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Non-monetary valuation using Multi-Criteria Decision Analysis: Using a strength-of-evidence approach to inform choices among alternatives.

ABSTRACT: This article demonstrates an approach to Multi-Criteria Decision Analysis that compares non-monetary ecosystem service (ES) outcomes for environmental decision making. ES outcomes are often inadequately defined and characterized by imprecision and uncertainty. Outranking methods enrich our understanding of the imperfect knowledge of ES outcomes by allowing decision makers to closely examine and apply preference measures to relationships among the outcomes. We explain the methodological assumptions related to the Preference Ranking Organization METHod for Enrichment Evaluation (PROMETHEE) method, and apply it to a wetland restoration planning study in Rhode Island, USA. In the study, we partnered with a watershed management organization to evaluate four wetland restoration alternatives for their abilities to supply five ES: flood water regulation, scenic landscapes, learning opportunities, recreation, and birds. Twenty-two benefit indicators were identified for the ES as well as one indicator for social equity and one indicator for reliability of ES provision. We developed preference functions to characterize the strength of evidence across estimated indicator values between pairs of alternatives. We ranked the alternatives based on these preferences and weights on ES relevant to different planning contexts. We discuss successes and challenges of implementing PROMETHEE, including feedback from our partners who utilized the methods.

SUBMITTER: Martin DM

PROVIDER: S-EPMC8193858 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundRespiratory syncytial virus (RSV) is a highly infectious disease that poses a significant clinical and medical burden, as well as social disruption and economic costs, recognized by the World Health Organization as a public health issue. After several failed attempts to find preventive candidates (compounds, products, including vaccines), new alternatives might be available, one being nirsevimab, the first and only option approved for RSV prevention in neonates and infants during their first RSV season. The objective of this study was to develop a novel multi-criteria decision analysis (MCDA) framework for RSV antibody-based preventive alternatives and to use it to assess the value of nirsevimab vs. placebo as a systematic immunization approach to prevent RSV in neonates and infants during their first RSV season in Spain.MethodsBased on a pre-established model called Vaccinex, an ad-hoc MCDA framework was created to reflect relevant attributes for the assessment of current and future antibody-based preventive measures for RSV. The estimated value of nirsevimab was obtained by means of an additive linear model combining weights and scores assigned by a multidisciplinary committee of 9 experts. A retest and three sensitivity analyses were conducted.ResultsNirsevimab was evaluated through a novel framework with 26 criteria by the committee as a measure that adds value (positive final estimated value: 0.56 ± 0.11) to the current RSV scenario in Spain, by providing a high efficacy for prevention of neonates and infants. In addition, its implementation might generate cost savings in hospitalizations and to the healthcare system and increase the level of public health awareness among the general population, while reducing health inequities.ConclusionsUnder a methodology with increasing use in the health field, nirsevimab has been evaluated as a measure which adds value for RSV prevention in neonates and infants during their first RSV season in Spain.

Project description:The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk.

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Non-monetary valuation using Multi-Criteria Decision Analysis: Using a strength-of-evidence approach to inform choices among alternatives.

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