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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.

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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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