PATIENT-CENTERED DECISION MAKING: LESSONS FROM MULTI-CRITERIA DECISION ANALYSIS FOR QUANTIFYING PATIENT PREFERENCES

2017 ◽  
Vol 34 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Kevin Marsh ◽  
J. Jaime Caro ◽  
Erica Zaiser ◽  
James Heywood ◽  
Alaa Hamed

Objectives: Patient preferences should be a central consideration in healthcare decision making. However, stories of patients challenging regulatory and reimbursement decisions has led to questions on whether patient voices are being considered sufficiently during those decision making processes. This has led some to argue that it is necessary to quantify patient preferences before they can be adequately considered.Methods: This study considers the lessons from the use of multi-criteria decision analysis (MCDA) for efforts to quantify patient preferences. It defines MCDA and summarizes the benefits it can provide to decision makers, identifies examples of MCDAs that have involved patients, and summarizes good practice guidelines as they relate to quantifying patient preferences.Results: The guidance developed to support the use of MCDA in healthcare provide some useful considerations for the quantification of patient preferences, namely that researchers should give appropriate consideration to: the heterogeneity of patient preferences, and its relevance to decision makers; the cognitive challenges posed by different elicitation methods; and validity of the results they produce. Furthermore, it is important to consider how the relevance of these considerations varies with the decision being supported.Conclusions: The MCDA literature holds important lessons for how patient preferences should be quantified to support healthcare decision making.

Author(s):  
Paul Hansen ◽  
Nancy Devlin

Multi-criteria decision analysis (MCDA) is increasingly used to support healthcare decision-making. MCDA involves decision makers evaluating the alternatives under consideration based on the explicit weighting of criteria relevant to the overarching decision—in order to, depending on the application, rank (or prioritize) or choose between the alternatives. A prominent example of MCDA applied to healthcare decision-making that has received a lot of attention in recent years and is the main subject of this article is choosing which health “technologies” (i.e., drugs, devices, procedures, etc.) to fund—a process known as health technology assessment (HTA). Other applications include prioritizing patients for surgery, prioritizing diseases for R&D, and decision-making about licensing treatments. Most applications are based on weighted-sum models. Such models involve explicitly weighting the criteria and rating the alternatives on the criteria, with each alternative’s “performance” on the criteria aggregated using a linear (i.e., additive) equation to produce the alternative’s “total score,” by which the alternatives are ranked. The steps involved in a MCDA process are explained, including an overview of methods for scoring alternatives on the criteria and weighting the criteria. The steps are: structuring the decision problem being addressed, specifying criteria, measuring alternatives’ performance, scoring alternatives on the criteria and weighting the criteria, applying the scores and weights to rank the alternatives, and presenting the MCDA results, including sensitivity analysis, to decision makers to support their decision-making. Arguments recently advanced against using MCDA for HTA and counterarguments are also considered. Finally, five questions associated with how MCDA for HTA is operationalized are discussed: Whose preferences are relevant for MCDA? Should criteria and weights be decision-specific or identical for repeated applications? How should cost or cost-effectiveness be included in MCDA? How can the opportunity cost of decisions be captured in MCDA? How can uncertainty be incorporated into MCDA?


2016 ◽  
Vol 19 (7) ◽  
pp. A489-A490 ◽  
Author(s):  
A Gilabert-Perramon ◽  
C Lens ◽  
JI Betolaza ◽  
JC March ◽  
J Espín ◽  
...  

Axioms ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 124
Author(s):  
Dragiša Stanujkić ◽  
Darjan Karabašević ◽  
Gabrijela Popović ◽  
Predrag S. Stanimirović ◽  
Florentin Smarandache ◽  
...  

Some decision-making problems, i.e., multi-criteria decision analysis (MCDA) problems, require taking into account the attitudes of a large number of decision-makers and/or respondents. Therefore, an approach to the transformation of crisp ratings, collected from respondents, in grey interval numbers form based on the median of collected scores, i.e., ratings, is considered in this article. In this way, the simplicity of collecting respondents’ attitudes using crisp values, i.e., by applying some form of Likert scale, is combined with the advantages that can be achieved by using grey interval numbers. In this way, a grey extension of MCDA methods is obtained. The application of the proposed approach was considered in the example of evaluating the websites of tourism organizations by using several MCDA methods. Additionally, an analysis of the application of the proposed approach in the case of a large number of respondents, done in Python, is presented. The advantages of the proposed method, as well as its possible limitations, are summarized.


2020 ◽  
Vol 10 (13) ◽  
pp. 4614
Author(s):  
João Carneiro ◽  
Diogo Martinho ◽  
Patrícia Alves ◽  
Luís Conceição ◽  
Goreti Marreiros ◽  
...  

To support Group Decision-Making processes when participants are dispersed is a complex task. The biggest challenges are related to communication limitations that impede decision-makers to take advantage of the benefits associated with face-to-face Group Decision-Making processes. Several approaches that intend to aid dispersed groups attaining decisions have been applied to Group Decision Support Systems. However, strategies to support decision-makers in reasoning, understanding the reasons behind the different recommendations, and promoting the decision quality are very limited. In this work, we propose a Multiple Criteria Decision Analysis Framework that intends to overcome those limitations through a set of functionalities that can be used to support decision-makers attaining more informed, consistent, and satisfactory decisions. These functionalities are exposed through a microservice, which is part of a Consensus-Based Group Decision Support System and is used by autonomous software agents to support decision-makers according to their specific needs/interests. We concluded that the proposed framework greatly facilitates the definition of important procedures, allowing decision-makers to take advantage of deciding as a group and to understand the reasons behind the different recommendations and proposals.


2019 ◽  
Vol 47 (S4) ◽  
pp. 25-33 ◽  
Author(s):  
Megan S. Wright

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions.


Author(s):  
Haylee Lane ◽  
Jennifer M. Martin ◽  
Terry Haines

The aim of this chapter is to explore the factors that health managers adopt when making decisions on how to allocate limited healthcare resources. The objective is to increase knowledge and understanding of decision making processes at the macro, meso, and micro levels and priority setting. An examination of current healthcare decision-making processes used for resource allocation around the world highlights the disparities in models and approaches and the often ad hoc nature of decisions made. A description of the allied health workforce highlights the size and significance of this workforce and why understanding decisions made in regards to allied health resources is of importance. Issues of access and equity are also considered in relation to notions of fairness and efficacy in relation to health outcomes.


2011 ◽  
Vol 26 (8) ◽  
pp. 881-886 ◽  
Author(s):  
Rashmi K. Sharma ◽  
Mark T. Hughes ◽  
Marie T. Nolan ◽  
Carrie Tudor ◽  
Joan Kub ◽  
...  

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