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Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA

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Abstract

Healthcare decision making is usually characterized by a low degree of transparency. The demand for transparent decision processes can be fulfilled only when assessment, appraisal and decisions about health technologies are performed under a systematic construct of benefit assessment. The benefit of an intervention is often multidimensional and, thus, must be represented by several decision criteria. Complex decision problems require an assessment and appraisal of various criteria; therefore, a decision process that systematically identifies the best available alternative and enables an optimal and transparent decision is needed. For that reason, decision criteria must be weighted and goal achievement must be scored for all alternatives. Methods of multi-criteria decision analysis (MCDA) are available to analyse and appraise multiple clinical endpoints and structure complex decision problems in healthcare decision making. By means of MCDA, value judgments, priorities and preferences of patients, insurees and experts can be integrated systematically and transparently into the decision-making process. This article describes the MCDA framework and identifies potential areas where MCDA can be of use (e.g. approval, guidelines and reimbursement/pricing of health technologies). A literature search was performed to identify current research in healthcare. The results showed that healthcare decision making is addressing the problem of multiple decision criteria and is focusing on the future development and use of techniques to weight and score different decision criteria. This article emphasizes the use and future benefit of MCDA.

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Acknowledgments

The authors would like to thank the reviewers for their valuable and constructive contribution. The reviewers were Vakaramoko Diaby, James Dolan and Sitaporn Youngkong; the authors were blind to the reviewers’ identities during the peer review and revision of the manuscript.

Author contributions

ACM and AK contributed to the conception, developed the theoretical framework, and contributed to the writing of the manuscript. All authors gave final approval of the version to be submitted.

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Authors and Affiliations

  1. IGM Institut Gesundheitsökonomie und Medizinmanagement, Hochschule Neubrandenburg, Brodaer Straße 2, 17033, Neubrandenburg, Germany

    Axel C. Mühlbacher & Anika Kaczynski

  2. Gesellschaft für empirische Beratung GmbH (GEB), Freiburg, Germany

    Axel C. Mühlbacher

  3. Center for Health Policy and Inequalities Research, Duke Global Health Institute, Durham, NC, USA

    Axel C. Mühlbacher

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  1. Axel C. Mühlbacher
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Correspondence to Axel C. Mühlbacher.

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No funding was obtained to prepare this manuscript. The authors Axel Mühlbacher and Anika Kaczynski declare that there are no conflicts of interest.

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Mühlbacher, A.C., Kaczynski, A. Making Good Decisions in Healthcare with Multi-Criteria Decision Analysis: The Use, Current Research and Future Development of MCDA. Appl Health Econ Health Policy 14, 29–40 (2016). https://doi.org/10.1007/s40258-015-0203-4

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