1. Alejandra Duenas ScHARR
Is multi-criteria decision analysis applicable to public health decision making?
Alejandra Duenas
ScHARR

2. Outline What does NICE do? Developing NICE public health guidance
Multi-criteria decision aid methods (MCDA)
MCDA in public health
Future work
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3. National Institute for Health and Clinical Excellence (NICE)
“NICE is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health. NICE produces four types of guidance: technology appraisal guidance, clinical guidelines, interventional procedure guidance and public health guidance.”
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4. Examples of areas of public health
Prevention and early identification of alcohol-use disorders in adults and young people
Interventions for looked after children and young people
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5. Intervention/programme guidance development stages
Scoping
Development
Validation
Publication
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6. Aim of the scope clear definition of the intervention/programme
background information
what to exclude
settings, practitioners and public health services
guidance is responsive to public health policy and practice
key questions for guidance development
ensure guidance can be completed
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7. Development Public Health Collaborating Centre (ScHARR):
evidence reviews
economic analysis
stakeholders submit additional evidence (4 weeks)
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8. Stakeholders draft scope synopsis of the reviews and economic analysis
draft recommendations
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9. Public Health Interventions Advisory Committee
considers and interprets effectiveness and cost effectiveness evidence
formulates recommendations (public health interventions):
NHS
local government
public health in England
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10. Public Health Interventions Advisory Committee
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11. Programme Development Group
considers and interprets effectiveness and cost effectiveness evidence
formulates recommendations (public health programmes):
NHS
local government
public health in England
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12. Programme Development Group
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13. Guidance summary of evidence main conclusions overview of methodology
recommendations for practice and research
synopsis of evidence (evidence reviews and economic analysis)
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14. Guidance (cont) reviews of the evidence and economic analysis
field work report
implementation materials
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15. Multi-criteria decision aid methods
UTilities Additives DIScriminantes (UTADIS)
Analytic Hierarchy Process (AHP)
Outranking methods
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16. Multi-criteria decision aid methods
AHP - Example
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17. Multi-criteria decision aid (MCDA)
4 different decision problems:
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18. MCDA description ranking sorting choice 13/11/2018
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19. MCDA description ranking sorting choice 13/11/2018
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20. MCDA description ranking sorting choice 13/11/2018
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21. MCDA description ranking sorting choice 13/11/2018
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22. Example
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23. Example
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24. MCDA in public health To map the multitude of components:
decision maker (DM)
stakeholders
objectives
environment
alternative courses of action public health
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25. MCDA in public health
Articulation of the DM's preferences considering:
goals
aspiration levels
mechanisms for overcoming barriers and constraints
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26. MCDA in public health
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27. DM’s preferences
Membership function of fuzzy individual schedule fitness:
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28. Aspiration levels
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29. Fitness function definition
Fuzzy set A = acceptable distance between the objective value and the aspiration level
The membership function A represents the degree to which an achieved objective value satisfies the DM with respect to its distance from the aspiration level ALn.
A ( ) 1
0.5 
0.5
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30. Fitness function definition
linguistically quantified statement = “most distances between the achieved objective values and the aspiration levels are acceptable”
“Q ’s are A”
Fitness function D is defined as:
D(xv) = Truth[“Q ’s are A”] = Q( )  [0, 1]
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31. Fitness function definition
Yager’s algebraic approach:
For the quantifier “most”:
Q( ) =
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32. Fitness function definition
Find that maximises the degree of truth of the linguistically quantified fitness function:
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33. Group Decision Making
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34. Future work Analyse how to include uncertainty
Analyse the group accordance
Incorporate MCDA to public health decision making
13/11/2018
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