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Volume 42 Number 5, September/October 2005
Pages 635 — 644

Abstract - A multicriteria decision analysis of augmentative treatment of upper limbs in persons with tetraplegia

J. M. Marjan Hummel, PhD;1* Govert J. Snoek, MD;2-3 Janine A. van Til, MSc;2 Wouter van Rossum, PhD;1 Maarten J. IJzerman, Prof PhD2

1Faculty of Business, Public Administration and Technology, University of Twente, Enschede, the Netherlands; 2Roessingh Research and Development, Enschede, the Netherlands; 3Roessingh Rehabilitation Centre, Enschede, the Netherlands.
Abstract — This study supported the evaluation by a rehabilitation team of the performance of two treatment options that improve the arm-hand function in subjects with sixth cervical vertebra (C6) level Motor Group 2 tetraplegia. The analytic hierarchy process, a technique for multicriteria decision analysis, was used by a rehabilitation team and potential recipients to quantitatively compare a new technology, Functional Electrical Stimulation (FES), with conventional surgery. Perform-ance was measured by functional improvement, treatment load, risks, user-friendliness, and social outcomes. Functional improvement after FES was considered better than that after conventional surgery. However, the rehabilitation team's overall rating for conventional surgery was slightly higher than that for FES (57% vs 44%). Compared with the rehabilitation team, potential recipients gave greater weight to burden of treatment and less weight to functional improvement. This study shows that evaluation of new technology must be more comprehensive than the evaluation of functional improvement alone, and that patient preferences may differ from those of the rehabilitation team.
Key words: analytic hierarchy process, decision analysis, Functional Electrical Stimulation, group decision support, hand function therapy, performance, reconstructive surgery, rehabilitation team, shared decision making, tetraplegia.

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