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Medical Decision Making Using the Analytic Hierarchy Process

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  • James G. Dolan

Abstract

The analytic hierarchy process (AHP) was used to determine which of seven recommended antibiotic regimens represented optimal initial therapy for a young woman hospitalized for treat ment of acute pyelonephritis. The model included the following criteria: maximize cure, minimize adverse effects (broken down into very serious, serious, and limited), minimize antibiotic resis tance, and minimize cost (divided into total cost and patient cost). The criteria were weighted according to judgments made by 61 practicing clinicians. Alternatives were compared relative to the criteria using published information on the expected frequencies of urinary pathogens and drug toxicity, local antibiotic sensitivities and antibiotic charges, and expert opinion regarding their propensities for inducing antimicrobial resistance. The analysis identified ampicillin com bined with gentamicin as the optimal regimen. This study illustrates several features of the AHP that make it promising for use in medical decision making: its ability to incorporate multiple criteria into a formal decision model, its procedural simplicity, and its similarity to current patient management guidelines. Further studies to establish the role of the AHP in medical decision making are warranted.

Suggested Citation

  • James G. Dolan, 1989. "Medical Decision Making Using the Analytic Hierarchy Process," Medical Decision Making, , vol. 9(1), pages 51-56, February.
    • Handle: RePEc:sae:medema:v:9:y:1989:i:1:p:51-56
    DOI: 10.1177/0272989X8900900109
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    References listed on IDEAS

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    1. James G. Dolan & Bernard J. Isselhardt & Joseph D. Cappuccio, 1989. "The Analytic Hierarchy Process in Medical Decision Making," Medical Decision Making, , vol. 9(1), pages 40-50, February.
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    Cited by:

    1. Johanna Vásquez & Sergio Botero, 2020. "Hybrid Methodology to Improve Health Status Utility Values Derivation Using EQ-5D-5L and Advanced Multi-Criteria Techniques," IJERPH, MDPI, vol. 17(4), pages 1-18, February.
    2. Pu Ji & Hong-yu Zhang & Jian-qiang Wang, 2017. "Fuzzy decision-making framework for treatment selection based on the combined QUALIFLEX–TODIM method," International Journal of Systems Science, Taylor & Francis Journals, vol. 48(14), pages 3072-3086, October.
    3. James Dolan, 2010. "Multi-Criteria Clinical Decision Support," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 3(4), pages 229-248, December.
    4. Matthew Liberatore & Robert Nydick & Constantine Daskalakis & Elisabeth Kunkel & James Cocroft & Ronald Myers, 2009. "Helping Men Decide About Scheduling a Prostate Cancer Screening Exam," Interfaces, INFORMS, vol. 39(3), pages 209-217, June.
    5. Liberatore, Matthew J. & Nydick, Robert L., 2008. "The analytic hierarchy process in medical and health care decision making: A literature review," European Journal of Operational Research, Elsevier, vol. 189(1), pages 194-207, August.
    6. Hasan, Mostafa & Büyüktahtakın, İ. Esra & Elamin, Elshami, 2019. "A multi-criteria ranking algorithm (MCRA) for determining breast cancer therapy," Omega, Elsevier, vol. 82(C), pages 83-101.
    7. Singpurwalla, Norah & Forman, Ernest & Zalkind, David, 1999. "Promoting shared health care decision making using the analytic hierarchy process," Socio-Economic Planning Sciences, Elsevier, vol. 33(4), pages 277-299, December.

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    1. Johanna Vásquez & Sergio Botero, 2020. "Hybrid Methodology to Improve Health Status Utility Values Derivation Using EQ-5D-5L and Advanced Multi-Criteria Techniques," IJERPH, MDPI, vol. 17(4), pages 1-18, February.
    2. James Dolan, 2010. "Multi-Criteria Clinical Decision Support," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 3(4), pages 229-248, December.
    3. Singpurwalla, Norah & Forman, Ernest & Zalkind, David, 1999. "Promoting shared health care decision making using the analytic hierarchy process," Socio-Economic Planning Sciences, Elsevier, vol. 33(4), pages 277-299, December.
    4. Hasan, Mostafa & Büyüktahtakın, İ. Esra & Elamin, Elshami, 2019. "A multi-criteria ranking algorithm (MCRA) for determining breast cancer therapy," Omega, Elsevier, vol. 82(C), pages 83-101.
    5. Liberatore, Matthew J. & Nydick, Robert L., 2008. "The analytic hierarchy process in medical and health care decision making: A literature review," European Journal of Operational Research, Elsevier, vol. 189(1), pages 194-207, August.
    6. Pu Ji & Hong-yu Zhang & Jian-qiang Wang, 2017. "Fuzzy decision-making framework for treatment selection based on the combined QUALIFLEX–TODIM method," International Journal of Systems Science, Taylor & Francis Journals, vol. 48(14), pages 3072-3086, October.

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