Development and pilot of a multicriteria decision analysis (MCDA) tool for health services administrators

Blythe, Robin; Naidoo, Shamesh; Abbott, Cameron; Bryant, Geoffrey; Dines, Amanda; Graves, Nicholas

doi:10.1136/bmjopen-2018-025752

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…The use of MCDA in health services research is increasing. Health technology assessments, economic evaluations and priority setting have all been reviewed using this technique in situations where a simple cost-effectiveness or cost-benefit calculation is deemed too narrow in scope [ 12 13 14 15 ]. This is a potentially suitable framework for assessing integration, where benefits may be intangible in the short term and when longer evaluation periods are impractical.…”

Section: Introductionmentioning

confidence: 99%

Application of a Mixed Methods Multi-Criteria Decision Analysis Framework in Integrated Health Care

Blythe

Carter

Abell

et al. 2022

International Journal of Integrated Care

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Background: Evaluating integrated care programs is complex. Integration benefits may not become apparent within short evaluation timeframes, and many programs provide a wide variety of health and non-health benefits. To address these challenges, we illustrate a mixed methods approach for evaluating multiple integrated care programs using multi-criteria decision analysis. Methods: We adapted a decision support tool used by local decision makers to compare data extracted from 17 different integrated care evaluations. Criteria included impact on health services capacity, patient outcomes, integration of care, workforce development and implementation risk, weighted based on stakeholder preferences. Program benefits were compared to their implementation costs, and assessed using cost-effectiveness methods. Sensitivity analysis examined the impact of different criteria weights. Results and discussion: This method captured a diverse range of benefits provided by integrated care programs and provided an accessible heuristic to compare many projects simultaneously. However, this approach may not be sensitive to the appropriateness of each criterion to the health system, the magnitude of difference in individual criteria, equity considerations or socio-political factors. Internal and external validation, especially for subjective criteria such as implementation risk, are needed. Conclusions: This work offers a feasible, flexible and pragmatic approach for evaluating integrated care programs.

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Section: Introductionmentioning

confidence: 99%

Application of a Mixed Methods Multi-Criteria Decision Analysis Framework in Integrated Health Care

Blythe

Carter

Abell

et al. 2022

International Journal of Integrated Care

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“…For instance, this is the case of the design and validation of criteria (Marsh et al, 2016), which vice versa need to be performed anytime new specific criteria are to be conceived. This means that the assessment of devices can be implemented immediately (Blythe et al, 2019; Bretoni et al, 2019). Beneficial consequences are evident.…”

Section: Discussionmentioning

confidence: 99%

“…In this regard, the impossible application of criteria to devices other than those for whom criteria were conceived (lack of generalizability) implies identifying new criteria, anytime a device ever assessed before has to be evaluated. This requires that, before the very assessment can be implemented (Blythe et al, 2019; Bretoni et al, 2019), criteria are designed and validated to check for their plausibility (Marsh et al, 2016). In its turn, this lack of criteria generalizability affects decisions' timeliness, fundamental in healthcare contexts where the timely use of a new technology can be decisive for diagnosing or accessing treatment.…”

Section: Literature Analysismentioning

confidence: 99%

“…This requires that, before the very assessment can be implemented (Blythe et al, 2019;Bretoni et al, 2019), criteria are designed and validated to check for their plausibility (Marsh et al, 2016). In its turn, this lack of criteria generalizability affects decisions' timeliness, fundamental in healthcare contexts where the timely use of a new technology can be decisive for diagnosing or accessing treatment.…”

Section: Literature Analysismentioning

confidence: 99%

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Health Technology Assessment of medical devices. Overcoming the critical issues of current assessment

Tallarico

Aloini

Dulmin

et al. 2021

Multi Criteria Decision Anal

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Medical devices are introduced in the market with an ever‐increasing rate, with important benefits for the whole society's health. In the greatest majority of cases, although representing the entry point for devices, healthcare local institutions/hospitals do not receive any macro‐level guidance from (inter)national authorities for their assessment. Hence, in the absence of a methodological support, local institutions/hospitals started to assess devices autonomously, building on Health Technology Assessment (HTA) tools based on Multi‐Criteria Decision Analysis (MCDA), in order to take into‐account the multifaceted aspects connected with devices. However, the strategies described so far in the scientific literature for implementing MCDA in local‐based HTA of medical devices suffer from a harsh methodological weaknesses – that is, the use of bespoke criteria for the specific device to be assessed ‐ that severely affect the evaluation of medical devices. Within this scenario, this work proposes a new tool based on peer‐to‐peer IF‐TOPSIS, intended for micro‐level assessment of medical devices with the main objective of overcoming the above‐mentioned critical issues and provide local institutions/hospitals with a general tool. An example of application of this tool in the choice between three neurological devices is shown. Contributions are both theoretical and practical. Theoretically, while proposing a general MCDA tool for micro‐level HTA, we answer the call for the identification of key methodological principles for the local assessment of medical devices. At the practical level, this tool is readily implementable and can be adapted to consider the local idiosyncratic characteristics of the context where decisions have to be made.

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“… 11 Efficient and reliable policy strategies require comprehensive tools that can assess the impact and cost-effectiveness of planned measures. 7 , 12 Digitalization has enabled policy makers, and other bodies involved in evaluating the costs of health, well-being and safety interventions, to develop different calculators that can measure the impact of different policy interventions. In this study, we use the term calculator to refer to tools or frameworks that provide a deterministically constructed outcome and cost estimate for specific interventions that promote health, well-being or safety.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness calculators for health, well-being and safety promotion: a systematic review

Hult

Halminen

Linna

et al. 2021

European Journal of Public Health

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Background The health, well-being and safety of the general population are important goals for society, but forecasting outcomes and weighing up the costs and benefits of effective promotional programmes is challenging. This study aimed to identify and describe the cost-effectiveness calculators that analyze interventions that promote health, well-being and safety. Methods Our systematic review used the CINAHL, PsycINFO, SocINDEX, EconLit, PubMed and Scopus databases to identify peer-reviewed studies published in English between January 2010 and April 2020. The data were analyzed with narrative synthesis. Results The searches identified 6880 papers and nine met our eligibility and quality criteria. All nine calculators focussed on interventions that promoted health and well-being, but no safety promotion tools were identified. Five calculators were targeted at group-level initiatives, two at regional levels and two at national levels. The calculators combined different data sources, in addition to data inputted by users. This included empirical research and previous literature. The calculators created baseline estimates and assessed the cost-effectiveness of the interventions before or after they were implemented. The calculators were heterogeneous in terms of outcomes, the interventions they evaluated and the data and methods used. Conclusion This review identified nine calculators that assessed the cost-effectiveness of health and well-being interventions and supported decision-making and resource allocations at local, regional and national levels, but none focussed on safety. Producing calculators that work accurately in different contexts might be challenging. Further research should identify how to assess sustainable evaluation of health, well-being and safety strategies.

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Development and pilot of a multicriteria decision analysis (MCDA) tool for health services administrators

Cited by 13 publications

References 17 publications

Application of a Mixed Methods Multi-Criteria Decision Analysis Framework in Integrated Health Care

Application of a Mixed Methods Multi-Criteria Decision Analysis Framework in Integrated Health Care

Health Technology Assessment of medical devices. Overcoming the critical issues of current assessment

Cost-effectiveness calculators for health, well-being and safety promotion: a systematic review

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