OBJECTIVE

To develop an integral antimicrobial therapy quality index (AMTQI) using the multi-criteria decision analysis (MCDA) methodology and to validate the calculation models in an in-hospital setting.

MATERIALS AND METHODS

Based on the content analysis and expert questionnaires, a set of criteria for assessing the quality of antimicrobial therapy (AMT), assessment scales were developed, and weight coefficients (WC) were calculated using the direct weighting (DW) method and the indirect method of Potentially All Pairwise RanKings of all possible Alternatives (PAPRIKA). Based on the obtained WCs, a simple linear aggregation model (SLAM) with two sets of WCs (DW and PAPRIKA) and a multi-attribute value theory (MAVT) with a set of PAPRIKA WCs were created. Model validation and scenario sensitivity analysis were performed on 10 case histories of patients in an inpatient department.

RESULTS

A list of 12 AMT quality criteria was created; the WC criteria using DW were comparable, while the PAPRIKA method showed more differences between the WCs. When calculating AMTQI, the comparability of the assessment for each AMT case was found (mean SLAM (DW) value was 73.3±26.2, SLAM (PAPRIKA) 73.0±24.9, and MAVT (PAPRIKA) 72.1±25.1 points). The result rankings were the same in the SLAM models and differed in the two patients in the MAVT. All models demonstrated robustness for 8 of the 12 criteria in the scenario sensitivity analysis.

CONCLUSION

A MCDA method can be used to develop a model of an AMTQI based on a comprehensive set of universal criteria, with the SLAM and MAVT models appearing comparable. However, the results obtained need to be confirmed using more data. The AMTQI can be used in the internal and external audit of quality control of medical care in healthcare organizations.