Value in oncology from multi-criteria decision analysis: A systematic review
Main Article Content
Objective: This study aims for three purposes: a) review the published MCDAs in oncology to identify the criteria considered valuable by the stakeholders, b) evaluate the adherence to best practice recommendations, and c) Propose a value tree, based on the findings of the systematic review, reflecting the most important criteria for the different stakeholders.
Material and Methods: This systematic review consisted of the following phases: identification, screening, eligibility assessment, assessment of adherence to best practices, and extraction of the information. The identification was conducted in PUBMED, EMBASE, EBSCO, SCIENCE DIRECT, SCOPUS, LILACS, and Web of Science including records from January 1st, 1990, to February 28th, 2021. The adherence to best practices in MCDA were evaluated. A new value tree was made.
Results: Thirteen articles were included. Colon, breast, and hematological cancer were the most frequently evaluated (n=10, 69,2%). Physicians and patients were the most representative participants. The value measurement approach was the most used (n=11, 84,6%). The overall adherence rate to the recommendations was 77,3%. One hundred ninety-five criteria were identified. The relevant criteria for all stakeholders were “Improvement clinical efficacy" (24,5%), "Severity of disease" (13,5%), and "Improvement of safety & tolerability." (10,3%). The physicians valued "Improvement clinical efficacy" (28,4%), "Severity of disease" (10,5%), and "Improvement of safety & tolerability." (8,4%) The most relevant criterion for the patients was "Severity of disease" (34,4%), "Improvement of clinical efficacy." (24,1%), and "Improvement of perceived health status" (13,8%). The significant criteria for administrative and academics were "Innovativeness of intervention" (37%) and "Improvement clinical efficacy" (14,8%).
Conclusion: The number of MCDAs in oncology is scarce and with moderate adherence to best practice recommendations. A value tree based on relevant criteria was proposed.
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