. 2024 Apr 1;31(4):1876-1898.

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

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.

PMID: 38668044
PMCID: PMC11049582
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

Pam Takhar et al. Curr Oncol. 2024.

. 2024 Apr 1;31(4):1876-1898.

doi: 10.3390/curroncol31040141.

Authors

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.

PMID: 38668044
PMCID: PMC11049582
DOI: 10.3390/curroncol31040141

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.

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Conflict of interest statement

The authors declare no conflicts of interest with the exception of M.T. (Mina Tadrous), who has received consulting fees from CADTH and Green Shield Canada. F.D. was employed at Prioritize Consulting Ltd. and was contracted by the Canadian Real-world Evidence for Value in Cancer Drugs and Collaboration as a consultant to support the development of the MCDA rating tool. At the time this work was conducted, J.B. was employed at Ontario Health and is now employed by MORSE Consulting Inc., which receives consulting fees from pharmaceutical companies unrelated to the content of this work.

Figures

**Figure 1**
An overview of the MCDA Process.

See this image and copyright information in PMC

References

1. Impact of RWE on HTA Decision-Making IQVIA Institute December 2022. [(accessed on 6 September 2023)]. Available online: https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publicati....
1. CADTH . Guidance for Reporting Real-World Evidence. CADTH; Ottawa, ON, Canada: 2023. [(accessed on 5 February 2024)]. Available online: https://www.cadth.ca/sites/default/files/RWE/MG0020/MG0020-RWE-Guidance-....
1. National Institute for Health and Care Excellence NICE Real-World Evidence Framework. 2022. [(accessed on 5 February 2024)]. Available online: https://www.nice.org.uk/corporate/ecd9/resources/nice-realworld-evidence....
1. Framework for FDA’s Real-World Evidence Program. U.S. Food and Drug Administration; Silver Spring, MD, USA: 2018. [(accessed on 5 February 2024)]. Available online: https://www.fda.gov/media/120060/download?attachment.
1. Health Canada . Elements of Real World Data/Evidence Quality throughout the Prescription Drug Product Life Cycle. Government of Canada; Ottawa, ON, Canada: 2020. [(accessed on 5 February 2024)]. Available online: https://www.canada.ca/en/services/health/publications/drugs-health-produ....

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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

Affiliations

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

Authors

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Abstract

Conflict of interest statement

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Grants and funding

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