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Patient decision aid based on multi-criteria decision analysis for disease-modifying drugs for multiple sclerosis:
I E H Kremer1, P J Jongen2,3, S M A A Evers4,5
1Department of Health Services Research, School CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands. i.kremer@maastrichtuniversity.nl.
BMC Medical Informatics and Decision Making
|April 10, 2021
Summary
A prototype patient decision aid was developed for multiple sclerosis (MS) treatment choices using multi-criteria decision analysis (MCDA). Further development is needed to address identified issues before clinical testing can occur.
Area of Science:
- Medical Decision Making
- Health Informatics
- Neurology
Background:
- Treatment decisions for multiple sclerosis (MS) are preference-sensitive, necessitating shared decision-making between patients and healthcare professionals.
- Patient decision aids can facilitate shared decision-making by providing information on disease and treatment options, eliciting patient preferences, and guiding discussions.
- A prototype decision aid for MS patients in the Netherlands was developed using multi-criteria decision analysis (MCDA) principles to support preference elicitation and treatment matching.
Purpose of the Study:
- To develop and evaluate a prototype patient decision aid for multiple sclerosis (MS) treatment selection.
- To incorporate multi-criteria decision analysis (MCDA) to simplify the complex decision-making process for patients.
- To adhere to International Patient Decision Aid Standards throughout the development process.
Main Methods:
- Determined scope to include disease-modifying drugs (DMDs) for relapsing-remitting MS and clinically isolated syndrome.
- Assessed user information needs via focus groups (19 patients) and best-worst scaling surveys (185 patients, 60 healthcare professionals).
- Conducted a literature review on DMD effectiveness and burden, developed an online MCDA-based prototype, and performed alpha testing with 13 patients and 4 healthcare professionals.
Main Results:
- Alpha testing identified issues related to content, framing, MCDA weighting methods, and presentation of treatment rankings based on patient preferences.
- Adaptations were made to the prototype based on alpha testing feedback.
- Further verification, validation, implementation feasibility assessment, and evaluation of shared decision-making support are required.
Conclusions:
- The developmental process of an MCDA-based patient decision aid for MS treatment decisions faced challenges, with some issues remaining unresolved.
- Further development is necessary to address identified issues before proceeding to beta pilot testing.
- The ultimate value of the MCDA-based decision aid for MS patients, healthcare professionals, and care quality requires further investigation.
