Collaborative development of composite indices from qualitative value judgements: The EURO-HEALTHY Population Health Index model

Abstract

Promoting participation and combining evidence with expert knowledge in constructing composite indices that can be meaningfully interpreted are key open challenges identified in performance measurement literature. To address them, this article proposes a sociotechnical decision-aid process, under a collaborative value-modelling framework, rooted in both process consultation and multicriteria value measurement principles. It consists of two phases (structuring and model building), each one developed in a sequence of non-face-to-face (Web-Delphi) and face-to-face (decision conferencing) group processes, designed to allow for increased participation. Performance indicators are selected and structured in a value-tree (phase one), upon which a group hierarchical additive value-function model is built (phase two), supported by the MACBETH multicriteria decision-support system. Collaborative questioning protocols allow to elicit and reconcile individual qualitative value judgements, in a Web-Delphi platform. The collective knowledge thus acquired is used in decision conferencing with a core group to define value functions and weights. Extensive sensitivity and robustness analyses serve to test the requisiteness of the model, giving rise to a shared structure of composite indices. The proposed approach was shaped within the EURO-HEALTHY project, to create a Population Health Index intended to be a tool enabling policymakers to analyse population health and related inequalities at the regional level across the European Union, and design improvement policies. Many stakeholders and experts from different intervention and knowledge areas, and located across Europe, participated in the different modelling activities, as detailed in this article. Research paths derived from learnings acquired are suggested to further improve process effectiveness and flexibility.