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Applying multiple criteria decision analysis to comparative benefit-risk assessment: choosing among statins in primary prevention

Tervonen, Tommi, Naci, Huseyin, van Valkenhoef, Gert, Ades, Anthony E., Angelis, Aris ORCID: 0000-0002-0261-4634, Hillege, Hans L. and Postmus, Douwe (2015) Applying multiple criteria decision analysis to comparative benefit-risk assessment: choosing among statins in primary prevention. Medical Decision Making, 35 (7). pp. 859-871. ISSN 0272-989X

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Identification Number: 10.1177/0272989X15587005


Decision makers in different health care settings need to weigh the benefits and harms of alternative treatment strategies. Such health care decisions include marketing authorization by regulatory agencies, practice guideline formulation by clinical groups, and treatment selection by prescribers and patients in clinical practice. Multiple criteria decision analysis (MCDA) is a family of formal methods that help make explicit the tradeoffs that decision makers accept between the benefit and risk outcomes of different treatment options. Despite the recent interest in MCDA, certain methodological aspects are poorly understood. This paper presents 7 guidelines for applying MCDA in benefitrisk assessment and illustrates their use in the selection of a statin drug for the primary prevention of cardiovascular disease. We provide guidance on the key methodological issues of how to define the decision problem, how to select a set of nonoverlapping evaluation criteria, how to synthesize and summarize the evidence, how to translate relative measures to absolute ones that permit comparisons between the criteria, how to define suitable scale ranges, how to elicit partial preference information from the decision makers, and how to incorporate uncertainty in the analysis. Our example on statins indicates that fluvastatin is likely to be the most preferred drug by our decision maker and that this result is insensitive to the amount of preference information incorporated in the analysis.

Item Type: Article
Official URL:
Additional Information: © 2015 The Authors
Divisions: Social Policy
LSE Health
Subjects: R Medicine > R Medicine (General)
Date Deposited: 29 May 2015 08:54
Last Modified: 20 Oct 2021 02:16

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