Hancerliogullari Gulsah, Hancerliogullari Kadir Oymen, Koksalmis Emrah
School of Management, Centre of Operational Research, Management Sciences & Information Systems, University of Southampton, Southampton, UK.
Department of Industrial Engineering, Faculty of Management, Istanbul Technical University, Istanbul, Turkey.
BMC Med Inform Decis Mak. 2017 Jan 23;17(1):14. doi: 10.1186/s12911-017-0409-5.
Determining the most suitable anesthesia method for circumcision surgery plays a fundamental role in pediatric surgery. This study is aimed to present pediatric surgeons' perspective on the relative importance of the criteria for selecting anesthesia method for circumcision surgery by utilizing the multi-criteria decision making methods.
Fuzzy set theory offers a useful tool for transforming linguistic terms into numerical assessments. Since the evaluation of anesthesia methods requires linguistic terms, we utilize the fuzzy Analytic Hierarchy Process (AHP) and fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). Both mathematical decision-making methods are originated from individual judgements for qualitative factors utilizing the pair-wise comparison matrix. Our model uses four main criteria, eight sub-criteria as well as three alternatives. To assess the relative priorities, an online questionnaire was completed by three experts, pediatric surgeons, who had experience with circumcision surgery.
Discussion of the results with the experts indicates that time-related factors are the most important criteria, followed by psychology, convenience and duration. Moreover, general anesthesia with penile block for circumcision surgery is the preferred choice of anesthesia compared to general anesthesia without penile block, which has a greater priority compared to local anesthesia under the discussed main-criteria and sub-criteria.
The results presented in this study highlight the need to integrate surgeons' criteria into the decision making process for selecting anesthesia methods. This is the first study in which multi-criteria decision making tools, specifically fuzzy AHP and fuzzy TOPSIS, are used to evaluate anesthesia methods for a pediatric surgical procedure.
确定包皮环切手术最合适的麻醉方法在小儿外科手术中起着基础性作用。本研究旨在通过运用多标准决策方法，呈现小儿外科医生对于包皮环切手术麻醉方法选择标准相对重要性的观点。
模糊集理论为将语言术语转化为数值评估提供了有用工具。由于麻醉方法的评估需要语言术语，我们运用模糊层次分析法（AHP）和模糊理想解相似排序法（TOPSIS）。这两种数学决策方法均源自利用成对比较矩阵对定性因素的个人判断。我们的模型使用四个主要标准、八个子标准以及三个备选方案。为评估相对优先级，三位有包皮环切手术经验的小儿外科专家完成了一份在线问卷。
与专家对结果的讨论表明，与时间相关的因素是最重要的标准，其次是心理、便利性和持续时间。此外，与无阴茎阻滞的全身麻醉相比，包皮环切手术采用阴茎阻滞的全身麻醉是首选的麻醉方式，在讨论的主要标准和子标准下，其优先级高于局部麻醉。
本研究呈现的结果凸显了将外科医生的标准纳入麻醉方法选择决策过程的必要性。这是第一项使用多标准决策工具，特别是模糊AHP和模糊TOPSIS来评估小儿外科手术麻醉方法的研究。
