Applying the Analytic Hierarchy Process in healthcare research: A systematic literature review and evaluation of reporting

Abstract

BackgroundThe Analytic Hierarchy Process (AHP), developed by Saaty in the late 1970s, is one of the methods for multi-criteria decision making. The AHP disaggregates a complex decision problem into different hierarchical levels. The weight for each criterion and alternative are judged in pairwise comparisons and priorities are calculated by the Eigenvector method. The slowly increasing application of the AHP was the motivation for this study to explore the current state of its methodology in the healthcare context.MethodsA systematic literature review was conducted by searching the Pubmed and Web of Science databases for articles with the following keywords in their titles or abstracts: “Analytic Hierarchy Process,” “Analytical Hierarchy Process,” “multi-criteria decision analysis,” “multiple criteria decision,” “stated preference,” and “pairwise comparison.” In addition, we developed reporting criteria to indicate whether the authors reported important aspects and evaluated the resulting studies’ reporting.ResultsThe systematic review resulted in 121 articles. The number of studies applying AHP has increased since 2005. Most studies were from Asia (almost 30 %), followed by the US (25.6 %). On average, the studies used 19.64 criteria throughout their hierarchical levels. Furthermore, we restricted a detailed analysis to those articles published within the last 5 years (n = 69). The mean of participants in these studies were 109, whereas we identified major differences in how the surveys were conducted. The evaluation of reporting showed that the mean of reported elements was about 6.75 out of 10. Thus, 12 out of 69 studies reported less than half of the criteria.ConclusionThe AHP has been applied inconsistently in healthcare research. A minority of studies described all the relevant aspects. Thus, the statements in this review may be biased, as they are restricted to the information available in the papers. Hence, further research is required to discover who should be interviewed and how, how inconsistent answers should be dealt with, and how the outcome and stability of the results should be presented. In addition, we need new insights to determine which target group can best handle the challenges of the AHP.

Comparison of different approaches applied in Analytic Hierarchy Process – an example of information needs of patients with rare diseases

“…Hence, it could conceivably be hypothesized that using smaller ranges, e.g., a 7- or 5-point scale, would lead to more consistent answers. Unfortunately, we cannot compare the response behavior with that reported in other published studies, because such an analysis was not conducted in these studies [1]. Furthermore, it can be argued that group decisions frequently represent the compromise solution of the group participants, and therefore, the group judgements are a mean of the individual judgements and consequently the group’s priorities have a more limited range.…”

“…The number of studies measuring patient priorities by using the Analytic Hierarchy Process (AHP) has increased significantly in the last few years [1]. The AHP was developed by Thomas L. Saaty in the 1970s to solve complex problems of multiple criteria decision-making [2], based on the idea that it is more reliable to judge the relative importance of several criteria with the help of respective pairwise comparison in a hierarchical structure than to judge their absolute importance [3].…”

“…In addition, the AHP can be used to relate subjective criteria, which can be both quantitative and qualitative. As implied, it has been demonstrated that the AHP is a useful method for healthcare delivery as well as medical informatics decision-making [1, 4–7]. In this study, we ranked the information needs of people having a rare disease and their relatives using different AHP methods.…”

“…However, there are no best practices or a common gold standard available for applying the methods [1]. More precisely, it is noticeable that there are several methodological differences in the published studies concerning data acquisition and aggregation [1]. In some studies, single participants were interviewed (e.g.…”

Appropriate criteria set for personnel promotion across organizational levels using analytic hierarchy process (AHP)

“…For the current developments, theoretical extensions, issues and applications of the AHP, see the reviews of Zahedi (1986), Vaidya and Kumar (2006) and Sipahi and Timor (2010) on the overview of applications, Ho (2008) for the integration of other approaches and their applications, Ishizaka and Labib (2011) on its main developments, Subramanian and Ramanathan (2012) for its various applications in operations management, (Schmidt et al, 2015) for healthcare research, Anis and Islam (2015) for applications in higher learning institutions, Chandio et al (2013) on GIS-based integration, Maleki and Zahir (2013) on rank reversal phenomenon issue, and Godinho et al (2011) issues with R&D project selection application, among others.…”