Danner Marion, Vennedey Vera, Hiligsmann Mickaël, Fauser Sascha, Gross Christian, Stock Stephanie
Institute for Health Economics and Clinical Epidemiology, Cologne University Hospital, Gleueler Straße 176-178, 50935, Cologne, Germany.
Department of Health Services Research, CAPHRI School for Primary Care and Public Health, Maastricht University, Maastricht, The Netherlands.
Patient. 2016 Oct;9(5):481-92. doi: 10.1007/s40271-016-0179-7.
In this study, we tested the feasibility of an interviewer-assisted analytic hierarchy process (AHP) in a special patient population with age-related macular degeneration (AMD).
One aim was to generate preference weights regarding AMD treatment characteristics. A secondary aim was to explore the consistency of preference judgments and reasons for inconsistency.
We generated quantitative importance weights for decision criteria using the matrix multiplication method. A qualitative study component in the form of asking patients to think aloud throughout their judgments was implemented to facilitate understanding of quantitative findings. Consistency ratios were calculated as a measure of logical judgment performance within AHP. If consistency ratios exceeded 0.2, we explored reasons for inconsistency.
We interviewed 86 patients and generated preference weights for criteria. Patients rated the injection's effect on visual function the highest (0.44), followed by the frequency of monitoring visits (0.18), approval status (0.13), injection frequency (0.13), and side effects (0.12). Inconsistency in judgments was prevalent at the subcriteria level. Whereas much of the observed inconsistency was due to an excessive use of high/extreme value judgments, these judgments seemed to result from patients reasonably trying to highlight their strong preferences.
Our study combines quantitative with qualitative data to explore patients' preference weights and decision processes using the AHP. It suggests that the type of inconsistency observed in judgments of AMD patients mostly results from rational decision making, not from error or lack of understanding. Further research should address which type and extent of inconsistency might be acceptable in different AHP settings.
在本研究中，我们测试了访谈者辅助层次分析法（AHP）在年龄相关性黄斑变性（AMD）特殊患者群体中的可行性。
一个目标是生成关于AMD治疗特征的偏好权重。第二个目标是探索偏好判断的一致性以及不一致的原因。
我们使用矩阵乘法方法为决策标准生成定量重要性权重。实施了一项定性研究，要求患者在整个判断过程中边思考边说，以促进对定量结果的理解。计算一致性比率作为层次分析法中逻辑判断性能的一种度量。如果一致性比率超过0.2，我们会探究不一致的原因。
我们采访了86名患者并生成了标准的偏好权重。患者对注射对视觉功能的影响评价最高（0.44），其次是监测访视频率（0.18）、批准状态（0.13）、注射频率（0.13）和副作用（0.12）。在子标准层面，判断不一致很普遍。虽然观察到的大部分不一致是由于过度使用高/极端值判断，但这些判断似乎是患者合理地试图突出他们强烈的偏好所致。
我们的研究结合定量和定性数据，使用层次分析法探索患者的偏好权重和决策过程。这表明在AMD患者判断中观察到的不一致类型大多源于理性决策，而非错误或理解不足。进一步的研究应探讨在不同的层次分析法设置中哪种类型和程度的不一致可能是可接受的。
