Multi-criteria decision analysis for supporting the selection of medical devices under uncertainty

Innovative approaches to the assessment and management of medical technologies use a combination of health technology assessment (HTA) and operations research methods, specifically multiple-criteria decision analysis (MCDA). The purpose of this article is to develop methodological support and provide a theoretical justification for decision support in the selection of medical devices under conditions of uncertainty, using MRI systems as an example. The goal of the method application has been formulated as follows: determine a ranked list of MRI systems for contributory health organisations administered by regional authorities (regional hospitals) in the Czech Republic. An analytic hierarchy process (AHP) and the Delphi method were used to identify experts' preferences and for consensus building. The expert group was selected based on eight complex-valued criteria, and each expert was given a weighting factor. A set of 13 MRI systems and the 14 key default specifications that play the most important roles when hospitals select MRIs for purchase were defined. Strong conformity (W ≥ 0.6, p < 0.05) within the experts' judgments was revealed. A prediction regarding alternatives, weights and changes in priority vectors over the following 8 years has been provided. The developed approach is useful in decision support when selecting medical devices under conditions of uncertainty by hospitals.