BackgroundThe rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital.MethodsAHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital.ResultsAlthough safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution.ConclusionsAHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department.

The choice of a complex technology requires a detailed Health Technology Assessment (HTA). Before performing a HTA, it is fundamental to analyze scientifically all the clinical needs, which have to be satisfied. In this study we focused on the assessment of a CT scan, which is one of the most complex and costly biomedical device. A CT scan, is prevalently used in radiology, but its results are fundamental for the efficacy of different clinical intervention. In this paper we present the results of a scientif ic needs analysis performed using AHP. We first defined a hierarchy of clinical needs, including 12 needs into four categories: performance, patients' safety, usability, technical Issues. Than we submitted questionnaires to clinicians with different specializations working in different units: radiology, emergency, minimally invasive ear surgery, neurology, emergency neurology. From the results it emerged that the priority of the needs differs for each specialization, and particularly if the device is used in an emergency unit or not. This strongly affects the choice of the model of CT scan into a process of HTA.