Metachoice for Benchmarking: a case study

Purpose-In a previous paper the authors emphasized the advantages of multicriteria methodologies to evaluate business performance. The purpose of this paper is to highlight the metachoice problem that always arises in a benchmark multicriteria analysis that can be synthesized as follows: “how to choose an algorithm to choose?” Design/methodology/approach-In order to perform a benchmark analysis, a set of criteria must be chosen. In the Balanced Scorecard approach, for example, key performance indicators (KPIs) are grouped in four different perspectives: Financial, customer, internal processes and learning and growth. In this paper, the authors focus on multicriteria benchmark analysis applied to KPIs of the financial perspective. The paper considers a set of criteria used in financial statement analysis based on balance sheet, income statement and cash flow statement. A case study is described. Findings-The main findings of the paper are when the evaluation of a firm is based on different genuine criteria, a metachoice problem arises: Multicriteria ranking algorithms cannot be selected using a multicriteria algorithm; the choice of an algorithm ultimately depends on the subjective preference of the policy maker; and the authors metachoice solution to the benchmarking problem is in accordance with Simon’s satisfacing solution, describing a non-maximizing performance measurement methodology. Practical implications-The paper provides several practical implications in all cases in which a ranking has to be assigned to a group of firms based on financial performances. More in general the problem is very relevant when a ranking has to be carried out with respect to a set of projects, a set of strategies, a set of organizational units, etc. Originality/value-The adoption of a set of criteria is certainly an advantage to avoid uni-criterial myopic evaluation. However, this also creates some methodological problems. The paper demonstrates the “relativity” (subjectivity) of results of the evaluation process when there are many evaluation criteria, as in a benchmark context. This is a metachoice problem that cannot be solved by using another multicriteria algorithm. © Emerald Group Publishing Limited

Pulmonary atelectasis during paediatric anaesthesia: CT scan evaluation and effect of positive endexpiratory pressure (PEEP).

The case series consisted of ten children, ranged in age from one to three years (median 1.8 yrs), and in body weight from 10.2 to 13.5 kg (median 11.7 kg), in ASA class 1 or 2, all without lung disease. Having undergone general anaesthesia for cranial or abdominal CT scans, the patients were studied for pulmonary morphology. The first pulmonary CT scan was taken five min after induction of general inhalational anaesthesia; preoxygenation was avoided and an intraoperative F(i)O 2≤0.4 was used. Densities in dependent regions of both lungs were observed in all children. After ventilation with PEEP of 5 cmH 2O, all the observed densities disappeared without impairment of heart rate, blood pressure, haemoglobin saturation and endtidal CO 2 (P(E)CO 2). We conclude that the appearance in children of atelectasis cannot be explained by a reabsorption of O 2 mechanism and by denitrogenation. However, a PEEP of 5 cmH 2O is able both to recruit all the available alveolar units, and to induce the disappearance of atelectasis in dependent lung regions