An MCDM-based health technology assessment (HTA) study for evaluating kidney stone treatment alternatives

Abstract

The prevalence of kidney stone disease has increased during the last decade due to various reasons such as changes in dietary and water consumption. To overcome this issue, new treatment approaches are being developed. Today, Extracorporeal Shock Wave Lithotripsy (ESWL) and Laser Lithotripsy (LL) are the most popular approaches for the fragmentation of kidney stones. However, the advantages and limitations of these treatment methods are still being questioned by healthcare professionals. A systematic and efficient approach is thus required to help healthcare providers for selecting the best treatment approach. Multi-Criteria Decision-Making (MCDM) techniques are a reliable and powerful approach to respond to the need for such comparative analysis. Hence, the aim of this study is to propose an HTA-based hierarchical evaluation structure for kidney stone treatment methods utilizing the Hierarchical Fuzzy TOPSIS method and conduct a case study on LL and ESWL. The structure consists of 5 main criteria and 24 sub-criteria. The study group for linguistic evaluations consists of medical doctors (nephrologists and urologists) and researchers. Closeness coefficient values are obtained as 0.577 and 0.372 for LL and ESWL, respectively. It is concluded that LL should be selected as the ideal alternative under the proposed hierarchical evaluation structure. The study is expected to bring insights to further studies as well as healthcare providers who are working in the field.