Multiple Criteria Decision Making (MCDM)

1. Multiple Criteria Decision Making (MCDM) Samson Tu 2011/07/15 GLINDA Project Meeting Updated on 2011/12/15

2. What is MCDM? • Wikipedia • A discipline aimed at supporting decision makers faced with making numerous and sometimes conflicting evaluations. MCDA aims at highlighting these conflicts and deriving a way to come to a compromise in a transparent process • Dyer et al 1992 • The role of the value function is a demarcating feature between MAUT [Multi-Attribute Utility Theory]and MCDM. Generally, if the value function is explicit, the method is considered in the MAUT category; if the value function is implicit (assumed to exist but is otherwise unknown) or no such function is assumed to exist, the method is usually classified under MCDM. In most MCDM methods, the user need not be aware that there is a value function

3. Analytic Hierarchy ProcessExample of MCDM • Pair-wise ranking of alternatives wrt criteria • Pair-wise ranking of criteria wrt goal Mathematical procedure for deriving priorities

4. Application to Mult-ComorbidProblem [1] • Choice of “concerns” to address (pink) based on how well they accomplish “subgoals” (yellow) and the priorities of subgoals. • Potentially patients provide the ranking of priorities of subgoals • Potentially use a knowledge base to assess how well addressing “concerns” accomplish “subgoals” • Allow clinician/patient to alter rankings Manage Multi-Comorbid Patient Ease of implementation Relieve immediate pain/discomfort Maximize independent functioning Minimize long term bad outcomes Breathlessness Renal Failure Cardiovascular outcomes

5. Application to Mult-Comorbid Problem? • Choose interventions (pink) based on how they address “concerns” (yellow) and the priority of the concerns • System uses heuristics to generate rankings • Allow clinician/patient to alter rankings • Combinatorial explosion if alternatives involves sets of interventions Manage Multi-Comorbid Patient Address cardiovascular concerns Address diabetic complications Address independence concerns Add ACE-I Add Metformin

6. Criticisms of MCDM • Differing MCDM procedures give different results • Ranking reversal • Adding an “irrelevant” alternative may change ranking of existing alternatives • Both alternatives A & B are preferred over N • Considering A & B alone, A > B • Considering A, B, & N, B < A • Real-life situation • 2000 US election • Bush vs Gore, with or without Nader • Some refinement of AHP eliminate ranking reversal