Ending the war in multi-criteria decision analysis: Taking the best from two worlds : the development and evaluation of guidelines for the use of MACBETH in multi-criteria group decision making for the assessment of new medical products

"Measuring Attractiveness by a Categorical Based Evaluation Technique” (MACBETH) is a multi-criteria decision analysis (MCDA) method based on pairwise comparisons that has only rarely been used in healthcare-related group decision making. The Analytic Hierarchy Process (AHP) on the other hand has seen ongoing use in this field, even though its methodology has been severely criticised in the past. The objective of this study was the development of guidelines for the use of MACBETH as a feasible method for multi-criteria group decision making in the assessment of criteria related to the development of new medical products. A thorough literature study was conducted to compare AHP and MACBETH and to identify specific structures, differences, advantages and disadvantages of both approaches. Best practices of the AHP were then used for the development of the guidelines. In a subsequent pilot panel session about the prevention of frailty in the elderly, the feasibility of the guidelines was tested. Additionally, data about the relative importance of frailty criteria was gained and the perception of the methodology and the results by elderly individuals was assessed. Finally, recommendations for the broader use of MACBETH could be proposed.