MULTI CRITERIA DECISION ANALYSIS METHODS IN HEALTH CARE: CURRENT STATUS, GOOD PRACTICE AND FUTURE RECOMMENDATIONS

Purpose: Recently, there has been a sharp increase in its application in health care, but a challenge to the use of MCDA in health care may, however, be the diversity of MCDA approaches and the lack of guidance about which is appropriate in different circumstances. The objective of this paper is to raise awareness of the variety of multi criteria decision analysis (MCDA) approaches that are available and to set the research agenda for improving the implementation of MCDA. 

Method: The paper is organized into the following sections. The first section provides examples of the use of MCDA to support health care decisions. The following section summarizes the process involved in implementing MCDA, including the methodological decisions that need to be made. The paper concludes with a discussion of good practice recommendations and future research that is required to support the implementation of MCDA in health care. 

Result: The diversity of different MCDA approaches is highlighted before providing an overview of the common steps involved in implementing MCDA. The methodological decisions required at each step of the MCDA process are then described. The paper concludes with recommendations for further research required to develop guidance for those planning to use MCDA to support health care decision making.

Conclusion: MCDA has already been used and is well suited to support a broad range of health care decision problems but beyond the high level steps that are common across the MCDA studies, it is difficult to point to good practice. The few exceptions to this conclusion include: the importance of developing a clear understanding of the decision problem; ensuring that criteria comply the MCDA requirements; appropriate weighting, scoring and aggregating; analysis and testing the implications uncertainty in the analytical structure and parameter inputs. There is a need for further research to develop a framework to support the selection of the appropriate MCDA technique for specific health care decisions.