Value based decision support to prioritize development of innovative technologies for image-guided vascular surgery in the hybrid operating theater

Innovative technologies for minimally invasive interventions have the potential to add value to vascular procedures in the hybrid operating theater (HOT). Restricted budgets require prioritization of the development of these technologies. We aim to provide vascular surgeons with a structured methodology to incorporate possibly conflicting criteria in prioritizing the development of new technologies. We propose a multi-criteria decision analysis framework to evaluate the value of innovative technologies for the HOT based on the MACBETH methodology. The framework is applied to a specific case: The new HOT in a large teaching hospital. Three upcoming innovations are scored for three different endovascular procedures. Two vascular surgeons scored the expected performance of these innovations for each of the procedures on six performance criteria and weighed the importance of these criteria. The overall value of the innovations was calculated as the weighted average of the performance scores. On a scale from 0-100 describing the overall value, the current HOT scored halfway the scale (49.9). A wound perfusion measurement tool scored highest (69.1) of the three innovations, mainly due to the relatively high score for crural revascularization procedures (72). The novel framework could be used to determine the relative value of innovative technologies for the HOT. When development costs are assumed to be similar, and a single budget holder decides on technology development, priority should be given to the development of a wound perfusion measurement tool.