensus rate was 72% or better between each of the four
                       subsystems, which further highlights the consistency of results. It was observed that the
                       average consensus rate decreased noticeably in subsystems where there were either an
                       increase in assessment classes, more rules, or more complex rules with more conditions
                       for  experts  to  evaluate.  These  factors  contributed  to  each  subsystem’s  complexity,
                       contributing to the overall decrease in average consensus rate. The assessed fuzzy rules
                       will build upon the designed fuzzy system by feeding the four different fuzzy engines
                       from subsystems I-IV with supporting information to link the inputs to the outputs.


                                                FUZZY SYSTEM RESULTS

                          The fuzzy logic toolbox of Matlab R2015b (Version 2.2.22) was used to construct
                       and  simulate  each  fuzzy  subsystem  individually,  with  data  gathered  from  experts.  A
                       series of 3-D surface plots were generated relating the inputs of each subsystem to their
                       respective  outputs.  This  was  accomplished  through  the  products  of  the  proposed
                       architecture, including the development of membership functions from quantitative data
                       collected from experts, and the expert subjective assessment of rules. These generated
                       surface plots allow for a clearer view of how the different fuzzy subsystems function, and
                       it makes the relation between inputs more visually accessible. Additionally, the surface
                       plots allow for determining the outputs of the subsystems in a straightforward manner by
                       only using inputs, bypassing lengthy calculations. This section provides the results from
                       the  fuzzy  logic  subsystems  and  presents  the  surface  plots  for  the  output  of  the
                       subsystems.
                          Figure 21 illustrates the surface of subsystem I, defined by two input axes, patient
                       complexity  and  patient  demand,  and  one  output  axis,  ED  demand.  The  values for  ED
                       demand on the surface plot range from 8 to 92, resulting from the centroid method used
                       for  defuzzification.  Generally  speaking,  it  can  be  observed  on  the  surface  that  ED
                       demand  will  increase  with  patient  complexity  if  patient  demand  is  held  constant,  and
                       similarly  ED  demand  will  increase  with  patient  demand  if  patient  complexity  is  held
                       constant. Interestingly, when patient demand is approaches a value of 1, the ED demand
                       plateaus when patient complexity is between 1 and 2, unless patient complexity increases.
                       The  step-like  structure  occurring  for  patient  demand  higher  than  1  resembles  another
                       local  step  structure  for  patient  complexity  higher  than  4,  where  ED  demand  cycles
                       between  plateaus  and  increases  until  it  plateaus  near  its  maximum  value.  For  patient
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