PHP132 VALUE OF MULTI-CRITERIA DECISION ANALYSIS IN EARLY ASSESSMENT OF MEDICAL DIAGNOSTIC DEVICES

Abstract

OBJECTIVES: Multicriteria decision analytic (MCDA) techniques are a powerful tool in evaluating health care interventions where multiple, often competing, factors need to be considered. The analytic hierarchy process (AHP) is one such technique. We have applied AHP to evaluate medical diagnostic technologies as to support product development and market access. The main objective of this study is to show feasibility of AHP in terms of applicability and outcome. We therefore have studied the expected performance of the Photoacoustic Mammoscope (PAM), a new imaging device for detection of breast cancer based on photoacoustic imaging. METHODS: Before starting the study we defined different diagnostic and screening scenarios for the PAM including criteria that are important in the acceptance of the device. We finally defined four strategies including mammography, ultrasound and MRI imaging. The Analytic Hierarchy Process (AHP) analysis was then used to identify the relative importance of evaluation criteria, and to identify the relative performance of four different breast cancer imaging techniques. RESULTS: According to the expert panel the most important criterion in the design of a diagnostic breast imaging device is sensitivity (overall weight was 54%). Factors that mainly determine the performance on sensitivity are the visualization of mass margins, mass shape and vascularization. Second most important criterion was safety. CONCLUSIONS: From an early assessment of photoacoustic imaging it may be concluded that the potential clinical performance justifies further development and implementation of PAM. However, further research on the use of AHP in medical product development is required. We present and discuss some ideas to further integrate clinical evidence into MCDA using Bayesian techniques as well as sensitivity analyses on the model inputs.