PST12 THE USE OF MULTI-CRITERIA DECISION METHODS IN HEALTH CARE.WHICH METHOD IS MOST SUITABLE FOR HEALTHY AND COGNITIVELY IMPAIRED POPULATION?

Abstract

OBJECTIVES: To select the best multi-criteria decision making method for use with cognitively impaired patients. Population. A convenience sample of 28 subjects, 12 healthy and 16 cognitively impaired. METHODS: Based on a literature review, 5 multicriteria methods were chosen for comparison including: Kepner-tregoe analysis (KTA), simple multi attribute rating technique (SMART), SMART using swing weights (SWING), Analytic Hierarchy Process (AHP) and Conjoint Analysis (CA). Four attributes of treatment were identified (impact, duration, and end-result of treatment and associated risks). Subjects were asked to both rank and rate the importance of these attributes. After using the methods to establish preferences for treatment, subjects were asked to judge the overall difficulty of the techniques on 1–10 score, and answer questions regarding clarity of explanation of method, difficulty in answering questions, understanding method in relation to goal, and use of the method in health care situations. Subjects were interviewed either once (n = 14) or twice (n = 14) (Only the results of the first measurement are presented) RESULTS: In the overall rating of methods CA scored best (mean score 3.65), followed by SMART (3.70), AHP (4.00), SWING (4.40) and KTA (4.67). CA also scored best on verbal/written explanation, understanding of method in relation to goal second and usefulness in health care situations, and scored second place on difficulty in answering questions. In the impaired population, AHP was rated best on the overall difficulty score. CONCLUSIONS: In this pilot study, conjoint analysis was the most preferred method of preference elicitation. Our main concern regarding CA is the time it takes to fill out a CA questionnaire and the fact that data analysis is most complicated of all methods included. Another concern regarding the use of multicriteria methods needing further study is the rate of rank-reversal between methods in the cognitively impaired population.