학술논문
Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage
Document Type
article
Author
Pasquale De Nardo; Elisa Gentilotti; Fulvia Mazzaferri; Eleonora Cremonini; Paul Hansen; Herman Goossens; Evelina Tacconelli; E. Durante Mangoni; L.L. Florio; R. Zampino; F. Mele; I. Gentile; B. Pinchera; N. Coppola; M. Pisaturo; R. Luzzati; N. Petrosillo; E. Nicastri; A. Corpolongo; M.A. Cataldo; A. D’Abramo; G. Maffongelli; L. Scorzolini; C. Palazzolo; E. Boumis; A. Pan; A. D’Arminio Monforte; F. Bai; S. Antinori; F.G. De Rosa; S. Corcione; T. Lupia; S.M. Pinna; S. Scabini; F. Canta; S. Belloro; Z. Bisoffi; A. Angheben; F. Gobbi; E. Turcato; N. Ronzoni; L. Moro; S. Calabria; P. Rodari; G. Bertoli; G. Marasca; M. Puoti; A. Gori; A. Bandera; D. Mangioni; M. Rizzi; F. Castelli; A. Montineri; C.A. Coco; M. Maresca; M. Frasca; D. Aquilini; M. Vincenzi; L. Lambertenghi; M.E. De Rui; E. Razzaboni; P. Cattaneo; A. Visentin; A. Erbogasto; I. Dalla Vecchia; I. Coledan; M. Vecchi; G. Be; L. Motta; A. Zaffagnini; N. Auerbach; P. Del Bravo; A.M. Azzini; E. Righi; E. Carrara; A. Savoldi; M. Sibani; E. Lattuada; G. Carolo; M. Cordioli; F. Soldani; M.D. Pezzani; S. Avallone; R. Bruno; A. Ricciardi; M.P. Saggese; G. Malerba
Source
International Journal of Infectious Diseases, Vol 98, Iss , Pp 494-500 (2020)
Subject
Language
English
ISSN
1201-9712
Abstract
Objective: To use Multi-Criteria Decision Analysis (MCDA) to determine weights for eleven criteria in order to prioritize COVID-19 non-critical patients for admission to hospital in healthcare settings with limited resources. Methods: The MCDA was applied in two main steps: specification of criteria for prioritizing COVID-19 patients (and levels within each criterion); and determination of weights for the criteria based on experts’ knowledge and experience in managing COVID-19 patients, via an online survey. Criteria were selected based on available COVID-19 evidence with a focus on low- and middle-income countries (LMICs). Results: The most important criteria (mean weights, summing to 100%) are: PaO2 (16.3%); peripheral O2 saturation (15.9%); chest X-ray (14.1%); Modified Early Warning Score-MEWS (11.4%); respiratory rate (9.5%); comorbidities (6.5%); living with vulnerable people (6.4%); body mass index (5.6%); duration of symptoms before hospital evaluation (5.4%); CRP (5.1%); and age (3.8%). Conclusions: At the beginning of a new pandemic, when evidence for disease predictors is limited or unavailable and effective national contingency plans are difficult to establish, the MCDA prioritization model could play a pivotal role in improving the response of health systems.