Published Apr 1, 2020
Karen Moons Liliane Pintelon Pieterjan Jorissen Dirk De Ridder Wouter Everaerts


The recent trend is towards value-based healthcare, which is characterized by the relationship between quality of care and the associated costs. However, value in healthcare is a largely unmeasured and misunderstood concept. In particular, a definition of multi-stakeholder value in healthcare decision-making is missing. In this case study, we review the radical prostatectomy procedure because previous studies have shown discrepancies between what the patient’s value most and what the experts think the patient’s value most. The objective of this research is to address this gap by identifying a multi-stakeholder definition of value which will improve healthcare decision-making. Multi-criteria decision-making (MCDM) techniques, more specifically the Analytic Hierarchy Process (AHP), are applied to prioritize the quality of care indicators according to the following six pillars of quality: safety, effectiveness, efficiency, timeliness, patient-centeredness and equity. In addition, the average cost of a radical prostatectomy is estimated. A distinction is made between three treatment stages in order to calculate the overall quality score by assigning weights to criteria in each treatment stage. According to the AHP weights, the pillars of effective, patient-centered and equitable care contribute the most to value creation. Finally, some of the challenges of MCDM studies are addressed, such as conflicting preferences between stakeholder groups. In conclusion, this case study stresses the need to adapt operational research methods and knowledge to be applied in value-based healthcare. The AHP is a suitable approach to address the needs of healthcare decision-makers, to set priorities, and to identify value improvement opportunities while considering all of the stakeholders involved in the full care cycle.


How to Cite

Moons, K., Pintelon, L., Jorissen, P., De Ridder, D., & Everaerts, W. (2020). IDENTIFICATION OF MULTI-STAKEHOLDER VALUE IN MEDICAL DECISION-MAKING. International Journal of the Analytic Hierarchy Process, 12(1).


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Value-based healthcare, Multi-stakeholder decision-making, Analytic Hierarchy Process

Adunlin, Georges, Vakaramoko Diaby and Hong Xiao (2015). Application of Multicriteria Decision Analysis in health care: a systematic review and bibliometric analysis. Health Expectations 18(6), 1894–1905. doi:

De Bekker-Grob, E. W., Bliemer, M.C.J., Donkers, B. et al. (2013). Patients’ and urologists’ preferences for prostate cancer treatment: a discrete choice experiment. British Journal of Cancer, 109, 633-640. doi:

Belgian Cancer Registry, BCR. 2017. Cancer Fact Sheet Prostate Cancer.

Dyer, R.F., and Forman, E.H. (1992). Group decision support with the Analytic Hierarchy Process. Decision Support Systems, 8(2), 99-124. doi:

Fontenot, P.A. & Mansour, A.M. (2013). Reporting positive surgical margins after radical prostatectomy: time for standardization. BJU International, E290-299. doi: