Can Streamlined Multicriteria Decision Analysis Be Used to Implement Shared Decision Making for Colorectal Cancer Screening

Background. Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multicriteria decision analysis (MCDA) is an established method well suited for supporting shared decision making. Our study goal was to determine whether a streamlined form of MCDA using rank-order–based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods. We converted priorities for 4 decision criteria and 3 subcriteria regarding colorectal cancer screening obtained from 484 average-risk patients using the analytic hierarchy process (AHP) in a prior study into rank-order–based priorities using rank order centroids. We compared the 2 sets of priorities using Spearman rank correlation and nonparametric Bland–Altman limits of agreement analysis. We assessed the differential impact of using the rank-order–based versus the AHP-based priorities on the results of a full MCDA comparing...