Patient-Centered Hearing Technology Assessment: Integrating ICF Into Multicriteria Decision Making
Author(s)
Bettina Schlick, PhD, Annegret Hoch, MSc, Michael Urban, MBA, MSc.
MED-EL Elektromedizinische Geräte Gesellschaft m.b.H., Innsbruck, Austria.
MED-EL Elektromedizinische Geräte Gesellschaft m.b.H., Innsbruck, Austria.
OBJECTIVES: Health Technology Assessment (HTA) in hearing rehabilitation increasingly demands comprehensive, patient-centered evaluation frameworks that go beyond traditional cost-effectiveness metrics. Our aim was to enable a simplified comparison of hearing interventions.
METHODS: A case study on the decision between different interventions for hearing rehabilitation was conducted using a novel approach by integrating the International Classification of Functioning, Disability and Health (ICF) into Multicriteria Decision Analysis (MCDA). The ICF provides a standardized, biopsychosocial model for describing health and disability, enabling the inclusion of diverse functional, environmental, and personal factors relevant to hearing loss. By embedding ICF domains into the MCDA framework, this method allows for the systematic appraisal of hearing interventions across multiple criteria, including body functions, activity limitations, and participation restrictions.
RESULTS: We evaluated relevant criteria using audiological measures as well as patient reported outcomes. Based on a value measurement approach with linear value functions, three treatment alternatives were compared within a performance matrix. An aggregate score was calculated based on weights obtained from a survey of professionals in the field of hearing rehabilitation. Overall, intervention B received the highest score of 63, while intervention A and C scored 42 and 46, with scores being robust to variation in the value measurement model. Results demonstrate that our integrated approach supports more equitable and context-sensitive evaluations. Furthermore, it addresses key methodological challenges in MCDA, such as criteria selection, weighting, and stakeholder diversity, by grounding them in the ICF’s internationally recognized taxonomy.
CONCLUSIONS: The proposed model is able to capture broader health outcomes and user-relevant benefits often overlooked in conventional HTA. Further research is needed to assess the benefits of MCDA over other composite indicator methods for future HTA in hearing rehabilitation.
METHODS: A case study on the decision between different interventions for hearing rehabilitation was conducted using a novel approach by integrating the International Classification of Functioning, Disability and Health (ICF) into Multicriteria Decision Analysis (MCDA). The ICF provides a standardized, biopsychosocial model for describing health and disability, enabling the inclusion of diverse functional, environmental, and personal factors relevant to hearing loss. By embedding ICF domains into the MCDA framework, this method allows for the systematic appraisal of hearing interventions across multiple criteria, including body functions, activity limitations, and participation restrictions.
RESULTS: We evaluated relevant criteria using audiological measures as well as patient reported outcomes. Based on a value measurement approach with linear value functions, three treatment alternatives were compared within a performance matrix. An aggregate score was calculated based on weights obtained from a survey of professionals in the field of hearing rehabilitation. Overall, intervention B received the highest score of 63, while intervention A and C scored 42 and 46, with scores being robust to variation in the value measurement model. Results demonstrate that our integrated approach supports more equitable and context-sensitive evaluations. Furthermore, it addresses key methodological challenges in MCDA, such as criteria selection, weighting, and stakeholder diversity, by grounding them in the ICF’s internationally recognized taxonomy.
CONCLUSIONS: The proposed model is able to capture broader health outcomes and user-relevant benefits often overlooked in conventional HTA. Further research is needed to assess the benefits of MCDA over other composite indicator methods for future HTA in hearing rehabilitation.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA267
Topic
Health Technology Assessment, Medical Technologies, Patient-Centered Research
Topic Subcategory
Value Frameworks & Dossier Format
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Sensory System Disorders (Ear, Eye, Dental, Skin)