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Multi-criteria decision analysis for health technology assessment: addressing methodological challenges to improve the state of the art

Monica Oliveira (), Inês Mataloto and Panos Kanavos
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Inês Mataloto: Universidade de Lisboa
Panos Kanavos: LSE Health London School of Economics and Political Science

The European Journal of Health Economics, 2019, vol. 20, issue 6, No 10, 918 pages

Abstract: Abstract Background Multi-criteria decision analysis (MCDA) concepts, models and tools have been used increasingly in health technology assessment (HTA), with several studies pointing out practical and theoretical issues related to its use. This study provides a critical review of published studies on MCDA in the context of HTA by assessing their methodological quality and summarising methodological challenges. Methods A systematic review was conducted to identify studies discussing, developing or reviewing the use of MCDA in HTA using aggregation approaches. Studies were classified according to publication time and type, country of study, technology type and study type. The PROACTIVE-S approach was constructed and used to analyse methodological quality. Challenges and limitations reported in eligible studies were collected and summarised; this was followed by a critical discussion on research requirements to address the identified challenges. Results 129 journal articles were eligible for review, 56% of which were published in 2015–2017; 42% focused on pharmaceuticals; 36, 26 and 18% reported model applications, issues regarding MCDA implementation analyses, and proposing frameworks, respectively. Poor compliance with good methodological practice (

Keywords: Multi-criteria decision analysis; Health technology assessment; Systematic review; Methodological quality; Methodological challenges; MCDA modelling (search for similar items in EconPapers)
JEL-codes: I I10 I18 C44 D80 (search for similar items in EconPapers)
Date: 2019
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DOI: 10.1007/s10198-019-01052-3

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