Multi-criteria Decision Analysis for Health Technology Assessment of Intensive Care Ventilators for Pediatric Patients.

Abstract BackgroundThe technological complexity and heterogeneity of intensive care ventilator models currently available on the market together with the heterogeneity in pediatric patients (0 to 18 years old), make the choice of the best machine for pediatric healthcare setting crucial.This paper is aimed at addressing all the critical aspects linked to the implementation of intensive care ventilators in a pediatric setting, highlighting the most relevant technical features and describing the methodology to conduct health technology assessment (HTA) for supporting the decision-making process.Four ventilators models were included in the assessment process. A decision-making support tool (DoHTA method) based on Analytic Hierarchy Process, was applied. 28 Key Performance Indicators (KPIs) were identified, defining the safety, clinical effectiveness, organizational, technical, and economic aspects. The Performance scores of each ventilator have been measured with respect to KPIs integrated with the total cost of ownership (TCO) analysis, leading to a final rank of the four possible technological solutions. ResultsThe final technologies’ performance scores reflected a deliver valued, contextualized, and shared outputs, detecting the most performant technological solution for the specific hospital context. HTA results had informed and supported the pediatric hospital decision-making process. ConclusionsThis study, identifying and discussing the pros and cons of innovative features of ventilators and all the evaluation criteria and aspects to be taken into account during the evaluation process, can be considered as a valuable proof of evidence as well as a reliable and transferable method for conducting a decision making process in a hospital context.