Candidate for the Lee B. Lusted Student Prize Competition
Method: This methodological paper presents the main MCDA decision support methods (Elementary methods, Value-based measurement models, Goal Programming models and Outranking models) using a case study approach. For each family of method, an example of how an MCDA model would operate in a real decision-making context is presented from a critical perspective, highlighting parameter setting, selection of an appropriate evaluation model as well as the role of sensitivity and robustness analyses. The case study ends with strategies to bridge HTA decision-making and MCDA.
Result: Each family of methods presented in this paper has potential strengths and limitations. The selection of the appropriate MCDA method to support HTA decision-making is contingent upon the type of problems (choice, ranking, and sorting) to address as well as the decision-making level (e.g. Government, HTA bodies, hospital, etc…). Strategies to bridge HTA and MCDA include obtaining buy-in from stakeholders of the decision-making process at the political level and building capacity in MCDA in health care through introduction of formal training in academic curricula.
Conclusion: MCDA is both a process and a family of methods that has proven its usefulness in other fields such as operations research, management and environment. A unique feature that health care decision-makers should value regarding the use of MCDA is that it encompasses a variety of technique going from elementary to sophisticated techniques. It is a sound and flexible approach that can be applied to wide range of health care decision-making processes.