Patient involvement in reflective multicriteria decision analysis to assist decision making in oncology

Abstract

ObjectivesPatient involvement in drug evaluation decision making is increasing. The aim of the current study was to develop a multi-criteria decision analysis (MCDA) framework that would enable the inclusion of the patient perspective in the selection of appropriate criteria for MCDAs being used in the value assessments of oncologic drugs.MethodsA literature review was conducted to identify and define criteria used in drug assessments from patient perspectives. The Evidence and Value: Impact on Decision Making methodology was used to develop a MCDA framework. Identified criteria were discussed by a sample of oncology patient association representatives who decided which criteria were important from patient perspectives. Selected criteria were rated by importance. The preliminary MCDA framework was tested through the assessment of a hypothetical oncology treatment. A discussion was carried out to agree on a final pilot MCDA framework.ResultsTwenty-two criteria were extracted from the literature review. After criteria discussion, sixteen criteria remained. The most important criteria were comparative patient reported outcomes (PRO), comparative efficacy and disease severity. After the discussion generated by the scoring of the hypothetical oncology treatment, the final pilot MCDA framework included seven quantitative criteria (“disease severity”, “unmet needs”, “comparative efficacy / effectiveness”, “comparative safety / tolerability”, “comparative PROs”, “contribution of oncological innovation”) and one contextual criterion (“population priorities and access”).ConclusionsThe present study developed a pilot reflective MCDA framework that could increase patient's capability to participate in the decision-making process by providing systematic drug assessments from the patient perspective.

Early Access to Medicines: Use of Multicriteria Decision Analysis (MCDA) as a Decision Tool in Catalonia (Spain)

“…At the macro level, it has been mostly used by HTA bodies to rank and set priorities among therapeutic alternatives and inform reimbursement decisions [ 20 , 21 , 22 , 23 , 25 , 33 ], and it has also has been proposed for the benefit–risk assessment to support marketing authorisation [ 34 ]. At lower decision levels, MCDA has been used to inform hospital decision making to incorporate medicines into the hospital formulary [ 24 ] and also to support shared decision making involving the patient’s voice [ 35 ]. To our knowledge, this is the first study to use the MCDA tool to support decision making for individual requests that are assessed by a Committee.…”

Multiple criteria decision analysis approach to consider therapeutic innovations in the emergency department: The methoxyflurane organizational impact in acute trauma pain

“…emergency medicine is innovative, although comparisons of good practice guidelines with field-based observations in oncology have confirmed the relevance of this approach [31]. In the field of emergency medicine, the present study is the first to have highlighted organizational judgement criteria for ED physicians and hospital pharmacists.…”

Identifying Attributes for a Value Assessment Framework in China: A Qualitative Study

“…The unmet needs has been one of the criteria to determine the novelty of a health technology [ 47 , 48 ]. On the other hand, some multicriteria decision analysis (MCDA) frameworks included severity of disease alongside other attributes in the weighted-sum model [ 7 , 49 , 50 ], which assumes independence and compensation between attributes [ 51 ]. Therefore, the inclusion of disease severity in the weighted-sum model ignores the potential interactions and dependence between disease severity and other value attributes, which has been suggested by previous studies and our discussions with participants about the relative importance of attributes for diseases at different levels of severity [ 51 , 52 ].…”