Towards generic online multicriteria decision support in patient-centred health care.


Dowie, J; Kjer Kaltoft, M; Salkeld, G; Cunich, M; (2013) Towards generic online multicriteria decision support in patient-centred health care. Health expectations. ISSN 1369-6513 DOI: https://doi.org/10.1111/hex.12111

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Abstract

OBJECTIVE To introduce a new online generic decision support system based on multicriteria decision analysis (MCDA), implemented in practical and user-friendly software (Annalisa©). BACKGROUND All parties in health care lack a simple and generic way to picture and process the decisions to be made in pursuit of improved decision making and more informed choice within an overall philosophy of person- and patient-centred care. METHODS The MCDA-based system generates patient-specific clinical guidance in the form of an opinion as to the merits of the alternative options in a decision, which are all scored and ranked. The scores for each option combine, in a simple expected value calculation, the best estimates available now for the performance of those options on patient-determined criteria, with the individual patient's preferences, expressed as importance weightings for those criteria. The survey software within which the Annalisa file is embedded (Elicia©) customizes and personalizes the presentation and inputs. Principles relevant to the development of such decision-specific MCDA-based aids are noted and comparisons with alternative implementations presented. The necessity to trade-off practicality (including resource constraints) with normative rigour and empirical complexity, in both their development and delivery, is emphasized. CONCLUSION The MCDA-/Annalisa-based decision support system represents a prescriptive addition to the portfolio of decision-aiding tools available online to individuals and clinicians interested in pursuing shared decision making and informed choice within a commitment to transparency in relation to both the evidence and preference bases of decisions. Some empirical data establishing its usability are provided.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
PubMed ID: 23910715
Web of Science ID: 365046700008
URI: http://researchonline.lshtm.ac.uk/id/eprint/1126654

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