The Triads Geometric Consistency Index in AHP-Pairwise Comparison Matrices

The paper presents the Triads Geometric Consistency Index (T-GCI), a measure for evaluating the inconsistency of the pairwise comparison matrices employed in the Analytic Hierarchy Process (AHP). Based on the Saaty''s definition of consistency for AHP, the new measure works directly with triads of the initial judgements, without having to previously calculate the priority vector, and therefore is valid for any prioritisation procedure used in AHP. The T-GCI is an intuitive indicator defined as the average of the log quadratic deviations from the unit of the intensities of all the cycles of length three. Its value coincides with that of the Geometric Consistency Index (GCI) and this allows the utilisation of the inconsistency thresholds as well as the properties of the GCI when using the T-GCI. In addition, the decision tools developed for the GCI can be used when working with triads (T-GCI), especially the procedure for improving the inconsistency and the consistency stability intervals of the judgements used in group decision making. The paper further includes a study of the computational complexity of both measures (T-GCI and GCI) which allows selecting the most appropriate expression, depending on the size of the matrix. Finally, it is proved that the generalisation of the proposed measure to cycles of any length coincides with the T-GCI. It is not therefore necessary to consider cycles of length greater than three, as they are more complex to obtain and the calculation of their associated measure is more difficult

AHP-group decision making based on consistency

The Precise consistency consensus matrix (PCCM) is a consensus matrix for AHP-group decision making in which the value of each entry belongs, simultaneously, to all the individual consistency stability intervals. This new consensus matrix has shown significantly better behaviour with regards to consistency than other group consensus matrices, but it is slightly worse in terms of compatibility, understood as the discrepancy between the individual positions and the collective position that synthesises them. This paper includes an iterative algorithm for improving the compatibility of the PCCM. The sequence followed to modify the judgments of the PCCM is given by the entries that most contribute to the overall compatibility of the group. The procedure is illustrated by means of its application to a real-life situation (a local context) with three decision makers and four alternatives. The paper also offers, for the first time in the scientific literature, a detailed explanation of the process followed to solve the optimisation problem proposed for the consideration of different weights for the decision makers in the calculation of the PCCM

Patient involvement in clinical research: Why, when, and how

The development of a patient-centered approach to medicine is gradually allowing more patients to be involved in their own medical decisions. However, this change is not happening at the same rate in clinical research, where research generally continues to be carried out on patients, but not with patients. This work describes the why, when, and how of more active patient participation in the research process. Specific measures are proposed to improve patient involvement in 1) setting priorities, 2) study leadership and design, 3) improved access to clinical trials, 4) preparation and oversight of the information provided to participants, 5) post-study evaluation of the patient experience, and 6) the dissemination and application of results. In order to achieve these aims, the relative emphases on the ethical principles underlying research need to be changed. The current model based on the principle of beneficence must be left behind, and one that upholds the ethical principles of autonomy and non maleficence should be embraced. There is a need to improve the level of information that patients and society as a whole have on research objectives and processes; the goal is to promote the gradual emergence of the expert patient

Assessing Value-based Health Care Delivery for Hemodialysis

Rationale, aims and objectives Disparities in haemodialysis outcomes among centres have been well-documented. Besides, attempts to assess haemodialysis results have been based on non-comprehensive methodologies. This study aimed to develop a comprehensive methodology for assessing haemodialysis centres, based on the value of health care. The value of health care is defined as the patient benefit from a specific medical intervention per monetary unit invested (Value = Patient Benefit/Cost). This study assessed the value of health care and ranked different haemodialysis centres. Method A nephrology quality management group identified the criteria for the assess- ment. An expert group composed of stakeholders (patients, clinicians and managers) agreed on the weighting of each variable, considering values and preferences. Multi-criteria methodology was used to analyse the data. Four criteria and their weights were identified: evidence-based clinical performance measures = 43 points; yearly mortality = 27 points; patient satisfaction = 13 points; and health-related quality of life = 17 points (100-point scale). Evidence-based clinical performance measures included five sub-criteria, with respective weights, including: dialysis adequacy; haemoglobin concentration; mineral and bone disorders; type of vascular access; and hospitalization rate. The patient benefit was determined from co-morbidity–adjusted results and corresponding weights. The cost of each centre was calculated as the average amount expended per patient per year. Results The study was conducted in five centres (1–5). After adjusting for co-morbidity, value of health care was calculated, and the centres were ranked. A multi-way sensitivity analysis that considered different weights (10–60% changes) and costs (changes of 10% in direct and 30% in allocated costs) showed that the methodology was robust. The rankings: 4-5-3-2-1 and 4-3-5-2-1 were observed in 62.21% and 21.55%, respectively, of simula- tions, when weights were varied by 60%. Conclusions Value assessments may integrate divergent stakeholder perceptions, create a context for improvement and aid in policy-making decisions

Analysis of pairwise comparison matrices: an empirical research

Pairwise comparison (PC) matrices are used in multi-attribute decision problems (MADM) in order to express the preferences of the decision maker. Our research focused on testing various characteristics of PC matrices. In a controlled experiment with university students (N = 227) we have obtained 454 PC matrices. The cases have been divided into 18 subgroups according to the key factors to be analyzed. Our team conducted experiments with matrices of different size given from different types of MADM problems. Additionally, the matrix elements have been obtained by different questioning procedures differing in the order of the questions. Results are organized to answer five research questions. Three of them are directly connected to the inconsistency of a PC matrix. Various types of inconsistency indices have been applied. We have found that the type of the problem and the size of the matrix had impact on the inconsistency of the PC matrix. However, we have not found any impact of the questioning order. Incomplete PC matrices played an important role in our research. The decision makers behavioral consistency was as well analyzed in case of incomplete matrices using indicators measuring the deviation from the final order of alternatives and from the final score vector

The rank reversal problem in multi-criteria decision making : a literature review

Despite the importance of multicriteria decision-making (MCDM) techniques for constructing effective decision models, there are many criticisms due to the occurrence of a problem called rank reversal. Nevertheless, there is a lack of a systematic literature review on this important subject which involves different methods. This study reviews the pertinent literature on rank reversal, based on 130 related articles published from 1980 to 2015 in international journals, which were gathered and analyzed according to the following perspectives: multicriteria technique, year and journal in which the papers were published, co-authorship network, rank reversal types, and research goal. Thus our survey provides recommendations for future research, besides useful information and knowledge regarding rank reversal in the MCDM field

Patient involvement in clinical research: why, when, and how

José A Sacristán,1 Alfonso Aguarón,2 Cristina Avendaño-Solá,3 Pilar Garrido,4 Juan Carrión,5 Alipio Gutiérrez,6 Robert Kroes,7 Angeles Flores11Medical Department, Lilly Spain, 2Myeloma Patients Europe, 3Research Ethics Committee, University Hospital Puerta de Hierro, 4Oncology Department, Hospital Ramón y Cajal, 5FEDER (Spanish Federation for Rare Diseases), 6National Association of Health Journalists, Madrid, Spain; 7Clinical Open Innovation, Lilly Europe, Amsterdam, the Netherlands Abstract: The development of a patient-centered approach to medicine is gradually allowing more patients to be involved in their own medical decisions. However, this change is not happening at the same rate in clinical research, where research generally continues to be carried out on patients, but not with patients. This work describes the why, when, and how of more active patient participation in the research process. Specific measures are proposed to improve patient involvement in 1) setting priorities, 2) study leadership and design, 3) improved access to clinical trials, 4) preparation and oversight of the information provided to participants, 5) post-study evaluation of the patient experience, and 6) the dissemination and application of results. In order to achieve these aims, the relative emphases on the ethical principles underlying research need to be changed. The current model based on the principle of beneficence must be left behind, and one that upholds the ethical principles of autonomy and non maleficence should be embraced. There is a need to improve the level of information that patients and society as a whole have on research objectives and processes; the goal is to promote the gradual emergence of the expert patient.Keywords: patients, research, clinical trials, bioethics, engagemen

Growth factor priming differentially modulates components of the extracellular matrix proteome in chondrocytes and synovium-derived stem cells.

To make progress in cartilage repair it is essential to optimize protocols for two-dimensional cell expansion. Chondrocytes and SDSCs are promising cell sources for cartilage repair. We previously observed that priming with a specific growth factor cocktail (1 ng/mL transforming growth factor-β1, 5 ng/mL basic fibroblast growth factor, and 10 ng/mL platelet-derived growth factor-BB) in two-dimensional culture, led to significant improvement in mechanical and biochemical properties of synovium-derived stem cell (SDSC)-seeded constructs. The current study assessed the effect of growth factor priming on the proteome of canine chondrocytes and SDSCs. In particular, growth factor priming modulated the proteins associated with the extracellular matrix in two-dimensional cultures of chondrocytes and SDSCs, inducing a partial dedifferentiation of chondrocytes (most proteins associated with cartilage were down-regulated in primed chondrocytes) and a partial differentiation of SDSCs (some collagen-related proteins were up-regulated in primed SDSCs). However, when chondrocytes and SDSCs were grown in pellet culture, growth factor-primed cells maintained their chondrogenic potential with respect to glycosaminoglycan and collagen production. In conclusion, the strength of the label-free proteomics technique is that it allows for the determination of changes in components of the extracellular matrix proteome in chondrocytes and SDSCs in response to growth factor priming, which could help in future tissue engineering strategies