Saint-Hilary Gaelle, Cadour Stephanie, Robert Veronique, Gasparini Mauro
Dipartimento di Scienze Matematiche (DISMA) Giuseppe Luigi Lagrange, Politecnico di Torino, Torino, Italy.
Department of Biostatistics, Institut de Recherches Internationales Servier (IRIS), Suresnes, France.
Biom J. 2017 May;59(3):567-578. doi: 10.1002/bimj.201600113. Epub 2017 Feb 10.
Quantitative methodologies have been proposed to support decision making in drug development and monitoring. In particular, multicriteria decision analysis (MCDA) and stochastic multicriteria acceptability analysis (SMAA) are useful tools to assess the benefit-risk ratio of medicines according to the performances of the treatments on several criteria, accounting for the preferences of the decision makers regarding the relative importance of these criteria. However, even in its probabilistic form, MCDA requires the exact elicitations of the weights of the criteria by the decision makers, which may be difficult to achieve in practice. SMAA allows for more flexibility and can be used with unknown or partially known preferences, but it is less popular due to its increased complexity and the high degree of uncertainty in its results. In this paper, we propose a simple model as a generalization of MCDA and SMAA, by applying a Dirichlet distribution to the weights of the criteria and by making its parameters vary. This unique model permits to fit both MCDA and SMAA, and allows for a more extended exploration of the benefit-risk assessment of treatments. The precision of its results depends on the precision parameter of the Dirichlet distribution, which could be naturally interpreted as the strength of confidence of the decision makers in their elicitation of preferences.
已提出定量方法来支持药物研发和监测中的决策制定。特别是,多标准决策分析(MCDA)和随机多标准可接受性分析(SMAA)是根据治疗在多个标准上的表现来评估药物效益风险比的有用工具,同时考虑了决策者对这些标准相对重要性的偏好。然而,即使是概率形式的MCDA也要求决策者精确确定标准的权重,而这在实践中可能难以实现。SMAA具有更大的灵活性,可以在偏好未知或部分已知的情况下使用,但由于其复杂性增加和结果的高度不确定性,它不太受欢迎。在本文中,我们提出了一个简单模型,作为MCDA和SMAA的推广,通过将狄利克雷分布应用于标准权重并使其参数变化。这个独特的模型既可以拟合MCDA也可以拟合SMAA,并允许对治疗的效益风险评估进行更广泛的探索。其结果的精度取决于狄利克雷分布的精度参数,该参数可以自然地解释为决策者在偏好确定方面的信心强度。