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Additive Multicriteria Decision Analysis Models: Misleading Aids for Life-Critical Shared Decision Making

Author

Listed:
  • Edouard Kujawski

    (Complete Decisions, LLC, Baton Rouge, LA, USA)

  • Evangelos Triantaphyllou

    (Division of Computer Science and Engineering Louisiana State University, Baton Rouge, LA, USA)

  • Juri Yanase

    (Complete Decisions, LLC, Baton Rouge, LA, USA)

Abstract

Background. There is growing interest in multicriteria decision analysis ( MCDA) for shared decision making (SDM). A distinguishing feature is that a preferred treatment should extend years of life and/or improve health-related quality of life (HRQL). Additive MCDA models are inadequate for the task. A plethora of MCDA models exist, each claiming that it can correctly solve real-world problems. However, most were developed in nonhealth fields and rely on additive models. This makes the problem of choosing an MCDA model as an aid for SDM a challenging and urgent one. Methods. A published 2017 MCDA of a hypothetical prostate cancer patient is used as a case in point of how not to do and how to do MCDA for SDM. We critically review it and analyze it using several additive linear MCDA models with years of life and HRQL as attributes and the linear quality-adjusted life-year (QALY) model. The following simple reasonableness test is presented for applicability of a method as an aid for SDM: Can a treatment that causes premature death trump a treatment that causes acceptable adverse effects? Results. Additive MCDA models and the linear QALY recommend significantly different alternatives. Additive MCDA models fail the proposed reasonableness test; the linear QALY model passes. Conclusions. MCDA possesses a strong craft element in addition to its technical aspects. MCDA practitioners and clinicians need to understand model limitations to choose models appropriate to the context. Additive MCDA models are inadequate for life-critical SDM. We advocate QALY models with additional research for increased realism as a tool for SDM.

Suggested Citation

  • Edouard Kujawski & Evangelos Triantaphyllou & Juri Yanase, 2019. "Additive Multicriteria Decision Analysis Models: Misleading Aids for Life-Critical Shared Decision Making," Medical Decision Making, , vol. 39(4), pages 437-449, May.
    • Handle: RePEc:sae:medema:v:39:y:2019:i:4:p:437-449
    DOI: 10.1177/0272989X19844740
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    References listed on IDEAS

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    1. Kenneth C. Lichtendahl & Samuel E. Bodily, 2012. "Multiplicative Utilities for Health and Consumption," Decision Analysis, INFORMS, vol. 9(4), pages 314-328, December.
    2. Ralph L. Keeney, 2002. "Common Mistakes in Making Value Trade-Offs," Operations Research, INFORMS, vol. 50(6), pages 935-945, December.
    3. Gandjour, Afschin & Gafni, Amiram, 2010. "The additive utility assumption of the QALY model revisited," Journal of Health Economics, Elsevier, vol. 29(2), pages 325-328, March.
    4. Edwards, Ward & Barron, F. Hutton, 1994. "SMARTS and SMARTER: Improved Simple Methods for Multiattribute Utility Measurement," Organizational Behavior and Human Decision Processes, Elsevier, vol. 60(3), pages 306-325, December.
    5. Joseph S. Pliskin & Donald S. Shepard & Milton C. Weinstein, 1980. "Utility Functions for Life Years and Health Status," Operations Research, INFORMS, vol. 28(1), pages 206-224, February.
    6. Evangelos Triantaphyllou, 2010. "Data Mining and Knowledge Discovery via Logic-Based Methods," Springer Optimization and Its Applications, Springer, number 978-1-4419-1630-3, September.
    7. Yoram Wind & Thomas L. Saaty, 1980. "Marketing Applications of the Analytic Hierarchy Process," Management Science, INFORMS, vol. 26(7), pages 641-658, July.
    8. Bleichrodt, Han & Gafni, Amiram, 1996. "Time preference, the discounted utility model and health," Journal of Health Economics, Elsevier, vol. 15(1), pages 49-66, February.
    Full references (including those not matched with items on IDEAS)

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