title: Which criteria are considered in healthcare decisions? Insights from an international survey of policy and clinical decision makers.
abstract: OBJECTIVE
  The aim of this study was to gather qualitative and quantitative data on criteria considered by healthcare decision makers.
  
  
  METHODS
  Using snowball sampling and an online questionnaire with forty-three criteria organized into ten clusters, decision makers were invited by an international task force to report which criteria they consider when making decisions on healthcare interventions in their context. Respondents reported whether each criterion is "currently considered," "should be considered," and its relative weight (scale 0-5). Differences in proportions of respondents were explored with inferential statistics across levels of decision (micro, meso, macro), decision maker perspectives, and world regions.
  
  
  RESULTS
  A total of 140 decision makers (1/3 clinical, 2/3 policy) from 23 countries in five continents completed the survey. The most relevant criteria (top ranked for "Currently considered," "Should be considered," and weights) were Clinical efficacy/effectiveness, Safety, Quality of evidence, Disease severity, and Impact on healthcare costs. Organizational and skill requirements were frequently considered but had relatively low weights. For almost all criteria, a higher proportion of decision makers reported that they "Should be considered" than that they are "Currently considered" (p < .05). For more than 74 percent of criteria, there were no statistical differences in proportions across levels of decision, perspectives and world regions. Statistically significant differences across several comparisons were found for: Population priorities, Stakeholder pressure/interests, Capacity to stimulate research, Impact on partnership and collaboration, and Environmental impact.
  
  
  CONCLUSIONS
  Results suggest convergence among decision makers on the relevance of a core set of criteria and on the need to consider a wider range of criteria. Areas of divergence appear to be principally related to contextual factors.
authors.affiliation: University of Montreal; EVIDEM Collaboration.
authors.forename: Nataly
authors.initials: N
authors.lastname: Tanios
authors.forename: Monika
authors.initials: M
authors.lastname: Wagner
authors.forename: Michèle
authors.initials: M
authors.lastname: Tony
authors.forename: Rob
authors.initials: R
authors.lastname: Baltussen
authors.forename: Janine
authors.initials: J
authors.lastname: van Til
authors.forename: Donna
authors.initials: D
authors.lastname: Rindress
authors.forename: Paul
authors.initials: P
authors.lastname: Kind
authors.forename: Mireille M
authors.initials: MM
authors.lastname: Goetghebeur
mesh_terms: D000288:Administrative Personnel / Q000523:psychology*; D003657:Decision Making; D003695:Delivery of Health Care; D006801:Humans; D038622:Internationality; D011340:Problem Solving; D036301:Qualitative Research; D011795:Surveys and Questionnaires