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Comparison of Two Multi-Criteria Decision Techniques for Eliciting Treatment Preferences in People with Neurological Disorders

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Abstract

Objective: To present and compare two multi-criteria decision techniques (analytic hierarchy process [AHP] and conjoint analysis [CA]) for eliciting preferences in patients with cervical spinal cord injury (SCI) who are eligible for surgical augmentation of hand function, either with or without implantation of a neuroprosthesis. The methods were compared in respect to attribute weights, overall preference, and practical experiences.

Methods: Two previously designed and administered multi-criteria decision surveys in patients with SCI were compared and further analysed. Attributes and their weights in the AHP experiment were determined by an expert panel, followed by determination of the weights in the patient group. Attributes for the CA were selected and validated using an expert panel, piloted in six patients with SCI and subsequently administered to the same group of patients as participated in the AHP experiment.

Results: Both experiments showed the importance of non-outcome-related factors such as inpatient stay and number of surgical procedures. In particular, patients were less concerned with clinical outcomes in actual decision making. Overall preference in both the AHP and CA was in favor of tendon reconstruction (0.6 vs 0.4 for neuroprosthetic implantation). Both methods were easy to apply, but AHP was less easily explained and understood.

Conclusions: Both the AHP and CA methods produced similar outcomes, which may have been caused by the obvious preferences of patients. CA may be preferred because of the holistic approach of considering all treatment attributes simultaneously and, hence, its power in simulating real market decisions. On the other hand, the AHP method is preferred as a hands-on, easy-to-implement task with immediate feedback to the respondent. This flexibility allows AHP to be used in shared decision making. However, the way the technique is composed results in many inconsistencies. Patients preferred CA but complained about the number of choice tasks.

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Table I
Table II
Fig. 1
Fig. 1

Notes

  1. (N × T × A)/C ≥ 500, where N = number of respondents, T = number of choice sets per respondent, A = number of scenarios per choice set, and C = maximum number of levels.

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Acknowledgements

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. STeHPS Department, University of Twente, Enschede, the Netherlands

    Maarten J. IJzerman & Janine A. van Til

  2. Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, Ohio, USA

    Maarten J. IJzerman

  3. Roessingh Center for Rehabilitation, Enschede, the Netherlands

    Govert J. Snoek

Authors
  1. Maarten J. IJzerman
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  2. Janine A. van Til
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  3. Govert J. Snoek
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Correspondence to Maarten J. IJzerman.

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IJzerman, M.J., van Til, J.A. & Snoek, G.J. Comparison of Two Multi-Criteria Decision Techniques for Eliciting Treatment Preferences in People with Neurological Disorders. Patient-Patient-Centered-Outcome-Res 1, 265–272 (2008). https://doi.org/10.2165/1312067-200801040-00008

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