Multi–Criteria–Decision–Analysis (MCDA) for the Horizon Scanning of Health Innovations an Application to COVID 19 Emergency

Abstract

Aim: In this article, we aim to present a tool for the early assessment of medical technologies. This evaluation system was designed and implemented by the National Centre for HTA and the National Centre for Innovative Technologies of the Istituto Superiore di Sanita, Italy, in order to respond to an institutional commitment within the “Health Technologies Assessment Team” that was established to face the huge demand for the evaluation of Health Technologies during the pandemic event caused by COVID-19, with a smart and easy-to-use framework. Methods: Horizon scanning was conducted through a brief assessment carried out according to the multicriteria decision analysis methodology. Each HTA domain was attributed a score according to a pros/cons and opportunities/threats system, derived from evidence in the literature. Scores were weighted according to different perspectives. Scores were presented in a Cartesian graph showing the positioning according to the potential value and the perceived risk associated with the technology. Results: Two case studies regarding the early assessment were reported, concerning two specific technologies: an individual protection device and a contact tracking system.

Towards a New System for the Assessment of the Quality in Care Pathways: An Overview of Systematic Reviews

“…In our case, it is necessary to evaluate a complex process, which takes into account the different approaches available in the literature, integrated with each other, as described in Figure 4 . This multi-principle framework proposal ( Figure 4 ) arises from the Donabedian model [ 23 ] integrated with that of HTA [ 42 ], The Leuven Clinical Pathway Compass [ 22 ], and RMIC-MT [ 33 ], adapted to the health service model in each country. This proposal could guide the construction of a multi-criteria model to define a gold standard and related indicators for assessment of CP/ICP, in its completeness and complexity.…”

“…About the results of the classification of the indicators according to Donabedian, it emerged that the process and outcome indicators are more sensitive to the clinical conditions or settings (medical or surgical) than the structural indicators, which can be more easily standardized. Moreover, HTA represents an accurate methodological framework aimed at rationalizing the allocation of a care pathway, through the provision of information regarding the effectiveness, safety, and use of health technologies, as well as ethical, societal, and organizational domains [ 42 ].…”

Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures

“…These scores ranged on a Likert scale from -10 (minimum added value or minimum risk) to +10 (which corresponded to the maximum added value or maximum risk) [ 9 ]. Then, a scatterplot graph was drawn.…”

“…At the time of writing this manuscript, the number of reported cases is still among the highest in Europe [ 5 ]. Since the beginning of the pandemic, the number of cases in the country has been over 4,130,000, with, unfortunately, more than 122,000 deaths [ 6 , 7 , 8 , 9 , 10 ]. The reason for this public health failure was mainly related to a fragmentation of the decision-making process, with a lack of a strong, nationally centralized response to the emergency [ 11 ].…”

How can health technology assessment support our response to public health emergencies?

“…These are based on a three-part webinar series titled "Knowledge Exchange in the time of COVID-19: Using Evidence to Address Health Care Challenges in Low-and Middle-Income Countries" organized by the Access and Delivery Partnership (ADP) and the Health Intervention and Technology Assessment Program (HITAP) [12]. The knowledge gained from the webinar series as well as literature showcasing the value of HTAs in informing policy decisions [13][14][15] inspires our call for strengthening HTA processes and their institutionalization to address ongoing and future prioritization issues.…”