Abstract
BackgroundThere is an increased interest in the use of multi-criteria decision analysis (MCDA) to support regulatory and reimbursement decision making. The EVIDEM framework was developed to provide pragmatic multi-criteria decision support in health care, to estimate the value of healthcare interventions, and to aid in priority-setting. The objectives of this study were to test 1) the influence of different weighting techniques on the overall outcome of an MCDA exercise, 2) the discriminative power in weighting different criteria of such techniques, and 3) whether different techniques result in similar weights in weighting the criteria set proposed by the EVIDEM framework.MethodsA sample of 60 Dutch and Canadian students participated in the study. Each student used an online survey to provide weights for 14 criteria with two different techniques: a five-point rating scale and one of the following techniques selected randomly: ranking, point allocation, pairwise comparison and best worst scaling.ResultsThe results of this study indicate that there is no effect of differences in weights on value estimates at the group level. On an individual level, considerable differences in criteria weights and rank order occur as a result of the weight elicitation method used, and the ability of different techniques to discriminate in criteria importance. Of the five techniques tested, the pair-wise comparison of criteria has the highest ability to discriminate in weights when fourteen criteria are compared.ConclusionsWhen weights are intended to support group decisions, the choice of elicitation technique has negligible impact on criteria weights and the overall value of an innovation. However, when weights are used to support individual decisions, the choice of elicitation technique influences outcome and studies that use dissimilar techniques cannot be easily compared. Weight elicitation through pairwise comparison of criteria is preferred when taking into account its superior ability to discriminate between criteria and respondents’ preferences.Electronic supplementary materialThe online version of this article (doi:10.1186/1478-7547-12-22) contains supplementary material, which is available to authorized users.
Highlights
There is an increased interest in the use of multi-criteria decision analysis (MCDA) to support regulatory and reimbursement decision making
The objectives of this study were to test: 1) the influence of weights elicited with different techniques on the overall outcomes of a multi criteria decision analysis, 2) whether different weight elicitation techniques have equal discriminative power in weighting different criteria, and 3) whether different techniques result in similar weights in weighting the criteria set proposed by the EVIDEM framework
The sample was over representative of females, younger and highly educated individuals compared to the average population (Table 2)
Summary
There is an increased interest in the use of multi-criteria decision analysis (MCDA) to support regulatory and reimbursement decision making. The EVIDEM framework was developed to provide pragmatic multi-criteria decision support in health care, to estimate the value of healthcare interventions, and to aid in priority-setting. Regulatory authorities face a complex decision task when considering new drugs or medical technologies for access and reimbursement. They need to take into account multiple aspects of a new technology and weigh their impact on the value of the innovation. Because these decisions are complex if made unaided, decision makers typically use heuristic or intuitive approaches to simplify them [2]. MCDA methods rely on several steps before they identify the value of the decision alternatives, such as defining the problem, determining goals and requirements to the analysis, selecting criteria, determining their hierarchy, weighting the criteria and scoring the performance of alternative solutions to the problem [5]
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