The Development of the Multicriteria Decision Analysis in Specialized Burn Care: The Methodological Process
Author(s)
Raaba S.M. Thambithurai, MSc1, Denise van Uden, PhD1, Marjolein van der Vlegel, PhD1, Robin A.F. Verwilligen, PhD2, Paul P.M. van Zuijlen, Prof. MD PhD2, Marianne K. Nieuwenhuis, PhD, Prof3, Cornelis H. van der Vlies, MD Phd, ass. Prof1, Angelique E.A.M. Weel-Koenders, Prof, MD PhD4, Mariska Q.N. Hackert, PhD5, Margriet E. van Baar, PhD1.
1Alliance of Dutch Burn Care (ADBC), Burn Centre, Maasstad Hospital, Rotterdam, Netherlands, 2Alliance of Dutch Burn Care (ADBC), Burn Centre, Red Cross Hospital, Beverwijk, Netherlands, 3Alliance of Dutch Burn Care (ADBC), Burn Centre, Martini Hospital, Groningen, Netherlands, 4Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands, 5Department of Quality and Control, Maasstad Hospital, Rotterdam, Netherlands.
1Alliance of Dutch Burn Care (ADBC), Burn Centre, Maasstad Hospital, Rotterdam, Netherlands, 2Alliance of Dutch Burn Care (ADBC), Burn Centre, Red Cross Hospital, Beverwijk, Netherlands, 3Alliance of Dutch Burn Care (ADBC), Burn Centre, Martini Hospital, Groningen, Netherlands, 4Department of Rheumatology, Maasstad Hospital, Rotterdam, Netherlands, 5Department of Quality and Control, Maasstad Hospital, Rotterdam, Netherlands.
OBJECTIVES: Healthcare effects are ideally assessed using a combination of patient-relevant outcomes. To support economic evaluation from a value-based healthcare (VBHC) perspective, we aim to develop and validate a Multi-Criteria Decision Analysis (MCDA) framework for burn care (BC-MCDA) using real-world data.
METHODS: A BC-MCDA model was developed with stakeholders (patients, clinicians and managers) from three Dutch burn centers through interviews and focus groups. The VBHC burns core outcome set was used. Changes in each outcome were valued, resulting in scores. The importance of each outcome, compared to others was assessed, resulting in weights per outcome. The BC-MCDA model was validated using a cohort of adult patients receiving specialized burn care with a 12-month follow-up, during a 15-month period. Data from the Dutch Burn Repository R3 and the Burn Centers Outcomes Registry the Netherlands was used to compare BC-MCDA values and costs in patients with mild to moderate burns (<5%TBSA) versus severe burns (≥5%TBSA). Costs included direct medical costs from the start of treatment.
RESULTS: The BC-MCDA model consists of nine patient-reported outcomes ranging from pain to self-management. Scores and weights were established for each time point. The 12-month post-discharge analysis included 57 patients. Median age was 58 (IQR 43-69) years for mild and 55 (IQR 46-66) years for severe patients. The overall MCDA value resulted in 0.763 for mild patients and 0.723 for severe patients. The total mean costs per mild patient was €20.436 [95%CI: €11.471-€34.790] and € 53.983 [95%CI: €41.255-€67.763] per severe patient. The costs per unit of value for mild patients resulted in €2,68 per unit value and for severe patients €7,48.
CONCLUSIONS: Validation of the model showed that severe patients had lower MCDA values and higher costs. Additionally, an increase in value per unit is associated with higher costs in severe patients. The BC-MCDA enables economic evaluations from a VBHC perspective.
METHODS: A BC-MCDA model was developed with stakeholders (patients, clinicians and managers) from three Dutch burn centers through interviews and focus groups. The VBHC burns core outcome set was used. Changes in each outcome were valued, resulting in scores. The importance of each outcome, compared to others was assessed, resulting in weights per outcome. The BC-MCDA model was validated using a cohort of adult patients receiving specialized burn care with a 12-month follow-up, during a 15-month period. Data from the Dutch Burn Repository R3 and the Burn Centers Outcomes Registry the Netherlands was used to compare BC-MCDA values and costs in patients with mild to moderate burns (<5%TBSA) versus severe burns (≥5%TBSA). Costs included direct medical costs from the start of treatment.
RESULTS: The BC-MCDA model consists of nine patient-reported outcomes ranging from pain to self-management. Scores and weights were established for each time point. The 12-month post-discharge analysis included 57 patients. Median age was 58 (IQR 43-69) years for mild and 55 (IQR 46-66) years for severe patients. The overall MCDA value resulted in 0.763 for mild patients and 0.723 for severe patients. The total mean costs per mild patient was €20.436 [95%CI: €11.471-€34.790] and € 53.983 [95%CI: €41.255-€67.763] per severe patient. The costs per unit of value for mild patients resulted in €2,68 per unit value and for severe patients €7,48.
CONCLUSIONS: Validation of the model showed that severe patients had lower MCDA values and higher costs. Additionally, an increase in value per unit is associated with higher costs in severe patients. The BC-MCDA enables economic evaluations from a VBHC perspective.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA314
Topic
Health Technology Assessment
Topic Subcategory
Value Frameworks & Dossier Format
Disease
Injury & Trauma, No Additional Disease & Conditions/Specialized Treatment Areas