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How Well Can Analytic Hierarchy Process be Used to Elicit Individual Preferences? Insights from a Survey in Patients Suffering from Age-Related Macular Degeneration

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Abstract

Background

In this study, we tested the feasibility of an interviewer-assisted analytic hierarchy process (AHP) in a special patient population with age-related macular degeneration (AMD).

Objectives

One aim was to generate preference weights regarding AMD treatment characteristics. A secondary aim was to explore the consistency of preference judgments and reasons for inconsistency.

Methods

We generated quantitative importance weights for decision criteria using the matrix multiplication method. A qualitative study component in the form of asking patients to think aloud throughout their judgments was implemented to facilitate understanding of quantitative findings. Consistency ratios were calculated as a measure of logical judgment performance within AHP. If consistency ratios exceeded 0.2, we explored reasons for inconsistency.

Results

We interviewed 86 patients and generated preference weights for criteria. Patients rated the injection’s effect on visual function the highest (0.44), followed by the frequency of monitoring visits (0.18), approval status (0.13), injection frequency (0.13), and side effects (0.12). Inconsistency in judgments was prevalent at the subcriteria level. Whereas much of the observed inconsistency was due to an excessive use of high/extreme value judgments, these judgments seemed to result from patients reasonably trying to highlight their strong preferences.

Conclusion

Our study combines quantitative with qualitative data to explore patients’ preference weights and decision processes using the AHP. It suggests that the type of inconsistency observed in judgments of AMD patients mostly results from rational decision making, not from error or lack of understanding. Further research should address which type and extent of inconsistency might be acceptable in different AHP settings.

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Acknowledgments

The authors thank Dirk Müller, Philipp Müther, and Fabian Jülich for their input during study design; Fabian Jülich and Markos-Charalabos Dintsios for their review of the final manuscript; and Sabrina Liebner and Fatjana Bylo for their support during patient recruitment. The authors would also like to thank all patients for their participation.

Authors contributions

Marion Danner and Vera Vennedey conducted and analyzed the AHP interviews and drafted the manuscript. Christian Gross supported data analyses. Mickaël Hilligsmann and Sascha Fauser critically revised and contributed to the final manuscript. Stephanie Stock facilitated the project. Marion Danner acts as guarantor for the content of the paper.

Funding

Financial support for this investigator-initiated study was provided by Bayer Vital GmbH, Germany (who markets the product aflibercept). The funding agreement ensured the author’s independence in designing the study; collecting, analyzing, and interpreting the data; and writing and publishing the report. The authors Stephanie Stock, Christian Gross, Sascha Fauser, Mickaël Hiligsmann, Vera Vennedey, and Marion Danner report no additional conflicts of interest.

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Authors and Affiliations

  1. Institute for Health Economics and Clinical Epidemiology, Cologne University Hospital, Gleueler Straße 176-178, 50935, Cologne, Germany

    Marion Danner, Vera Vennedey, Christian Gross & Stephanie Stock

  2. Department of Health Services Research, CAPHRI School for Primary Care and Public Health, Maastricht University, Maastricht, The Netherlands

    Mickaël Hiligsmann

  3. Center for Ophthalmology, Cologne University Hospital, Cologne, Germany

    Sascha Fauser

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  1. Marion Danner
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  2. Vera Vennedey
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  6. Stephanie Stock
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Correspondence to Marion Danner.

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Danner, M., Vennedey, V., Hiligsmann, M. et al. How Well Can Analytic Hierarchy Process be Used to Elicit Individual Preferences? Insights from a Survey in Patients Suffering from Age-Related Macular Degeneration. Patient 9, 481–492 (2016). https://doi.org/10.1007/s40271-016-0179-7

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