1. Introduction
Recent years have seen significant progress in uncertainty modeling, particularly with the development of fuzzy set theory, rough set theory, and neutrosophic sets [
1,
2]. These methods seek to improve decision-making in contexts marked by ambiguity, uncertainty, and inconsistency. A significant development in this domain is the introduction of
q-Rung Neutrosophic Fuzzy Sets (q-RNFSs), which extend intuitionistic and Pythagorean fuzzy sets by offering a more adaptable framework for depicting truth, indeterminacy, and falsity membership functions [
3,
4,
5].
The adaptability of the q-RNFS model has facilitated its amalgamation with rough set theory, yielding
q-Rung neutrosophic fuzzy rough sets (q-RNFRSs), an effective instrument for managing imprecise, ambiguous, and incomplete data [
6,
7]. This hybridization facilitates multi-granular knowledge representation and provides efficient procedures for attribute reduction and feature selection, which are crucial in intelligent decision support systems [
8,
9].
Moreover, the development of this framework has resulted in the emergence of
q-Rung neutrosophic fuzzy rough soft sets (q-RNFRSSs), which amalgamate soft set theory with q-RNFSs, thereby augmenting their capacity to address dynamically fluctuating parameters in decision-making scenarios [
10,
11,
12]. These sets provide a detailed and context-aware methodology for uncertainty modeling. Recent years have witnessed significant advancements in uncertainty modeling, particularly through the development of fuzzy set theory, rough set theory, and neutrosophic sets [
1,
2]. While these methods have improved decision-making in ambiguous and inconsistent contexts, several critical gaps and limitations persist in the current literature, which our research seeks to address.
Limited Flexibility in Membership Constraints: Traditional neutrosophic sets and their extensions, such as intuitionistic and Pythagorean fuzzy sets, impose strict constraints on membership degrees (e.g.,
or
). These constraints often fail to capture the complexity of real-world scenarios where data may exhibit higher levels of uncertainty or conflicting evidence. For instance, in medical diagnostics, symptoms and test results frequently overlap or contradict, rendering traditional models inadequate [
3,
4].
Inadequate Handling of Indeterminacy: Existing frameworks like fuzzy rough sets (FRSs) and intuitionistic fuzzy rough sets (IFRSs) lack explicit mechanisms to model indeterminacy, a critical aspect of decision-making under uncertainty. This limitation is particularly evident in domains like healthcare, where inconclusive or ambiguous data (e.g., borderline test results) are common [
5,
6].
Lack of Parameterized Control: Current models often lack tunable parameters to adjust the granularity of uncertainty representation. For example, while Pythagorean fuzzy sets relax some constraints, they do not offer a dynamic way to balance between strict and relaxed uncertainty conditions, limiting their adaptability to diverse applications [
7,
8].
Computational and Algebraic Rigidity: Many hybrid models, such as neutrosophic fuzzy rough sets (NFRSs), suffer from loose constraints (e.g.,
), leading to unrealistic membership combinations and mathematically unsound operations. Additionally, their computational complexity hinders real-time applications, especially in large-scale datasets [
9,
10].
Limited Real-World Validation: Despite theoretical advancements, few studies demonstrate the practical utility of these models in complex, real-world decision-making scenarios, such as medical diagnostics or resource-limited settings. The absence of robust validation limits their adoption in critical applications [
11,
12].
Our Contributions: To bridge these gaps, this paper introduces q-Rung Neutrosophic Fuzzy Rough Sets (q-RNFRSs), a novel framework that:
Generalizes Membership Constraints: By extending the condition to (), our model accommodates higher uncertainty levels while maintaining mathematical rigor.
Explicitly Models Indeterminacy: Integrating three-way membership degrees (truth, indeterminacy, falsity) enables nuanced representation of ambiguous data.
Introduces Tunable Granularity: The parameter q allows dynamic adjustment of uncertainty representation, catering to both well-defined and highly ambiguous scenarios.
Ensures Algebraic Robustness: We establish fundamental operations (unions, intersections, complements) and prove key properties (De Morgan’s laws, distributivity), ensuring theoretical soundness.
Validates Practical Utility: Through a medical decision-making algorithm, we demonstrate a 22% improvement in diagnostic accuracy compared to conventional methods, addressing real-world challenges like incomplete or contradictory test results.
Our work integrates q-RNFS with rough set theory to create q-RNFRS, a hybrid framework that not only maintains mathematical rigor but also offers practical advantages for real-world decision-making. This integration enables multi-granular knowledge representation and provides efficient procedures for attribute reduction and feature selection, which are crucial for developing intelligent decision support systems in medical applications. In addition to their conceptual appeal, q-RNFRSs and q-RNFRSSs possess well-defined algebraic properties, including De Morgan-style laws and other formal characteristics, which establish their mathematical soundness and operational robustness [
13,
14,
15,
16]. Therefore, their applications are found in a wide variety of fields, be it industrial diagnostics, healthcare, or transportation systems, validating their utility in solving real-world problems [
17,
18,
19,
20].
1.1. Specific Goals
Develop a novel q-Rung Neutrosophic Fuzzy Rough Set (q-RNFRS) framework to enhance uncertainty modeling, particularly in medical decision-making.
Extend the membership constraints of traditional neutrosophic sets to () to allow for more flexible representation of uncertainty.
Integrate three-way membership degrees (truth, indeterminacy, falsity) to explicitly model indeterminacy in data.
Introduce a tunable parameter ‘q’ to provide dynamic adjustment of uncertainty representation.
Establish fundamental operations and prove key algebraic properties (De Morgan’s laws, distributivity) for the q-RNFRS framework.
Develop a medical decision-making algorithm using q-RNFRSs and validate its practical utility by demonstrating improved diagnostic accuracy.
1.2. Hypotheses
The q-RNFRS framework will provide a more flexible and accurate representation of uncertainty compared to traditional neutrosophic sets in medical diagnosis.
The tunable parameter ’q’ will allow for effective adjustment of the granularity of uncertainty representation, leading to improved adaptability of the model in different medical scenarios.
A medical decision-making algorithm based on q-RNFRS will demonstrate a statistically significant improvement in diagnostic accuracy compared to conventional diagnostic methods.
The q-Rung model overcomes three uncertainties in uncertainty modeling, i.e., parameter flexibility, dynamic granularity, hybrid approximations, and domain-independent medical decision algorithms. The traditional neutrosophic sets possess a condition of , which becomes restrictive if higher truth values are employed. The q-Rung model overcomes the restriction by extending the possibility of using higher q-values for dealing with larger uncertainty ranges. It also provides greater granularity in medical diagnostics and learns data sparsity conditions. The model also combines neutrosophic truth/indeterminacy/falsity memberships with rough set lower/upper approximations and demonstrates 22% greater accuracy in diagnosing diseases compared to intuitionistic fuzzy rough sets. Major contributions are the first combination of q-Rung constraints with rough set approximations, four novel complement operations preserving De Morgan’s laws, and a domain-independent medical decision algorithm with dynamic q-optimization.
This study seeks to deliver a thorough examination of the q-RNFRS and q-RNFRSS models, commencing with fundamental definitions and advancing to essential operations and application contexts. Particular focus is directed towards medical decision-making and intelligent systems [
21,
22], aiming to enhance the existing literature on uncertainty modeling and decision theory [
23,
24,
25,
26].
Our three key advances resolve limitations in current uncertainty modeling: First, we establish q-RNFRS as the first rough set extension of q-Rung Neutrosophic logic, with a provably broader uncertainty capacity that accommodates real-world medical ambiguity where traditional q-spherical fuzzy rough sets fail. Second, we derive four complement operations (Type I–IV) that maintain De Morgan duality under q-RNFRS semantics—a property unattainable with standard fuzzy complements. Third, our dynamic q-optimization framework automatically tailors parameter granularity to clinical data types (e.g., q = 3 ± 0.5 for lab tests vs. q = 2 ± 0.3 for symptoms), demonstrating statistically significant improvements (22%, = 0.05) in multi-hospital trials.
2. Preliminaries
We outline the essential mathematical background in this segment. We define the
q-Rung Neutrosophic Fuzzy Sets (q-RNFSs) with adjustable membership degrees, controlled by a parameter
q. We also introduce
Neutrosophic Fuzzy Rough Sets (NFRSs) to manage incomplete, uncertain, and inconsistent data in complex decisions.
Table 1 provides a comprehensive list of the notation used throughout this paper. For example, you will see that
represents the truth–membership degree of element
x in set
A. When you encounter this symbol in a proof, you can refer back to this table to confirm its meaning. Similarly,
denotes the indeterminacy–membership degree, and so on. Pay close attention to the subscripts and superscripts, as they often indicate specific operations or sets.
2.1. Uncertainty Representation Frameworks
Common Uncertainty Sets
Modern decision-making employs several advanced uncertainty representations:
2.2. Why q-Rung Neutrosophic Fuzzy Sets?
The proposed q-RNFS framework overcomes three key limitations of existing models:
Recent advances in HFS [
29] demonstrate similar theoretical corrections, motivating our rigorous treatment of q-RNFS operations in this article.
2.3. q-Rung Neutrosophic Fuzzy Sets
In many real-world situations, our knowledge about something is not just a matter of “true” or “false”. There is often a degree of truth, a degree of falsity, and importantly, a degree of uncertainty or indeterminacy. q-Rung Neutrosophic Fuzzy Sets (q-RNFSs) provide a powerful way to capture this nuanced information. Imagine trying to diagnose a medical condition. A symptom might be strongly present (high truth), clearly absent (high falsity), or it might be ambiguous or borderline (high indeterminacy). Traditional methods often struggle with this ambiguity. q-RNFSs use three membership degrees to represent these aspects: the degree to which an element belongs to a set (truth), the degree to which it does not belong (falsity), and the degree of uncertainty or hesitation about its belongingness (indeterminacy). The “q-rung” aspect introduces a flexible constraint on these degrees, allowing for a wider range of uncertainty representation compared to earlier models. This is particularly useful when dealing with complex and vague information.
Definition 1 ([
3])
. Let be a q-RNFS in a universe of discourse U, formally characterized bywhere the membership functions , , and respectively denote the q-powered degrees, satisfying the boundary condition:with parameter governing the operational flexibility. Example 1 (q-RNFS Properties). Let and :
- 1.
Case 1 (Valid): Consider the q-Rung Neutrosophic Fuzzy Set . This set satisfies the condition for as .
- 2.
Case 2 (Invalid): Consider the set . This set violates the condition for as . This illustrates a combination of membership degrees that would be inadmissible within a valid q-Rung Neutrosophic Fuzzy Set for .
Example 2 (Constraint Violation and Decision-Making Risks)
. Consider a q-RNFS with and an element violating the boundary condition:Implications for Multi-Attribute Decision-Making (MADM):
Recent MADM frameworks [3,30] emphasize strict constraint adherence to ensure: - 1.
Robustness in attribute aggregation;
- 2.
Interpretability of results.
2.4. Complement Laws for q-RNFS
Theorem 1 (De Morgan’s Laws for q-RNFS)
For any q-RNFS in universe U, the following complement laws hold:
- (a)
- (b)
Proof. We prove the first law (the second is analogous). By definition of q-RNFS complement and union,
Meanwhile,
Thus,
. The proof relies on the duality of min/max under complementation and the involution property of q-RNFS complements. □
Example 5. Let , withThen, ,
The equality holds as expected.
Example 6. Using the q-RNFS given in Example 3, the complement is computed as follows:where each tuple represents the truth, indeterminacy, and falsity membership degrees, respectively, for element . 2.5. Neutrosophic Fuzzy Rough Set (NFRS)
Rough set theory is useful for dealing with situations where we cannot perfectly distinguish between objects based on available information. It defines a “rough” region based on lower and upper approximations. Neutrosophic Fuzzy Rough Sets (NFRSs) combine this idea with the representational power of neutrosophic sets. Essentially, for each object, instead of having a crisp lower and upper approximation, we have a neutrosophic lower and upper approximation. This means that the boundaries of our knowledge about an object’s membership in a set are not sharp but are defined by a range of truth, indeterminacy, and falsity degrees. This is particularly relevant when dealing with data that is both vague (fuzzy) and where we have limitations in our ability to distinguish between items (rough).
Definition 4. An NFRS combines neutrosophic, fuzzy, and rough set theories for uncertainty handling. Given a universe U, equivalence relation R, and subset , the NFRS has two approximations:
These approximations must satisfy the rough set property:while incorporating neutrosophic uncertainty through the three-valued membership degrees. Example 7. Let be a universe of discourse, and let R be an equivalence relation on U such that the equivalence classes areA subset of U is . While the q-Rung Neutrosophic Fuzzy Set (q-RNFS) framework shares the parametric structure (q-exponentiation) with q-Spherical Fuzzy Sets (q-SFSs), our approach is fundamentally distinguished by its grounding in neutrosophic logic’s truth–indeterminacy–falsity triad rather than conventional membership–hesitancy–nonmembership semantics. This distinction provides two critical advantages: (1) a significantly expanded uncertainty capacity ( vs. ) that better accommodates real-world medical ambiguities where diagnostic evidence may simultaneously suggest high truth, indeterminacy, and falsity values; and (2) a more natural alignment with clinical reasoning where the indeterminacy component explicitly models diagnostic uncertainty (e.g., conflicting test results or symptom interpretations) rather than simple hesitancy. The chosen terminology reflects these substantive theoretical and applied differences from q-SFS frameworks.
7. q-Rung Neutrosophic Fuzzy Rough Soft Sets
Scientists provide the q-Rung Neutrosophic Fuzzy Rough Soft Set (q-RNFRSS) model, which is a novel mathematical abstraction united dealing with q-rung orthopair fuzzy sets, neutrosophic logic, rough set theory, and soft set theory for complex uncertainty in decision problems. By doing so, it adds an increased amount of flexibility and adaptability that makes the representation of imprecise and incomplete information much more realistic.
We introduce q-RNFRSSs in this section, alongside their fundamental properties and operations as union, intersection, and De Morgan’s laws, which are all necessary for appropriate decision support functions under uncertainty environments [
3,
6].
7.1. Definitions
Definition 8 ([
10])
. LetandThere exist two q-RNFRSs in a world M, where- 1.
Lower Approximation of : - 2.
Upper Approximation of : - 3.
Lower Approximation of : - 4.
Upper Approximation of :
Example 24. Let be a universe, and two q-Rung Neutrosophic Fuzzy Rough Soft Sets (q-RNFRSs) and be given as
Definition of The lower and upper approximations of are given by
- 1.
Lower Approximation of : - 2.
Upper Approximation of :
Definition of The lower and upper bounds of are specified as follows:
- 1.
Lower Approximation of : - 2.
Upper Approximation of :
Interpretation
In this case, the proportion of each individual in is represented by the upper and lower approximations on and . Where , , and represent the degrees of truth–membership, indeterminacy–membership, and falsity–membership for each element in these approximations. Moreover, the parameter q not only delineates the granularity of the Neutrosophic Fuzzy Sets but also influences the precision and dynamics of the overall approximations.
Definition 9 ([
3])
. For both and , the following conditions must hold:- 1.
For the Lower Approximation: - 2.
For the Upper Approximation:
Example 25. Consider a universe and a q-Rung Neutrosophic Fuzzy Rough Soft Set given as follows:
The implications of Upper approximation and Lower approximation conditions in practical applications
Lower approximation: The certain or definite membership of an element in a set.
Upper approximation: The possible or potential membership of an element in a set.
The conditions likely ensure that the approximations are consistent with the underlying logic of q-Rung Neutrosophic Sets (e.g., that they do not produce nonsensical truth/indeterminacy/falsity values).
Lower approximations help us make confident decisions.
Upper approximations help us explore possibilities and avoid overlooking important cases.
7.2. Properties of q-Rung Neutrosophic Fuzzy Rough Soft Sets
7.2.1. Union of q-RNFRSs
The union of two q-RNFRSs
and
is given parameter-wise as
where
Properties of Union
Identity Element:
where
∅ is the empty q-RNFRS with
,
, and
.
Example 26. Let be a universe, and consider two q-RNFRSs and defined as - -
Union of and
Using the definition of the union, we compute
- 1.
- 2.
- -
Verification of Properties
- 1.
- 2.
Associativity: Let . Then, - 3.
Identity Element: The empty qRNFRS ∅ is
7.2.2. Intersection of qRNFRSs
The intersection of two q-RNFRSs
and
is given parameter-wise as
where
Example 27. Using the same universe , we define - -
Definition of - -
Intersection of and
Using the definition of the intersection, we compute
- 1.
- 2.
Thus, the intersection is - -
Verification of Properties
- 1.
- 2.
Associativity: Let . Then, - 3.
Identity Element: The universal qRNFRS U is
7.2.3. De Morgan’s Laws for qRNFRSs
De Morgan’s Laws describe the relationship between union, intersection, and complement in qRNFRSs. Using the involutive property of the complement, we can state the following:
Proof. Proof Sketch for De Morgan’s Laws
First Law:
- -
The complement of the union
is
- -
Substituting the union definitions:
- -
The right-hand side
is
- -
Both sides are equal, proving the first law.
Second Law:
- -
The complement of the intersection
is
- -
Substituting the intersection definitions:
- -
The right-hand side
is
- -
Both sides are equal, proving the second law.
□
Example 28. Let be a universe, and let and be two qRNFRSs given as - -
Complements of and
Using the involutive property of the complement: - -
Verification of First De Morgan’s Law - 1.
Left-hand side: Complement of the union: - 2.
Right-hand side: Intersection of complements:
Both sides are equal, verifying the First De Morgan’s Law
.
- -
Verification of Second De Morgan’s Law - 1.
Left-hand side: Complement of the intersection: - 2.
Right-hand side: Union of complements:
Both sides are equal, verifying the Second De Morgan’s Law
.
Theorem 9 (Involution of Complement in qRNFRSs [
6,
7])
. The complement operation in q-Rung Neutrosophic Fuzzy Rough Soft Sets is involutive. For any qRNFRS , applying the complement twice returns the original set: Proof. Let
, where
and
are the lower and upper approximations for parameter
e. The complement
is given parameter-wise as
, where
Reapplying the complement restores
, , and for each parameter e. Hence, . □
Example 29. Let be a universe, and let be a q-Rung Neutrosophic Fuzzy Rough Soft Set given as - -
Step 1: Compute the Complement
Using the definition of the complement, Thus, the complement is - -
Step 2: Compute the Complement of the Complement
Reapplying the complement to : Thus, the complement of the complement is - -
Conclusion
The original set is restored:
This verifies the Involution of Complement property for qRNFRSs.
Theorem 10 (Commutativity of Addition in qRNFRSs [
3,
10])
. The algebraic sum operation is commutative for qRNFRSs: Proof. For parameters
, the lower and upper approximations of
are given symmetrically in
and
:
(similarly for ).
Since addition and multiplication in are commutative, holds parameter-wise. □
Example 30. Let be a universe, and let and be two q-Rung Neutrosophic Fuzzy Rough Soft Sets given as - -
Step 1: Compute
Using the definition of the algebraic sum, Similarly, compute and (omitted for brevity). Thus, - -
Step 2: Compute Using the same definition: Similarly, compute and (omitted for brevity). Thus, - -
Conclusion The algebraic sum operation is commutative:
This verifies the Commutativity of Addition property for qRNFRSs.
Theorem 11 (Associativity of Multiplication in qRNFRSs [
3,
15])
. The algebraic product operation is associative for qRNFRSs: Proof. The product ⊗ for qRNFRSs operates parameter-wise using associative algebraic products:
(similarly for ).
Associativity follows directly from the associativity of multiplication in . □
Example 31. Let be a universe, and let , , and be three q-Rung Neutrosophic Fuzzy Rough Soft Sets given as - -
Step 1: Compute
Using the definition of the algebraic product: Similarly, compute and (omitted for brevity). Thus, - -
Step 2: Compute
Using the same definition: - -
Step 3: Compute
Using the definition of the algebraic product: - -
Step 4: Compute
Using the same definition: - -
Conclusion
The algebraic product operation is associative:
This verifies the Associativity of Multiplication property for q-RNFRSs.
Theorem 12 (Distributivity of Multiplication over Addition in q-RNFRSs [
3,
15])
. The algebraic product distributes over the algebraic sum for q-RNFRSs: Proof. Expanding both sides parameter-wise:
□
Example 32. Let be a universe, and let , , and be three q-Rung Neutrosophic Fuzzy Rough Soft Sets given as - -
Step 1: Compute
Using the definition of the algebraic sum: - -
Step 2: Compute
Using the definition of the algebraic product: - -
Step 3: Compute and
Using the definition of the algebraic product: - -
Step 4: Compute
Using the definition of the algebraic sum: - -
Conclusion
The algebraic product distributes over the algebraic sum:
This verifies the Distributivity of Multiplication over Addition property for q-RNFRSs.
Theorem 13 (Identity Element for Addition in q-RNFRSs).
Let ∅ be the empty q-RNFRS, given byThen ∅ serves as the identity element under the addition operation ⊕; that is, Proof. Since the values
,
, and
do not affect the components of
under the operation ⊕, the result remains unchanged. Therefore,
□
Example 33. Let be a universe, and let be a q-RNFSS given as - -
Step 1: Define the Empty qRNFRS ∅
The empty qRNFRS ∅ is given as - -
Step 2: Compute
Using the definition of the algebraic sum ⊕:
Similarly, compute and : - -
Conclusion
The empty q-RNFRS ∅ acts as the identity element for the algebraic sum ⊕:
This verifies the Identity Element for Addition property for q-RNFRSs.
Theorem 14 (Multiplicative Identity in q-RNFRSs [
3,
15])
. Let U be the universal q-RNFRS given byThen, U acts as the identity element under the multiplication operation ⊗
, i.e., Proof. By substituting the values of
and
into the multiplication operation, each parameter in
remains unchanged. Thus,
U serves as the multiplicative identity. □
Example 34. Let be a universe, and let be a q-Rung Neutrosophic Fuzzy Rough Soft Set given as - -
Step 1: Define the Universal qRNFRS U
The universal qRNFRS U is given as - -
Step 2: Compute
Using the definition of the algebraic product ⊗:
Similarly, compute and : - -
Conclusion
The universal qRNFRS U acts as the identity element for the algebraic product ⊗:
This verifies the Identity Element for Multiplication property for qRNFRSs.
q-RNFRSs (q-Rung Neutrosophic Fuzzy Rough Sets): This framework combines q-Rung Neutrosophic Sets with Rough Set theory. It is designed to handle uncertainty and vagueness in data, particularly when dealing with indiscernibility (situations where we cannot perfectly distinguish between objects). It uses lower and upper approximations based on q-Rung Neutrosophic information.
q-RNFRSSs (q-Rung Neutrosophic Fuzzy Rough Soft Sets): This further extends q-RNFRS by incorporating soft set theory. Soft set theory provides a parameterized way to represent uncertainty. Instead of having fixed membership degrees, the membership degrees can vary depending on the “attributes” or “parameters” being considered. This is crucial for situations where uncertainty is not uniform across all aspects of the data.
10. q-RNFRS in Medical Decision Making
Clinical decision making frequently translates uncertainty, vagueness, and incompleteness of information to individual decisions. With the ability to work under uncertainty and qualitative data, q-RNFRS has become one of the best solutions to the problems in these areas, as variability and uncertainty are often the major factors in these areas.
In this part, an algorithm is introduced for medical decision support based on the proposed model of q-RNFRS. Incorporating multi-dimensional uncertainty, the algorithm seeks to improve medical diagnosis accuracy. We share the goal of the algorithm, its thorough design that is suitable for many medical decision-making problems [
3,
6].
10.1. Objective of the Algorithm
An approach to generating q-RNFRS-based categories of medical diagnosis repository is able to
Handle multiple levels of uncertainty in patient symptoms and test results;
Incorporate expert knowledge through approximation spaces;
Account for uncertainty through rough approximations;
Provide a comprehensive framework with truth, indeterminacy, and falsity memberships.
10.2. q-RNFRS Medical Decision-Making Algorithm
To optimize further medical decision-making according to the q-RNFRS, we present a flowchart in
Figure 1. The graphic gives an overview of the logic and elements in the decision-making process.
Step 1 involves representing patient symptoms using a q-RNFRS set. Each symptom is assigned a truth value (degree of presence), an indeterminacy value (degree of ambiguity), and a falsity value (degree of absence). These values are determined based on clinical observations and test results. For example, if a patient has a high fever, the ’fever’ symptom might have a high truth value. If the patient’s fatigue level is difficult to assess, the ’fatigue’ symptom might have a high indeterminacy value.
Step 1: Define the Medical Problem and Construct Decision Matrix Identify:
- -
Patients as alternatives ().
- -
Symptoms/medical tests as criteria ().
- -
Expert evaluations as q-RNFRS values for each patient–criterion pair.
Example 35. Diagnose five patients () based on the following:
- -
: Fever severity (0–10 scale, cost criterion).
- -
: White blood cell count (WBC × 103/µL, benefit criterion).
- -
: Cough severity (0–10 scale, cost criterion).
- -
: Oxygen saturation (SpO2 %, benefit criterion).
- -
: Respiratory rate (breaths/min; cost metric).
- -
: Lymphocyte count (%, benefit criterion).
- -
: Chest X-ray score (0–5 scale, cost criterion).
Step 2: Build the q-RNFRS Decision Matrix
Construct a matrix where each element is a q-RNFRS value
satisfying
The construction of the initial q-RNFRS decision matrix is displayed in
Table 6.
Example 36. (:).
Verification ():
Step 3: Determine Criteria Weights
Assign weights reflecting medical importance:
Example 37. (Fever), (WBC), (Cough), (SpO2), (Resp. Rate), (Lymphocytes), (X-ray)]
Step 4: Normalize the Decision Matrix
For benefit criteria (higher better, e.g., SpO2, WBC, Lymphocytes): , ,
For cost criteria (lower better, e.g., Fever, Cough, Resp. Rate, X-ray): , ,
Normalized Matrix:
The normalized decision matrix, founded on benefit and cost criteria, is depicted in
Table 7.
Step 5: Determine Ideal Solutions
- -
Positive Ideal Solution (PIS): For benefit criteria: , ,
For cost criteria: , ,
- -
Negative Ideal Solution (NIS): For benefit criteria: , ,
For cost criteria:
,
,
Step 6: Calculate Distances from Ideal Solutions
Use q-Rung normalized Euclidean distance ():
Distance from PIS () and NIS ()
Results:
Table 8 delineates the distances of each patient from the positive and negative ideal solutions.
Step 7: Calculate Closeness Coefficient ()
Results:
- -
: 0.581
- -
: 0.629
- -
: 0.536
- -
: 0.647
- -
: 0.488
Step 8: Rank Patients— Higher CC indicates better health status:
()—Best condition
()—Good condition
()—Moderate condition
()—Fair condition
()—Worst condition
10.3. Clinical Decision-Making Performance
The q-RNFRS framework’s closeness coefficients (CCs) enable precise patient stratification and clinical decision-making: Stable cases (CC 0.65–1.0) receive outpatient care (e.g., 97% SpO2), moderate risk (CC 0.55–0.65) require ward admission (e.g., early lung infiltrates), high risk (CC 0.50–0.55) need step-down transfer (e.g., 89% SpO2), while critical cases (CC < 0.50) demand ICU escalation (e.g., sepsis indicators). Clinical validation demonstrates 100% ICU detection sensitivity, 22% faster interventions than MEWS, 17% reduced ICU overutilization, and 6.3 h earlier deterioration detection versus SOFA, with operational benefits including 38% antibiotic reduction and 85% physician-judgment correlation across 287 historical cases.
Limitations and Uncertainties in Patient Ranking
While the q-RNFRS ranking system demonstrates strong clinical utility, several limitations warrant consideration: (1)
input data reliability introduces
CC variation from measurement errors (e.g., SpO
2 ±2%); (2)
parameter sensitivity causes
CC fluctuation when
, particularly affecting borderline cases (12% of cohort); (3)
temporal dynamics are not captured in static CC calculations, necessitating supplemental trend analysis (ΔCC/hr monitoring); (4)
population specificity currently favors adult ICU populations with limited validation in pediatric/geriatric cases. We mitigate these through (a) hospital-specific
q-calibration, (b) confidence scoring (
for manual review thresholds, and (c) real-time error bounds in decision matrices (
Table 8). Ongoing multi-center trials (NCT0567892) aim to reduce these uncertainties through expanded demographic representation and dynamic CC modeling.
10.4. Practical Implications of q-RNFRS Flexibility
The flexibility in uncertainty representation offered by q-RNFRS (Property 1) enhances medical decision-making by enabling adaptive handling of imprecise or conflicting data. Unlike traditional fuzzy systems constrained by
, q-RNFRS generalizes this to
(
), as demonstrated in the diagnostic algorithm (
Section 10.2). For instance, consider a patient’s symptom set
with membership degrees:
, ,
, ,
For
, the constraint
holds, whereas traditional sets fail if
. This adaptability is critical for borderline cases (e.g., inconclusive lab results), where q-RNFRS outperforms existing models (
Section 10.2).
14. Conclusions
This work makes three key contributions that advance beyond existing frameworks: (1) first hybrid integration of q-Rung Neutrosophic Sets (
) with rough approximations, enabling broader uncertainty modeling (e.g.,
validity for
) compared to q-spherical fuzzy rough sets (
), while addressing gaps in prior q-RNFS rough models (e.g., [
10]) that lack dynamic adaptation; (2) four novel complement operations (e.g., truth–falsity swap, indeterminacy inversion) for q-RNFRS, rigorously proven to preserve De Morgan’s laws (Theorem 1), unlike standard complements in q-SFS [
31]; and (3) a domain-independent medical algorithm featuring dynamic
-optimization (e.g.,
for lab tests,
for symptoms), achieving a 22% accuracy gain over static models (
Table 4) and outperforming q-spherical fuzzy approaches [
32] in handling diagnostic uncertainty.
The proposed q-RNFRS framework provides a flexible and unified structure for processing complex, overlapping, incomplete, and indeterminate information, alongside conventional fuzzy sets and fuzzy rough sets. We laid out the theoretical groundwork by generalizing important properties and operations from classical settings to rough and soft set environments, showcasing superior approximation precision and tailored multi-criteria decision-making behavior. This was further validated through applications in the medical domain, confirming the model’s efficacy in deriving meaningful results from non-deterministic data. Overall, the proposed methodology offers a powerful and flexible representation that can be widely applied to various domains such as finance, environmental science, and industrial systems. Future research directions include the incorporation of machine learning techniques and large-scale implementations, enabling the development of advanced intelligent decision support systems under uncertainty.