- مبلغ: ۸۶,۰۰۰ تومان
- مبلغ: ۹۱,۰۰۰ تومان
Health technology assessments (HTAs) are often difficult to conduct because of the decisive procedures of the HTA algorithm, which are often complex and not easy to apply. Thus, their use is not always convenient or possible for the assessment of technical requests requiring a multidisciplinary approach. This paper aims to address this issue through a multi-criteria analysis focusing on the analytic hierarchy process (AHP). This methodology allows the decision maker to analyse and evaluate different alternatives and monitor their impact on different actors during the decision-making process. However, the multi-criteria analysis is implemented through a simulation model to overcome the limitations of the AHP methodology. Simulations help decision-makers to make an appropriate decision and avoid unnecessary and costly attempts. Finally, a decision problem regarding the evaluation of two health technologies, namely, the evaluation of two biological prostheses for incisional infected hernias, will be analysed to assess the effectiveness of the model.
A particularly strict application was considered as a case study here, as the system was tested on the evaluation of biomedical equipment technology (using a target for this type of method) but for a more complex choice of technologies related to biological prostheses that can look highly similar to each other. However, they are then applied using a simulation model that shows many different aspects that an initial analysis can overlook but which are crucial to the final decision. The complexity of the case study was demonstrated, especially in terms of the differentiation between different dynamic biomedical systems and operating procedures. This model was shown to be advantageous in terms of the stability of the results (avoiding the use of calculating average trends in the simulation period). The most interesting result was the discrepancy in the result obtained by the application of the AHP in a static environment.
Further advancements for the simulation model can also be considered, which will focus on connections, through the use of appropriate feedback, not only between different sub-criteria belonging to a given criterion but between all elements of the hierarchy through analysis of a network structure typical of the ANP and a methodology implemented by Saaty to overcome some gaps of the AHP. The model was found to be effective, having demonstrated its ability to overturn the results of the static AHP. However, generally the HTA is context specific. Therefore, the issues addressed in this paper are related to the context under investigation. The results of this application cannot be generalized for criterion implications. Other numerous factors (e.g., demographic considerations) should be taken into consideration to generalize the results. Another limitation of this methodology which affects the generalization of the results is represented by the involvement of human in the decision-making process.