The New Decision Analysis Guidance from ISPOR: How it is Like HouseHunters


‘Multiple criteria decision analysis’ is a crummy name for a great concept (aren’t all big decisions analyzed using multiple criteria?). MCDA means assessing alternatives while simultaneously considering several objectives. It’s a useful way to look at difficult healthcare choices. But oftentimes, results of these analyses aren’t communicated clearly, limiting their usefulness.

ISPOR, the International Society For Pharmacoeconomics and Outcomes Research, has developed new MCDA guidance, available in the latest issue of Value for Health (paywall). To be sure, healthcare decision makers have always weighed medical, social, and economic factors: MCDA helps stakeholders bring concrete choices and transparency to the process of evaluating outcomes research – where as we know, controversy is always a possibility.

Anyone can use MCDA. To put it mildly, it’s difficult to balance saving lives with saving money. Fundamentally, MCDA means listing options, defining decision criteria, weighting those criteria, and then scoring each option. Some experts build complex economic models, but anyone can apply this decision technique in effective, less rigorous ways.

You know those checklists at the end of every HouseHunters episode where people weigh location and size against budget? That’s essentially it: Making important decisions, applying judgment, and balancing multiple goals (raise the kids in the city or the burbs?) – and even though they start out by ranking priorities, once buyers see their actual options, deciding on a house becomes substantially more complex.

MCDA gains traction in health economics. As shown in the diagram (source: ISPOR), the analysis hinges on assigning relative weights to individual decision criteria. While this brings rationality and transparency to complex decisions, it also invites passionate discussions. Some might expect these techniques to remove human judgment from the process, but MCDA leaves it front and center.

Looking for new ways to communicate health economics research and other medical evidence? Register now for the 2nd annual HEOR Writing workshop in March.

Pros and cons. Let’s not kid ourselves: You have to optimize on something. MCDA is both beautiful and terrifying because it forces us to identify tradeoffs: Quality, quick improvement, long-term health benefits? Uncertain outcomes only complicate things further. One of the downsides is that, upon seeing elaborate projections and models, people can become over-confident in the numbers. Uncertainty is never fully recognized or quantified. (Recall the Rumsfeldian unknown unknown.) Sensitivity analysis is essential, to illustrate which predicted outcomes are strongly influenced by small adjustments.

Communicating the results. MCDA is a great way to bring interdisciplinary groups into a conversation. But because it is so complex, it’s essential that the analysis be communicated effectively, so stakeholders understand the choices being made. At a minimum, this should include straightforward charts or tables identifying the decision criteria, showing how they’re weighted, and summarizing analytical results – bringing us back to the HouseHunters Wish List/Checklist. (If you’re new to HEOR writing, don’t miss this fantastic lineup of medical writers and HEOR experts.)

Resources to learn more. If you want to try MCDA, pick up one of the classic texts, such as Smart Choices: A Practical Guide to Making Better Decisions. The ISPOR report is Multiple Criteria Decision Analysis for Health Care Decision Making – An Introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force by Thokala et al. Additionally, ISPOR’s members offer useful insights into the pluses and minuses of this methodology – see, for example, Does the Future Belong to MCDA? The level of discourse over this guidance illustrates how challenging healthcare decisions have become.

Tracy Altman is the founder of Ugly Research. She’ll be presenting at the HEOR Writing Workshop on communicating value messages clearly with data, March 17-18 in Philadelphia.

 

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How to Shine at an Online Career Fair

On Wednesday, January 20, 2016, HealthEconomics.Com is hosting their 5th Online Career Fair specifically for the HEOR, Market Access and Real World Evidence audience.  The Career Fair is scheduled from 10am-2pm, and you can participate from anywhere in the world!  Ten employers will be there to recuit:  Boehringer-Ingelheim, Deloitte Belgium, Evidera, ICER (Institute for Clinical and Economic Review), Ipsos Healthcare, Lilly, PRMA Consulting, RTI Health Solutions, Takeda Pharmaceuticals, Washington and Jefferson College.

If you aren’t registered yet, no worries!  It takes just minutes to register and you can interview, job search, or network from your smart phone, tablet, or desktop computer anywhere there is an active internet connection.  Register here.  If you’re an employer and you want to get in on the action, visit here.

To help job-seekers prepare for the unique environment of an Online Career Fair, we wanted to re-share portions of a previously-conducted interview  with Scott Kabo and Michael Litten of Klein Hersh International recruiting, a firm specializing in many areas of healthcare, including pharma HEOR.  Take a minute to read their advice and we’ll see you online!  Happy job hunting and recruiting! Knock it out of the park!

[Patti]  What three pieces of advice do you offer to a Job Seeker as they prepare for a Career Fair?

[KH]  In every job search, job seekers should focus on:

1. Preparation;

2. Due Diligence; and,

3. Creating an agenda with goals to accomplish during the Career Fair.

It is important to know the specific companies that will be present at the Career Fair, and in advance of the event, research the job openings and the individual position description.  Know what company and job you will visit first, second, and so on.  It is recommended that the candidate prepare a specific script targeted toward each job, explaining why he/she would be a great fit for that advertised position and the company as a whole.  The candidate should be strategic in their efforts during the career fair, and if they aren’t sure what the company is looking for, to be prepared with “qualifying questions” that help elicit specific traits, skills, and experience that the company desires in the person who will fill that role.  Conduct due diligence on the company by searching the corporate website, reviewing press releases and announcements, and familiarizing oneself with the product portfolio and strategic focus.  “The art of an interview is your ability to ask questions and engage in dialogue,” emphasizes Kabo.  Moreover, even at a virtual career fair, all candidates should come to the interview prepared with a list of questions that help him or her understand the company, its culture, the specific role, and the skills necessary to succeed.

[Patti]  How should an Employer prepare for a Career Fair? 

[KH]  Michael Litten notes that some of same advice given to candidates embarking on a Career Fair also applies to employers:  namely, Preparation, Preparation, Preparation.  Employers should be fully capable of discussing the corporate goals, areas of focus, and uniqueness.  They should also be prepared to field common questions that candidates in the field of HEOR would ask about the specific job.  Interviewing goes both ways, particularly in high-demand areas like HEOR and Pricing, Reimbursement, and Market Access.  All human resources personnel should know what makes their company “sizzle” and be prepared for delivering a pitch that would make someone want to make the leap from their present company to a new place of employment.

[Patti]  This is a virtual Career Fair.  How should employers and job seekers specifically prepare for this on-line experience?

[KH]  Litten and Kabo encourage everyone to participate because – as they say – there really are no barriers to one attending in terms of location, travel, cost, etc.  This Virtual Career Fair for Health Economics & Outcomes Research is incredibly unique and a fantastic idea.  There are, however, a few things both a candidate and an employer should remember about this on-line experience.  Litten believes that the virtual experience has some commonalities with a telephone interview.  Both the employer and the candidate should be prepared to quickly and efficiently steer the conversation toward a specific role and to be able to say a few words that highlight the skill set needed or that the candidate possesses, up front.  Because this is a virtual environment typing this information, so be prepared for this.  Also, be ready to migrate through the booths to visit as many companies as possible, and make sure to get individual follow-up information with email addresses so you can establish that relationship outside of the Career Fair.

[Patti] What is the most common mistake you have observed in the interviewing process?

[KH]  Litten notes that time delays, including drawn-out scheduling and/or decision-making in the job search process by the hiring company, is the biggest challenge to both the employer and the job seeker.  If the process goes stagnant, the candidate will move onto another opportunity.  Occasionally, a candidate may be uncomfortable stating that they are not interested in a position, but ultimately, this honesty works best for all parties involved.  Additionally, it is important that the company clearly state if they desire a specific type of skill set.  Likewise, the candidate needs to be transparent about what skills they possess and the areas in which they are less comfortable.  Another common fallacy is for the candidate to play their cards “close to the vest”.  Kabo notes that candidates should clearly communicate their enthusiasm for the position and the company, if it exists. The last thing one wants is for the company to have a debrief after an interview and note, “we really liked the candidate’s technical capabilities, but we just didn’t get the sense they were interested in us!”  If you like each other, let it be known!

[Patti] How can a resume stand out in today’s marketplace?

[KH]  The most essential thing to remember is that people are busy, so conciseness is essential.  Your entire work career will likely not be reviewed job by job, bullet point by bullet point.  Litten strongly suggests including an “Expertise or Overall Summary of Profile” statement at the top of the resume, including relevant skill sets and today’s buzzwords.  He also notes that, in today’s environment, it is increasingly common for candidates to hold a series of short-term consulting jobs, often moving from one company to another in short-term contract positions.  If this is the case, it is essential to note that these moves were intentional and part of an organized process of consulting, and to note this at the top of the resume.   This immediately addresses the concern over the candidate being a “job-hopper”, and instead positions the candidate as someone who has chosen a particular tact to their career focused intentionally on short-term contracting positions.  This is acceptable, but an explanation at the top of the resume should indicate this approach.

If you are a hiring company and are interested in exhibiting or recruiting at the Career Fair contact Undine McEvoy at undine@healtheconomics.com.

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