Decision analysis for a data collection system of patient-controlled analgesia with a multi-attribute utility model

Data collection systems are very important for the practice of patient-controlled analgesia (PCA). This study aimed to evaluate 3 PCA data collection systems and selected the most favorable system with the aid of multiattribute utility (MAU) theory.

We developed a questionnaire with 10 items to evaluate the PCA data collection system and 1 item for overall satisfaction based on MAU theory. Three systems were compared in the questionnaire, including a paper record, optic card reader and personal digital assistant (PDA). A pilot study demonstrated a good internal and test-retest reliability of the questionnaire. A weighted utility score combining the relative importance of individual items assigned by each participant and their responses to each question was calculated for each system. Sensitivity analyses with distinct weighting protocols were conducted to evaluate the stability of the final results.

Thirty potential users of a PCA data collection system were recruited in the study. The item "easy to use" had the highest median rank and received the heaviest mean weight among all items. MAU analysis showed that the PDA system had a higher utility score than that in the other 2 systems. Sensitivity analyses revealed that both inverse and reciprocal weighting processes favored the PDA system. High correlations between overall satisfaction and MAU scores from miscellaneous weighting protocols suggested a good predictive validity of our MAU-based questionnaire.

The PDA system was selected as the most favorable PCA data collection system by the MAU analysis. The item "easy to use" was the most important attribute of the PCA data collection system. MAU theory can evaluate alternatives by taking into account individual preferences of stakeholders and aid in better decision-making.