The analytic hierarchy process in medical and health care decision making: A literature review

Liberatore, Matthew J.; Nydick, Robert L.

doi:10.1016/j.ejor.2007.05.001

Cited by 444 publications

(268 citation statements)

References 58 publications

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“…An important advantage of the analytic hierarchy process is that it measures the degree to which judgments are inconsistent and establishes an acceptable tolerance level for the degree of inconsistency. Other advantages and the disadvantages of the method have been broadly described previously [12,14]. Several authors have discussed the use and application of the analytic hierarchy process in health and medical decision making.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Periprosthetic Joint Infection in Medicare Patients: Multicriteria Decision Analysis

Díaz-Ledezma¹,

Lichstein²,

Parvızı³

2014

Clinical Orthopaedics &Amp; Related Research

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Background In the setting of finite healthcare resources, developing cost-efficient strategies for periprosthetic joint infection (PJI) diagnosis is paramount. The current levels of knowledge allow for PJI diagnostic recommendations based on scientific evidence but do not consider the benefits, opportunities, costs, and risks of the different diagnostic alternatives. Questions/purposes We determined the best diagnostic strategy for knee and hip PJI in the ambulatory setting for Medicare patients, utilizing benefits, opportunities, costs, and risks evaluation through multicriteria decision analysis (MCDA). Methods The PJI diagnostic definition supported by the Musculoskeletal Infection Society was employed for the MCDA. Using a preclinical model, we evaluated three diagnostic strategies that can be conducted in a Medicare patient seen in the outpatient clinical setting complaining of a painful TKA or THA. Strategies were (1) screening with serum markers (erythrocyte sedimentation rate [ESR]/ C-reactive protein [CRP]) followed by arthrocentesis in positive cases, (2) immediate arthrocentesis, and (3) serum markers requested simultaneously with arthrocentesis. MCDA was conducted through the analytic hierarchy process, comparing the diagnostic strategies in terms of benefits, opportunities, costs, and risks. Results Strategy 1 was the best alternative to diagnose knee PJI among Medicare patients (normalized value: 0.490), followed by Strategy 3 (normalized value: 0.403) and then Strategy 2 (normalized value: 0.106). The same ranking of alternatives was observed for the hip PJI model (normalized value: 0.487, 0.405, and 0.107, respectively). The sensitivity analysis found this sequence to be robust with respect to benefits, opportunities, and risks. However, if during the decisionmaking process, cost savings was given a priority of higher than 54%, the ranking for the preferred diagnostic strategy changed. Conclusions After considering the benefits, opportunities, costs, and risks of the different available alternatives, our preclinical model supports the American Academy of Orthopaedic Surgeons recommendations regarding the use of serum markers (ESR/CRP) before arthrocentesis as the best diagnostic strategy for PJI among Medicare patients. Level of Evidence Level II, economic and decision analysis. See Instructions to Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of Periprosthetic Joint Infection in Medicare Patients: Multicriteria Decision Analysis

Díaz-Ledezma¹,

Lichstein²,

Parvızı³

2014

Clinical Orthopaedics &Amp; Related Research

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“…Several papers have compiled the numerous AHP success stories (Forman and Gass 2001;Golden et al 1989;Ho 2008;Kumar and Vaidya 2006;Liberatore and Nydick 2008;Omkarprasad and Sushil 2006;Saaty and Forman 1992;Shim 1989;Vargas 1990;Zahedi 1986), but its popularity does not verify that the AHP recommendation is always the best alternative. In fact, AHP has been sharply criticised on several points (Bana e Costa and Vansnick 2008;Barzilai 2001;Belton and Gear 1983;Dodd and Donegan 1995;Donegan et al 1992;Dyer 1990;Holder 1991;Johnson et al 1979;Pöyhönen et al 1997;Salo and Hamalainen 1997;Webber et al 1996).…”

Section: Literature Reviewmentioning

confidence: 99%

Does AHP help us make a choice? An experimental evaluation

Ishizaka

Balkenborg

Kaplan

2011

Journal of the Operational Research Society

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In this paper, we use experimental economics methods to test how well Analytic Hierarchy Process (AHP) fares as a choice support system in a real decision problem. AHP provides a ranking that we statistically compare with three additional rankings given by the subjects in the experiment: one at the beginning, one after providing AHP with the necessary pair-wise comparisons and one after learning the ranking provided by AHP. While the rankings vary widely across subjects, we observe that for each individual all four rankings are similar. Hence, subjects are consistent and AHP is, for the most part, able to replicate their rankings. Furthermore, while the rankings are similar, we do find that the AHP ranking helps the decision-makers reformulate their choices by taking into account suggestions made by AHP.

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“…Data Envelopment analysis [1-3] is proven to be a useful tool in measuring efficiency and productivity of hospitals and health care related units [4,5]. Multi-criteria decision making approach has also been adopted extensively for performance analysis in healthcare sector [6,[8][9][10].The 9 papers comprising this special volume of the Journal of Medical Systems contribute to the theory and application of Data Envelopment Analysis (DEA). Papers were included in the special volume after a rigorous refereeing process, and represent only a small fraction of the total number of submitted manuscripts.…”

mentioning

confidence: 99%

“…Data Envelopment analysis [1][2][3] is proven to be a useful tool in measuring efficiency and productivity of hospitals and health care related units [4,5]. Multi-criteria decision making approach has also been adopted extensively for performance analysis in healthcare sector [6,[8][9][10].…”

mentioning

confidence: 99%

Performance Measurement in the Health sector: Uses of Frontier Efficiency Methodologies and Multi-Criteria Decision Making

Emrouznejad

Dey

2010

J Med Syst

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Performance measurement is essential for improvement. Although techniques for collecting, analyzing, and reporting data fall within the quantitative skill set of the organization, translating data into information that managers need to promote performance improvement requires a different and more subtle skill set. Health services sector is a complex area that is unique in all its characteristics. It has too many dimensions to be fitted into a simple singular unit and it is therefore essentially very difficult to approach the measurement of the performance of healthcare services by using one method or another [7]. Frontier Efficiency Methodologies and Multi-criteria Decision Making have been used rigorously in recent years. Data Envelopment analysis [1-3] is proven to be a useful tool in measuring efficiency and productivity of hospitals and health care related units [4,5]. Multi-criteria decision making approach has also been adopted extensively for performance analysis in healthcare sector [6,[8][9][10].The 9 papers comprising this special volume of the Journal of Medical Systems contribute to the theory and application of Data Envelopment Analysis (DEA). Papers were included in the special volume after a rigorous refereeing process, and represent only a small fraction of the total number of submitted manuscripts.The volume opens with an application focused on the performance of dialysis facilities. Nick Kontodimopoulos, Nikolaos D. Papathanasiou, Angeliki Flokou, Yannis Tountas and Dimitris Niakas examine the impact of nondiscretionary factors on DEA and SFA technical efficiency differences. They investigated the effect of factors such as operating environment on the efficiency. In a sample of 124 dialysis facilities, technical efficiency was compared according to ownership, region, years in operation and size. With second-stage Tobit regression, DEA and SFA efficiency was regressed against these environmental factors to determine their potential for predicting technical efficiency, as well as the efficiency differences between the two frontier methods. DEA expectedly generated lower mean efficiency scores than SFA, due to the "random effects" term computed by the latter, in addition to "true" inefficiency. This finding was consistent for the subgroups formed on the basis of the environmental factors. Thy found that half the variation in the DEA-SFA efficiency differences was explained by environmental factors. This suggests that in addition to market instabilities, luck, and other related phenomena, decisionmakers in their effort to determine optimal resource allocation, should point their attention to the potentially useful insight provided by environmental factors.In another application in measuring technical efficiency in primary health care in the Spanish region of Extremadura, José Manuel Cordero Ferrera, Eva Crespo Cebada and Luis R. Murillo Zamorano investigated the effect of exogenous variables on efficiency. In this context, the exogenous variables are represented by the main characteristics of the c...

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The analytic hierarchy process in medical and health care decision making: A literature review

Cited by 444 publications

References 58 publications

Diagnosis of Periprosthetic Joint Infection in Medicare Patients: Multicriteria Decision Analysis

Diagnosis of Periprosthetic Joint Infection in Medicare Patients: Multicriteria Decision Analysis

Does AHP help us make a choice? An experimental evaluation

Performance Measurement in the Health sector: Uses of Frontier Efficiency Methodologies and Multi-Criteria Decision Making

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