Inotrope Analysis for Acute and Chronic Reduced-EF Heart Failure Using Fuzzy Multi-Criteria Decision Analysis

Abstract

Heart failure is a progressive disease that leads to high mortality rates if left untreated, and inotropes are a class of drugs used to treat a type of heart failure where patients have reduced ejection fraction (HFrEF). This study aims to utilize the Fuzzy-Preference Ranking Organization Method for Enrichment Evaluation (F-PROMETHEE), an effectively used multi-criteria decision making (MCDM) technique. To analyze the characteristics of the most often used inotropes for acute HFrEF and chronic HFrEF, we use the same parameters set with distinct importance factors and aims for each property and, therefore, mathematically demonstrate the strengths and weaknesses of each inotrope alternative. As a result, a detailed ranking list for each HFrEF class was obtained, with supplementary information on how each parameter contributed to the ranking of each inotrope. From these results, it was concluded that the F-PROMETHEE method is applicable for evaluating the risks and benefits of various inotropes to determine a starting point for treating an average patient when making a quick decision without complete patient data. As demonstrated in this study, it is possible to easily use the same data set and only change some preference parameters according to individual needs to produce patient-specific results. In this study, we showed that creating a decision-making system that mathematically assists clinical specialists with their decision-making process is feasible.