PST11 THE USE OF MULTI-CRITERIA DECISION METHODS IN HEALTH CARE. DOES METHOD USED INFLUENCE OUTCOME?

OBJECTIVES: To investigate how the choice of multicriteria decision method influences outcome (ranking criteria and criteria weights). Population. A convenience sample of 28 subjects, 12 healthy and 16 cognitively impaired. METHODS: Based on a literature review, 5 multicriteria methods were chosen for comparison including: Kepner-tregoe analysis (KTA), simple multi attribute rating technique (SMART), SMART using swing weights (SWING), Analytic Hierarchy Process (AHP) and Conjoint Analysis (CA). Four attributes of treatment were identified (impact, duration, and end-result of treatment and associated risks). Subjects were asked to both rank and rate the importance of these attributes with each method. The order of methods was randomized and the total length of the interview was restricted to one hour. Some subjects therefore did not use all methods. Subjects were interviewed either once (n = 14) or twice (n = 14) (Only the results of the first measurement are presented) RESULTS: The highest percentages of rank reversals were found between CA and other methods (55–62%). The lowest percentage of rank reversals was between KTA and SMART (18%). The percentage of rank reversals was significantly higher in impaired population (An average of 54% compared to 36% in unimpaired population). When comparing actual weights, AHP and SMART correlate highly with all other methods except CA. CONCLUSIONS: The high percentages in rank reversal and divergent correlation between individual weights (especially CA compared to other methods) show that the method chosen influences outcome. This has to be taken into account when the ranks or weights are used in multi-criteria decision analysis to make actual treatment decisions. The dissimilar methodology of CA might explain the high percentages of rank-reversals and low correlation between this method and other. Also, the design of the survey might have influenced CA weights and ranking

User needs elicitation via analytic hierarchy process (AHP). A case study on a Computed Tomography (CT) scanner

Background: The rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital. Methods: AHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital. Results: Although safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution. Conclusions: AHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department

Higher Height, Higher Ability: Judgment Confidence as a Function of Spatial Height Perception

Based on grounded cognition theories, the current study showed that judgments about ability were regulated by the subjects' perceptions of their spatial height. In Experiment 1, we found that after seeing the ground from a higher rather than lower floor, people had higher expectations about their performance on a knowledge test and assigned themselves higher rank positions in a peer comparison evaluation. In Experiment 2, we examined the boundary conditions of the spatial height effects and showed that it could still occur even if we employed photos rather than actual building floors to manipulate the perceptions of spatial heights. In addition, Experiment 2 excluded processing style as an explanation for these observations. In Experiment 3, we investigated a potential mechanism for the spatial height effect by manipulating the scale direction in the questionnaire. Consequently, consistent with our representational dependence account, the effect of spatial heights on ability judgments was eliminated when the mental representation of ability was disturbed by a reverse physical representation. These results suggest that people's judgments about their ability are correlated with their spatial perception

Paving the path for implementation of clinical genomic sequencing globally - Are we ready?

Despite the emerging evidence in recent years, successful implementation of clinical genomic sequencing (CGS) remains limited and is challenged by a range of barriers. These include a lack of standardized practices, limited economic assessments for specific indications, limited meaningful patient engagement in health policy decision-making, and the associated costs and resource demand for implementation. Although CGS is gradually becoming more available and accessible worldwide, large variations and disparities remain, and reflections on the lessons learned for successful implementation are sparse. In this commentary, members of the Global Economics and Evaluation of Clinical Genomics Sequencing Working Group (GEECS) describe the global landscape of CGS in the context of health economics and policy and propose evidence-based solutions to address existing and future barriers to CGS implementation. The topics discussed are reflected as two overarching themes: (1) system readiness for CGS and (2) evidence, assessments, and approval processes. These themes highlight the need for health economics, public health, and infrastructure and operational considerations; a robust patient- and family-centered evidence base on CGS outcomes; and a comprehensive, collaborative, interdisciplinary approach

Augmenting Smart Buildings and Autonomous Vehicles with Wearable Thermal Technology

Smart buildings and autonomous vehicles are expected to see rapid growth and adoption in the coming decades. Americans spend over 90% of their lives in buildings or automobiles, meaning that 90% of their lives could be spent interfacing with intelligent environments. EMBR Labs has developed EMBR WaveTM, a wearable thermoelectric system, for introducing thermal sensation as a connected mode of interaction between smart environments and their occu-pants. In this paper we highlight applications of wearable thermal technology for passengers in autonomous vehicles and occupants of smart buildings. Initial find-ings, collected through partnerships with Draper and UC Berkeley, respectively, are presented that illustrate the potential for wearable thermal technology to im-prove the situational awareness of passengers in autonomous vehicles and im-prove personal comfort in smart buildings