Cargando…

Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art

BACKGROUND: Multi-criteria decision analysis (MCDA) concepts, models and tools have been used increasingly in health technology assessment (HTA), with several studies pointing out practical and theoretical issues related to its use. This study provides a critical review of published studies on MCDA...

Descripción completa

Detalles Bibliográficos
Autores principales: Oliveira, Mónica D., Mataloto, Inês, Kanavos, Panos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652169/
https://www.ncbi.nlm.nih.gov/pubmed/31006056
http://dx.doi.org/10.1007/s10198-019-01052-3
_version_ 1783438513116545024
author Oliveira, Mónica D.
Mataloto, Inês
Kanavos, Panos
author_facet Oliveira, Mónica D.
Mataloto, Inês
Kanavos, Panos
author_sort Oliveira, Mónica D.
collection PubMed
description BACKGROUND: Multi-criteria decision analysis (MCDA) concepts, models and tools have been used increasingly in health technology assessment (HTA), with several studies pointing out practical and theoretical issues related to its use. This study provides a critical review of published studies on MCDA in the context of HTA by assessing their methodological quality and summarising methodological challenges. METHODS: A systematic review was conducted to identify studies discussing, developing or reviewing the use of MCDA in HTA using aggregation approaches. Studies were classified according to publication time and type, country of study, technology type and study type. The PROACTIVE-S approach was constructed and used to analyse methodological quality. Challenges and limitations reported in eligible studies were collected and summarised; this was followed by a critical discussion on research requirements to address the identified challenges. RESULTS: 129 journal articles were eligible for review, 56% of which were published in 2015–2017; 42% focused on pharmaceuticals; 36, 26 and 18% reported model applications, issues regarding MCDA implementation analyses, and proposing frameworks, respectively. Poor compliance with good methodological practice (< 25% complying studies) was found regarding behavioural analyses, discussion of model assumptions and uncertainties, modelling of value functions, and dealing with judgment inconsistencies. The five most reported challenges related to evidence and data synthesis; value system differences and participant selection issues; participant difficulties; methodological complexity and resource balance; and criteria and attributes modelling. A critical discussion on ways to address these challenges ensues. DISCUSSION: Results highlight the need for advancement in robust methodologies, procedures and tools to improve methodological quality of MCDA in HTA studies. Research pathways include developing new model features, good practice guidelines, technologies to enable participation and behavioural research.
format Online
Article
Text
id pubmed-6652169
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-66521692019-08-09 Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art Oliveira, Mónica D. Mataloto, Inês Kanavos, Panos Eur J Health Econ Original Paper BACKGROUND: Multi-criteria decision analysis (MCDA) concepts, models and tools have been used increasingly in health technology assessment (HTA), with several studies pointing out practical and theoretical issues related to its use. This study provides a critical review of published studies on MCDA in the context of HTA by assessing their methodological quality and summarising methodological challenges. METHODS: A systematic review was conducted to identify studies discussing, developing or reviewing the use of MCDA in HTA using aggregation approaches. Studies were classified according to publication time and type, country of study, technology type and study type. The PROACTIVE-S approach was constructed and used to analyse methodological quality. Challenges and limitations reported in eligible studies were collected and summarised; this was followed by a critical discussion on research requirements to address the identified challenges. RESULTS: 129 journal articles were eligible for review, 56% of which were published in 2015–2017; 42% focused on pharmaceuticals; 36, 26 and 18% reported model applications, issues regarding MCDA implementation analyses, and proposing frameworks, respectively. Poor compliance with good methodological practice (< 25% complying studies) was found regarding behavioural analyses, discussion of model assumptions and uncertainties, modelling of value functions, and dealing with judgment inconsistencies. The five most reported challenges related to evidence and data synthesis; value system differences and participant selection issues; participant difficulties; methodological complexity and resource balance; and criteria and attributes modelling. A critical discussion on ways to address these challenges ensues. DISCUSSION: Results highlight the need for advancement in robust methodologies, procedures and tools to improve methodological quality of MCDA in HTA studies. Research pathways include developing new model features, good practice guidelines, technologies to enable participation and behavioural research. Springer Berlin Heidelberg 2019-04-20 2019 /pmc/articles/PMC6652169/ /pubmed/31006056 http://dx.doi.org/10.1007/s10198-019-01052-3 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Paper
Oliveira, Mónica D.
Mataloto, Inês
Kanavos, Panos
Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art
title Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art
title_full Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art
title_fullStr Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art
title_full_unstemmed Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art
title_short Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art
title_sort multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6652169/
https://www.ncbi.nlm.nih.gov/pubmed/31006056
http://dx.doi.org/10.1007/s10198-019-01052-3
work_keys_str_mv AT oliveiramonicad multicriteriadecisionanalysisforhealthtechnologyassessmentaddressingmethodologicalchallengestoimprovethestateoftheart
AT matalotoines multicriteriadecisionanalysisforhealthtechnologyassessmentaddressingmethodologicalchallengestoimprovethestateoftheart
AT kanavospanos multicriteriadecisionanalysisforhealthtechnologyassessmentaddressingmethodologicalchallengestoimprovethestateoftheart