Comparison of Two Multi-Criteria Decision Techniques for Eliciting Treatment Preferences in People with Neurological Disorders
Comparison of Two Multi-Criteria Decision Techniques for Eliciting Treatment Preferences in People with Neurological Disorders
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DOI：
10.2165/01312067-200801040-00008
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发表时间：
2008-10-01
影响因子：
3.6
通讯作者：
Snoek, Govert J.
中科院分区：
文献类型：
--
作者：
IJzerman, Maarten J.;van Til, Janine A.;Snoek, Govert J.
目的：介绍并比较两种多标准决策技术（层次分析法[AHP]和联合分析[CA]），用于在有资格接受手功能手术增强的颈脊髓损伤（SCI）患者中（无论是否植入神经假体）诱导偏好。属性权重，整体偏好，和实际experiences.Methods：两个先前设计和管理的多标准决策调查SCI患者进行了比较，并进一步分析的方法进行了比较。在AHP实验中的属性及其权重由专家小组确定，然后确定患者组的权重。属性的CA选择和验证使用的专家小组，试点在6例SCI患者，随后管理到同一组的患者参加了AHP experiment.Results：两个实验表明，非结果相关的因素，如住院时间和手术次数的重要性。特别是，患者在实际决策中不太关心临床结果。AHP和CA的总体偏好均有利于肌腱重建（0.6 vs 0.4神经假体植入）。这两种方法都很容易应用，但层次分析法是不容易解释和understanding.Conclusions：层次分析法和CA方法产生类似的结果，这可能是由患者的明显偏好。CA可能是首选的，因为整体的方法，同时考虑所有的治疗属性，因此，它的权力，在模拟真实的市场决策。另一方面，AHP方法是首选的动手，易于实施的任务，并立即反馈给答卷人。这种灵活性使得AHP可以用于共享决策。然而，该技术的组成方式导致了许多不一致之处。患者更喜欢CA，但抱怨选择任务的数量。
Objective: To present and compare two multi-criteria decision techniques (analytic hierarchy process [AHP] and conjoint analysis [CA]) for eliciting preferences in patients with cervical spinal cord injury (SCI) who are eligible for surgical augmentation of hand function, either with or without implantation of a neuroprosthesis. The methods were compared in respect to attribute weights, overall preference, and practical experiences.Methods: Two previously designed and administered multi-criteria decision surveys in patients with SCI were compared and further analysed. Attributes and their weights in the AHP experiment were determined by an expert panel, followed by determination of the weights in the patient group. Attributes for the CA were selected and validated using an expert panel, piloted in six patients with SCI and subsequently administered to the same group of patients as participated in the AHP experiment.Results: Both experiments showed the importance of non-outcome-related factors such as inpatient stay and number of surgical procedures. In particular, patients were less concerned with clinical outcomes in actual decision making. Overall preference in both the AHP and CA was in favor of tendon reconstruction (0.6 vs 0.4 for neuroprosthetic implantation). Both methods were easy to apply, but AHP was less easily explained and understood.Conclusions: Both the AHP and CA methods produced similar outcomes, which may have been caused by the obvious preferences of patients. CA may be preferred because of the holistic approach of considering all treatment attributes simultaneously and, hence, its power in simulating real market decisions. On the other hand, the AHP method is preferred as a hands-on, easy-to-implement task with immediate feedback to the respondent. This flexibility allows AHP to be used in shared decision making. However, the way the technique is composed results in many inconsistencies. Patients preferred CA but complained about the number of choice tasks.