Application of Multi-Criteria Decision Analysis (MCDA) to Prioritize Real-World Evidence Studies for Health Technology Management: Outcomes and Lessons Learned by the Canadian Real-World Evidence for Value of Cancer Drugs (CanREValue) Collaboration

Pam Takhar; Marc Geirnaert; Scott Gavura; Jaclyn Beca; Rebecca E Mercer; Avram Denburg; Caroline Muñoz; Mina Tadrous; Ambica Parmar; Francois Dionne; Darryl Boehm; Carole Chambers; Erica Craig; Maureen Trudeau; Matthew C Cheung; Joanne Houlihan; Valerie McDonald; Petros Pechlivanoglou; Marianne Taylor; Eric Wasylenko; Wiesława Dominika Wranik; Kelvin K W Chan

doi:10.3390/curroncol31040141

Application of Multi-Criteria Decision Analysis (MCDA) to Prioritize Real-World Evidence Studies for Health Technology Management: Outcomes and Lessons Learned by the Canadian Real-World Evidence for Value of Cancer Drugs (CanREValue) Collaboration

Curr Oncol. 2024 Apr 1;31(4):1876-1898. doi: 10.3390/curroncol31040141.

Authors

Pam Takhar¹, Marc Geirnaert², Scott Gavura¹, Jaclyn Beca^{1

3}, Rebecca E Mercer^{1

3

4}, Avram Denburg⁵, Caroline Muñoz^{1

3}, Mina Tadrous^{6

7}, Ambica Parmar^{8

9}, Francois Dionne¹⁰, Darryl Boehm¹¹, Carole Chambers¹², Erica Craig¹³, Maureen Trudeau⁸, Matthew C Cheung^{4

8

9}, Joanne Houlihan¹⁴, Valerie McDonald¹⁵, Petros Pechlivanoglou¹⁶, Marianne Taylor¹⁷, Eric Wasylenko^{18

19}, Wiesława Dominika Wranik^{20

21}, Kelvin K W Chan^{1

3

4

8

9}

Affiliations

¹ Ontario Health (Cancer Care Ontario), Toronto, ON M5G 2L3, Canada.
² CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada.
³ Canadian Centre for Applied Research in Cancer Control, Toronto, ON M5G 2L3, Canada.
⁴ Evaluative Clinical Services, Sunnybrook Research Institute, Toronto, ON M4N 3M3, Canada.
⁵ Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
⁶ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada.
⁷ Women's College Hospital, Toronto, ON M5S 1B2, Canada.
⁸ Division of Medical Oncology & Hematology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M3, Canada.
⁹ Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
¹⁰ Prioritize Consulting Ltd., Vancouver, BC V6S 2B3, Canada.
¹¹ Saskatchewan Cancer Agency, Regina, SK S4W 0G3, Canada.
¹² Alberta Health Services, Calgary, AB T5J 3E4, Canada.
¹³ New Brunswick Cancer Network, Fredericton, NB E3B 5G8, Canada.
¹⁴ Nova Scotia Health, Halifax, NS B3S 0H6, Canada.
¹⁵ Independent Patient Representative, Toronto, ON M6G 2V3, Canada.
¹⁶ Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
¹⁷ BC Cancer, Kelowna, BC V1Y 5L3, Canada.
¹⁸ Department of Oncology, University of Calgary, Calgary, AB T2N 1N4, Canada.
¹⁹ John Dossetor Health Ethics Centre, University of Alberta, Edmonton, AB T6G 2R7, Canada.
²⁰ Department of Public and International Affairs, Faculty of Management, Dalhousie University, Halifax, NS B3H 4R2, Canada.
²¹ Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada.

Abstract

Multi-criteria decision analysis (MCDA) is a value assessment tool designed to help support complex decision-making by incorporating multiple factors and perspectives in a transparent, structured approach. We developed an MCDA rating tool, consisting of seven criteria evaluating the importance and feasibility of conducting potential real-world evidence (RWE) studies aimed at addressing uncertainties stemming from initial cancer drug funding recommendations. In collaboration with the Canadian Agency for Drugs and Technologies in Health's Provincial Advisory Group, a validation exercise was conducted to further evaluate the application of the rating tool using RWE proposals varying in complexity. Through this exercise, we aimed to gain insight into consensus building and deliberation processes and to identify efficiencies in the application of the rating tool. An experienced facilitator led a multidisciplinary committee, consisting of 11 Canadian experts, through consensus building, deliberation, and prioritization. A total of nine RWE proposals were evaluated and prioritized as low (n = 4), medium (n = 3), or high (n = 2) priority. Through an iterative process, efficiencies and recommendations to improve the rating tool and associated procedures were identified. The refined MCDA rating tool can help decision-makers prioritize important and feasible RWE studies for research and can enable the use of RWE for the life-cycle evaluation of cancer drugs.

Keywords: decision-analysis; health technology assessment; multi-criteria decision analysis; oncology.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antineoplastic Agents* / therapeutic use
Canada
Consensus
Decision Support Techniques*
Humans
Neoplasms / drug therapy
Technology Assessment, Biomedical / methods

Substances

Antineoplastic Agents

Grants and funding

HRC- 535 154126/CIHR/Canada