Dowie Jack, Kjer Kaltoft Mette, Salkeld Glenn, Cunich Michelle
London School of Hygiene and Tropical Medicine, London, UK.
Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Health Expect. 2015 Oct;18(5):689-702. doi: 10.1111/hex.12111. Epub 2013 Aug 2.
To introduce a new online generic decision support system based on multicriteria decision analysis (MCDA), implemented in practical and user-friendly software (Annalisa©).
All parties in health care lack a simple and generic way to picture and process the decisions to be made in pursuit of improved decision making and more informed choice within an overall philosophy of person- and patient-centred care.
The MCDA-based system generates patient-specific clinical guidance in the form of an opinion as to the merits of the alternative options in a decision, which are all scored and ranked. The scores for each option combine, in a simple expected value calculation, the best estimates available now for the performance of those options on patient-determined criteria, with the individual patient's preferences, expressed as importance weightings for those criteria. The survey software within which the Annalisa file is embedded (Elicia©) customizes and personalizes the presentation and inputs. Principles relevant to the development of such decision-specific MCDA-based aids are noted and comparisons with alternative implementations presented. The necessity to trade-off practicality (including resource constraints) with normative rigour and empirical complexity, in both their development and delivery, is emphasized.
The MCDA-/Annalisa-based decision support system represents a prescriptive addition to the portfolio of decision-aiding tools available online to individuals and clinicians interested in pursuing shared decision making and informed choice within a commitment to transparency in relation to both the evidence and preference bases of decisions. Some empirical data establishing its usability are provided.
介绍一种基于多标准决策分析（MCDA）的新型在线通用决策支持系统，该系统通过实用且用户友好的软件（Annalisa©）实现。
医疗保健领域的各方都缺乏一种简单通用的方法来描绘和处理为追求改善决策以及在以人为本和以患者为中心的整体护理理念下做出更明智选择而需做出的决策。
基于MCDA的系统以对决策中替代选项优点的意见形式生成针对患者的临床指导，所有选项都进行评分和排名。在简单的期望值计算中，每个选项的分数将目前对这些选项在患者确定标准上表现的最佳估计与个体患者的偏好相结合，患者偏好以这些标准的重要性权重表示。嵌入Annalisa文件的调查软件（Elicia©）对展示和输入进行定制和个性化设置。记录了与开发此类基于决策的特定MCDA辅助工具相关的原则，并与其他实现方式进行了比较。强调了在开发和交付过程中在实用性（包括资源限制）与规范性严谨性和实证复杂性之间进行权衡的必要性。
基于MCDA/Annalisa的决策支持系统是对在线决策辅助工具组合中的规范性补充，可供个人和临床医生使用，他们致力于在决策的证据和偏好基础方面保持透明性以追求共同决策和明智选择。提供了一些证明其可用性的实证数据。
