Der Analytic Hierarchy Process (AHP): Eine Methode zur Entscheidungsunterstützung im Gesundheitswesen

Abstract

Regulatory decision bodies and clinical decision-makers have to decide on the approval, pricing and individualized treatment of patients. This decision is based on the assessment of the risk-benefit or cost-benefit ratios. The assessment of benefits often relies on multiple patient-relevant endpoints. Thereby the results of the clinical effects can be contrary. The more endpoints and the more heterogeneous the results, the more complex is the decision-making. The Analytic Hierarchy Process (AHP) is proposed to solve this problem by weighting multiple decision criteria. The aim of the systematic review was to analyze how the AHP can be used for decision-making in health care in terms of the prioritization of patient-relevant outcomes. Based on a systematic literature review, the study design of the AHP method, applicability and possible limitations for the weighting of patient-relevant outcomes are reported and discussed. The methodological principles are presented and specific concerns during implementation and due to the eigenvalue approach are analyzed. The AHP is suitable to structure group decisions of e.g. different providers, for the management of organizations or the transparent decision-making in regulatory decision bodies. The weakness of AHP is his problematic applicability within large patient populations and the documentation of their preferences. In the future it should be decided to what extent the methodological limitations of the AHP ask for the use of other stated preferences techniques.

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