The Expert Perspective in Treatment of Functional Gastrointestinal Conditions: A Multi-Criteria Decision Analysis Using AHP and BWS

摘要

Objectives The aim of this study was to identify and weight the expert's relevant decision criteria with regard to drug treatment of functional dyspepsia and motility disorders. Attributes such as onset of action, reduction of symptoms and side effects were to be examined in order to test their relevance to healthcare decision makers. Moreover, the objective was to verify the extent to which the analytic hierarchy process (AHP) and best-worst scaling (BWS) are suitable for use in context of an expert panel. Method In order to identify patient-relevant therapy characteristics, a literature search and qualitative interviews were conducted. On this basis, a questionnaire was developed using multi-criteria decision analysis. By means of the AHP and BWS, the study elicited the experts' priorities as regards the various aspects of treatments and gastrointestinal symptoms. The data collection from experts in gastroenterology was performed in real time within a group discussion using an item-response system. Results As a result of the interviews, seven characteristics and 10 symptoms were established. A total of N = 20 experts took part in the survey. The following criteria were shown to be the most relevant in the AHP: 'reduction of abdominal cramps' (w: 0.302), 'reduction of epigastric pain' (w: 0.250) and 'time to onset of action' (w: 0.117). In the BWS, it was shown that the gastrointestinal symptoms 'vomiting' (sqrt(b/w): 0.118), 'abdominal cramps' (sqrt(b/w): 0.157) and 'epigastric pain' (sqrt(b/w): 0.356) were the most significant. Discussion The methods represent a suitable and scientifically transparent approach for the elicitation of experts' priorities. Using AHP, it was possible to ascertain the most important aspects of drug treatment and to correlate positive and negative characteristics. The BWS showed which gastrointestinal symptoms had the least and most pronounced negative impact on patient well-being from expert perspective. The item-response system served as a valuable instrument to collect data based on a group discussion.