IDEAS home Printed from https://ideas.repec.org/a/spr/annopr/v351y2025i1d10.1007_s10479-024-06026-0.html
   My bibliography  Save this article

Towards sustainable dialysis modality selection: a multi-expert fuzzy analytical hierarchy process based approach for guided decision making

Author

Listed:
  • Safa Chabouh

    (Université de Tunis El Manar)

  • Sondes Hammami

    (Université de Tunis El Manar
    Université de Carthage)

  • Hafedh Fessi

    (Hospital Tenon)

  • Abdellatif Achour

    (Université de Sousse)

Abstract

Despite its proven cost-effectiveness and its capacity to cover the increasing demand for dialysis, especially hemodialysis, home hemodialysis (HHD) is not yet implemented in Tunisia. The aim of this paper is to conduct a socio-economic study of its introduction in Tunisia and provide guidance for nephrologists to select a dialysis modality while considering sustainability dimensions. First, a multi-expert fuzzy analytic hierarchy process (FAHP) based approach was conducted to assess HHD position among the existing dialysis modalities in Tunisia. Several criteria were considered: environmental; social; economic; organizational and medical. Furthermore, pairwise comparisons were provided by judgments of experts from two different contexts: one where HHD was already implemented (France) and another where HHD was not yet implemented (Tunisia). Based on the collected judgments, FAHP generated the ranking of dialysis modalities. Moreover, the impact of criteria weights variation on the ranking was studied. Then a decision model was proposed to guide nephrologists' prescription of dialysis modality based on the generated ranking as well as constraints related to the patient's environment and preferences. Our results highlighted that although in-center hemodialysis is the commonest modality in Tunisia, it is the least sustainable. However, HHD modalities proved to be more sustainable and are well ranked regarding all the considered criteria. Hence, it is worthy to introduce HHD in Tunisia from both medico-organizational and sustainability perspectives. By leveraging the FAHP results, this study demonstrated the practical application of the decision model, specifically designed for use by nephrologists, to foster sustainability in dialysis decision-making processes.

Suggested Citation

  • Safa Chabouh & Sondes Hammami & Hafedh Fessi & Abdellatif Achour, 2025. "Towards sustainable dialysis modality selection: a multi-expert fuzzy analytical hierarchy process based approach for guided decision making," Annals of Operations Research, Springer, vol. 351(1), pages 779-807, August.
    • Handle: RePEc:spr:annopr:v:351:y:2025:i:1:d:10.1007_s10479-024-06026-0
    DOI: 10.1007/s10479-024-06026-0
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10479-024-06026-0
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10479-024-06026-0?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Martin Howell & Rachael C. Walker & Kirsten Howard, 2019. "Cost Effectiveness of Dialysis Modalities: A Systematic Review of Economic Evaluations," Applied Health Economics and Health Policy, Springer, vol. 17(3), pages 315-330, June.
    2. Alla Mostepaniuk & Turgay Akalin & Mohammad Reza Parish, 2023. "Practices Pursuing the Sustainability of A Healthcare Organization: A Systematic Review," Sustainability, MDPI, vol. 15(3), pages 1-21, January.
    3. Kevin Marsh & Tereza Lanitis & David Neasham & Panagiotis Orfanos & Jaime Caro, 2014. "Assessing the Value of Healthcare Interventions Using Multi-Criteria Decision Analysis: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(4), pages 345-365, April.
    4. Henk Broekhuizen & Catharina Groothuis-Oudshoorn & Janine Til & J. Hummel & Maarten IJzerman, 2015. "A Review and Classification of Approaches for Dealing with Uncertainty in Multi-Criteria Decision Analysis for Healthcare Decisions," PharmacoEconomics, Springer, vol. 33(5), pages 445-455, May.
    5. Irina Vinogradova-Zinkevič, 2023. "Comparative Sensitivity Analysis of Some Fuzzy AHP Methods," Mathematics, MDPI, vol. 11(24), pages 1-41, December.
    6. Sarah Ben Amor & Fateh Belaid & Ramzi Benkraiem & Boumediene Ramdani & Khaled Guesmi, 2023. "Multi-criteria classification, sorting, and clustering: a bibliometric review and research agenda," Annals of Operations Research, Springer, vol. 325(2), pages 771-793, June.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ezbakhe, Fatine & Pérez-Foguet, Agustí, 2021. "Decision analysis for sustainable development: The case of renewable energy planning under uncertainty," European Journal of Operational Research, Elsevier, vol. 291(2), pages 601-613.
    2. Wulf, David & Bertsch, Valentin, 2016. "A natural language generation approach to support understanding and traceability of multi-dimensional preferential sensitivity analysis in multi-criteria decision making," MPRA Paper 75025, University Library of Munich, Germany.
    3. Abu Reza Md. Towfiqul Islam & Md. Mijanur Rahman Bappi & Saeed Alqadhi & Ahmed Ali Bindajam & Javed Mallick & Swapan Talukdar, 2023. "Improvement of flood susceptibility mapping by introducing hybrid ensemble learning algorithms and high-resolution satellite imageries," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 119(1), pages 1-37, October.
    4. Cleemput, Irina & Devriese, Stephan & Kohn, Laurence & Westhovens, René, 2018. "A multi-criteria decision approach for ranking unmet needs in healthcare," Health Policy, Elsevier, vol. 122(8), pages 878-884.
    5. Virginia Wiseman & Craig Mitton & Mary M. Doyle‐Waters & Tom Drake & Lesong Conteh & Anthony T. Newall & Obinna Onwujekwe & Stephen Jan, 2016. "Using Economic Evidence to Set Healthcare Priorities in Low‐Income and Lower‐Middle‐Income Countries: A Systematic Review of Methodological Frameworks," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 140-161, February.
    6. Salah Ghabri & Jean-Michel Josselin & Benoît Le Maux, 2019. "Could or Should We Use MCDA in the French HTA Process?," Post-Print halshs-02319704, HAL.
    7. Angelis, Aris & Kanavos, Panos, 2017. "Multiple Criteria Decision Analysis (MCDA) for evaluating new medicines in Health Technology Assessment and beyond: The Advance Value Framework," Social Science & Medicine, Elsevier, vol. 188(C), pages 137-156.
    8. Favretto, N. & Stringer, L.C. & Dougill, A.J. & Dallimer, M. & Perkins, J.S. & Reed, M.S. & Atlhopheng, J.R. & Mulale, K., 2016. "Multi-Criteria Decision Analysis to identify dryland ecosystem service trade-offs under different rangeland land uses," Ecosystem Services, Elsevier, vol. 17(C), pages 142-151.
    9. Riikka Hofmann & Claudia Pik Ki Chu & Alison Twiner & Jan D. Vermunt, 2024. "Patterns in Clinical Leadership Learning: Understanding the Quality of Learning about Leadership to Support Sustainable Transformation in Healthcare Education," Sustainability, MDPI, vol. 16(10), pages 1-20, May.
    10. Jason C Hsu & Jia-Yu Lin & Peng-Chan Lin & Yang-Cheng Lee, 2019. "Comprehensive value assessment of drugs using a multi-criteria decision analysis: An example of targeted therapies for metastatic colorectal cancer treatment," PLOS ONE, Public Library of Science, vol. 14(12), pages 1-17, December.
    11. Cuoghi, Kaio Guilherme & Leoneti, Alexandre Bevilacqua & Passador, João Luiz, 2022. "On the choice of public or private management models in the Brazilian Unified Health System (SUS)," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    12. Torkayesh, Ali Ebadi & Pamucar, Dragan & Ecer, Fatih & Chatterjee, Prasenjit, 2021. "An integrated BWM-LBWA-CoCoSo framework for evaluation of healthcare sectors in Eastern Europe," Socio-Economic Planning Sciences, Elsevier, vol. 78(C).
    13. Ya-Lan Chin & Feng-Shang Wu & Jian-Bing Liu & Yan Li & Jin Wang, 2024. "Exploring the role of interaction in older-adult service innovation: insights from the testing stage," Humanities and Social Sciences Communications, Palgrave Macmillan, vol. 11(1), pages 1-13, December.
    14. Liang, Yingying & Qin, Jindong & Ishizaka, Alessio, 2025. "Assessment of digital economy development with the new multicriteria sorting method: DCMSort," Omega, Elsevier, vol. 132(C).
    15. Luciano Barcellos-Paula & José M. Merigó & Anna M. Gil-Lafuente, 2024. "100 volumes of Mathematical Methods of Operations Research: a bibliometric overview," Mathematical Methods of Operations Research, Springer;Gesellschaft für Operations Research (GOR);Nederlands Genootschap voor Besliskunde (NGB), vol. 100(3), pages 753-796, December.
    16. Ivlev, Ilya & Vacek, Jakub & Kneppo, Peter, 2015. "Multi-criteria decision analysis for supporting the selection of medical devices under uncertainty," European Journal of Operational Research, Elsevier, vol. 247(1), pages 216-228.
    17. Gregório, Beatriz Cagigal & Pereira, Miguel Alves & Costa, Ana Sara, 2024. "Multi-criteria decision-aiding for public hospitals: The role of interactions among pairs of access and quality criteria," Omega, Elsevier, vol. 126(C).
    18. Bratanova, Alexandra & Ford, Jerad A. & Schleiger, Emma, 2023. "Prioritising Investment Opportunities in Research and Development Using Multiple Criteria Decision Analysis," MPRA Paper 116458, University Library of Munich, Germany.
    19. Bratanova, Alexandra & Cameron, Alicia & Thavat, Maylee & Fyfield, Amelia & Hajkowicz, Stefan, 2023. "Priority setting in international trade – application of multiple criteria decision analysis for Australian-Indonesia trade in the health sector," MPRA Paper 119407, University Library of Munich, Germany.
    20. Miquel Sitjar-Suñer & Rosa Suñer-Soler & Afra Masià-Plana & Emilia Chirveches-Pérez & Carme Bertran-Noguer & Concepció Fuentes-Pumarola, 2020. "Quality of Life and Social Support of People on Peritoneal Dialysis: Mixed Methods Research," IJERPH, MDPI, vol. 17(12), pages 1-15, June.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:annopr:v:351:y:2025:i:1:d:10.1007_s10479-024-06026-0. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.