APPLICATION OF MULTI-CRITERIA DECISION ANALYSIS IN HEALTHCARE: A SYSTEMATIC REVIEW OF THE LITERATURE

Purpose:

Multi-Criteria Decision Analysis (MCDA) has been widely used in the scientific field as a tool for evaluating options in decisions involving multiple often conflicting criteria, predefined constraints, as well as stakeholders. The use of MCDA is increasing in health care; however, the literature lacks systematic reviews of the application of MCDA. The objective of this paper is twofold. First, to identify, classify, and systematically review MCDA studies applied solely to the health care context. Second, to describe the extent to which existing MCDA techniques are useful in making more informed decisions.

Method:

A systematic review was conducted to identify English language studies published between January 1, 1980 and October 1, 2013. The electronic databases used were EMBASE, CINAHL, MEDLINE, PubMed, Web of Knowledge, and ProQuest. Electronic searches were supplemented by hand-searches. Studies considered for inclusion were those using MCDA techniques within the health care context, and involving the participation of stakeholders.

Result:

A total of 66 studies met the inclusion criteria. Those studies were published from 1981 to 2013. The publication trend showed that the number of health care studies utilizing MCDA is increasing steadily, reaching its highest pick during the year 2012. MCDA has been conducted in a vast array of health care topic areas, including diagnosis and treatment, formulary management, health technology assessment, public health, public policy, organ transplants, infrastructure development, geographic information systems, and resource planning. The majority of the studies were conducted in the United States of America (n=29). The Medical Decision Making journal published the highest number of articles (n=7). The Analytic Hierarchy Process (n=33) was the most used MCDA technique.

Conclusion:

MCDA is a powerful tool for integrating stakeholders’ preferences and values regarding multiple criteria, and it offers valuable guidance to support complex decision-making processes. MCDA has been user to address many health care questions. Even though, further research is needed to assess its value, and develop practice guidelines for the application and reporting of MCDA methods.