Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage
Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage
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DOI：
10.1016/j.ijid.2020.06.082
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发表时间：
2020-09-01
影响因子：
8.4
通讯作者：
Tacconelli, Evelina
中科院分区：
文献类型：
--
作者：
De Nardo, Pasquale;Gentilotti, Elisa;Tacconelli, Evelina
目的：使用多标准决策分析（MCDA）确定11个标准的权重，以便在资源有限的医疗机构中优先考虑COVID-19非危重患者入院。方法：MCDA主要分为两个步骤：（及各准则内的水平）;及根据专家管理COVID-19患者的知识及经验，透过网上调查厘定准则的权重。标准是根据现有的COVID-19证据选择的，重点是低收入和中等收入国家（LMIC）。（平均重量，总计为100%）为：PaO 2（16.3%）;外周氧饱和度（15.9%）;胸部X线（14.1%）;修订的预警评分-MEWS（11.4%）;呼吸频率（9.5%）;合并症（6.5%）;与弱势群体生活在一起（6.4%）;体重指数（5.6%）;住院评估前症状持续时间（5.4%）; CRP（5.1%）;年龄（3.8%）。在一场新的大流行开始时，当疾病预测因素的证据有限或无法获得，并且难以建立有效的国家应急计划时，军事和民防资源优先排序模式可在改善卫生系统的反应方面发挥关键作用。(c)2020年，任作家。由Elsevier Ltd代表国际传染病学会出版。这是一个在CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/by-ncnd/4.0/）。
Objective: To use Multi-Criteria Decision Analysis (MCDA) to determine weights for eleven criteria in order to prioritize COVID-19 non-critical patients for admission to hospital in healthcare settings with limited resources.Methods: The MCDA was applied in two main steps: specification of criteria for prioritizing COVID-19 patients (and levels within each criterion); and determination of weights for the criteria based on experts' knowledge and experience in managing COVID-19 patients, via an online survey. Criteria were selected based on available COVID-19 evidence with a focus on lowand middle-income countries (LMICs).Results: The most important criteria (mean weights, summing to 100%) are: PaO2 (16.3%); peripheral O-2 saturation (15.9%); chest X-ray (14.1%); Modified Early Warning Score-MEWS (11.4%); respiratory rate (9.5%); comorbidities (6.5%); living with vulnerable people (6.4%); body mass index (5.6%); duration of symptoms before hospital evaluation (5.4%); CRP (5.1%); and age (3.8%).Conclusions: At the beginning of a new pandemic, when evidence for disease predictors is limited or unavailable and effective national contingency plans are difficult to establish, the MCDA prioritization model could play a pivotal role in improving the response of health systems. (c) 2020 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).