International Journal of Infectious Diseases (Sep 2020)
Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage
- Pasquale De Nardo,
- Elisa Gentilotti,
- Fulvia Mazzaferri,
- Eleonora Cremonini,
- Paul Hansen,
- Herman Goossens,
- Evelina Tacconelli,
- E. Durante Mangoni,
- L.L. Florio,
- R. Zampino,
- F. Mele,
- I. Gentile,
- B. Pinchera,
- N. Coppola,
- M. Pisaturo,
- R. Luzzati,
- N. Petrosillo,
- E. Nicastri,
- A. Corpolongo,
- M.A. Cataldo,
- A. D’Abramo,
- G. Maffongelli,
- L. Scorzolini,
- C. Palazzolo,
- E. Boumis,
- A. Pan,
- A. D’Arminio Monforte,
- F. Bai,
- S. Antinori,
- F.G. De Rosa,
- S. Corcione,
- T. Lupia,
- S.M. Pinna,
- S. Scabini,
- F. Canta,
- S. Belloro,
- Z. Bisoffi,
- A. Angheben,
- F. Gobbi,
- E. Turcato,
- N. Ronzoni,
- L. Moro,
- S. Calabria,
- P. Rodari,
- G. Bertoli,
- G. Marasca,
- M. Puoti,
- A. Gori,
- A. Bandera,
- D. Mangioni,
- M. Rizzi,
- F. Castelli,
- A. Montineri,
- C.A. Coco,
- M. Maresca,
- M. Frasca,
- D. Aquilini,
- M. Vincenzi,
- L. Lambertenghi,
- M.E. De Rui,
- E. Razzaboni,
- P. Cattaneo,
- A. Visentin,
- A. Erbogasto,
- I. Dalla Vecchia,
- I. Coledan,
- M. Vecchi,
- G. Be,
- L. Motta,
- A. Zaffagnini,
- N. Auerbach,
- P. Del Bravo,
- A.M. Azzini,
- E. Righi,
- E. Carrara,
- A. Savoldi,
- M. Sibani,
- E. Lattuada,
- G. Carolo,
- M. Cordioli,
- F. Soldani,
- M.D. Pezzani,
- S. Avallone,
- R. Bruno,
- A. Ricciardi,
- M.P. Saggese,
- G. Malerba
Affiliations
- Pasquale De Nardo
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Italy; Corresponding author at: Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro, 37134 Verona, Italy.
- Elisa Gentilotti
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Italy
- Fulvia Mazzaferri
- Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
- Eleonora Cremonini
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Italy
- Paul Hansen
- Department of Economics, University of Otago, Dunedin, New Zealand
- Herman Goossens
- Laboratory of Medical Microbiology, Vaccine and Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
- Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Italy
- E. Durante Mangoni
- L.L. Florio
- R. Zampino
- F. Mele
- I. Gentile
- B. Pinchera
- N. Coppola
- M. Pisaturo
- R. Luzzati
- N. Petrosillo
- E. Nicastri
- A. Corpolongo
- M.A. Cataldo
- A. D’Abramo
- G. Maffongelli
- L. Scorzolini
- C. Palazzolo
- E. Boumis
- A. Pan
- A. D’Arminio Monforte
- F. Bai
- S. Antinori
- F.G. De Rosa
- S. Corcione
- T. Lupia
- S.M. Pinna
- S. Scabini
- F. Canta
- S. Belloro
- Z. Bisoffi
- A. Angheben
- F. Gobbi
- E. Turcato
- N. Ronzoni
- L. Moro
- S. Calabria
- P. Rodari
- G. Bertoli
- G. Marasca
- M. Puoti
- A. Gori
- A. Bandera
- D. Mangioni
- M. Rizzi
- F. Castelli
- A. Montineri
- C.A. Coco
- M. Maresca
- M. Frasca
- D. Aquilini
- M. Vincenzi
- L. Lambertenghi
- M.E. De Rui
- E. Razzaboni
- P. Cattaneo
- A. Visentin
- A. Erbogasto
- I. Dalla Vecchia
- I. Coledan
- M. Vecchi
- G. Be
- L. Motta
- A. Zaffagnini
- N. Auerbach
- P. Del Bravo
- A.M. Azzini
- E. Righi
- E. Carrara
- A. Savoldi
- M. Sibani
- E. Lattuada
- G. Carolo
- M. Cordioli
- F. Soldani
- M.D. Pezzani
- S. Avallone
- R. Bruno
- A. Ricciardi
- M.P. Saggese
- G. Malerba
- Journal volume & issue
-
Vol. 98
pp. 494 – 500
Abstract
Objective: To use Multi-Criteria Decision Analysis (MCDA) to determine weights for eleven criteria in order to prioritize COVID-19 non-critical patients for admission to hospital in healthcare settings with limited resources. Methods: The MCDA was applied in two main steps: specification of criteria for prioritizing COVID-19 patients (and levels within each criterion); and determination of weights for the criteria based on experts’ knowledge and experience in managing COVID-19 patients, via an online survey. Criteria were selected based on available COVID-19 evidence with a focus on low- and middle-income countries (LMICs). Results: The most important criteria (mean weights, summing to 100%) are: PaO2 (16.3%); peripheral O2 saturation (15.9%); chest X-ray (14.1%); Modified Early Warning Score-MEWS (11.4%); respiratory rate (9.5%); comorbidities (6.5%); living with vulnerable people (6.4%); body mass index (5.6%); duration of symptoms before hospital evaluation (5.4%); CRP (5.1%); and age (3.8%). Conclusions: At the beginning of a new pandemic, when evidence for disease predictors is limited or unavailable and effective national contingency plans are difficult to establish, the MCDA prioritization model could play a pivotal role in improving the response of health systems.
