Evaluation Of Risk And Benefit Of Antidepressant Using The Analytic Hierarchy Process

Objective:To evaluate risk and benefit of antidepressant using Analytic Hierarchy Process(AHP),comprehensive scores of each antidepressant were obtained and ranked for clinical rational use of drug.Methods:(1).Define the decision goal,criteria,and alternatives.The first step in AHP analysis involves defining the goal of the decision,The stated decision goal will be to rank the options for depression treatment.the alternatives being considered,and the criteria to determine how well the alternatives can be expected to meet the goal.Two criteria will be defined as determining the best treatment of depression: the benefits and risks.The criteria for benefits will be focused on the effective rate of 2,6 weeks after onset of medication;the criteria for risks will be sub-divided into two sub criteria: the number and severity of ADR.The four medication options that will be considered are Mirtazapine;Venlafaxine;Citalopram;Sertraline.(2).Judgment through pairwise comparisons.Pairwise comparisons at each hierarchical level present the judgments and they must be evaluated according to a scale developed by Saaty,which ranges from 1 to 9.comparing the ability of the alternatives to fulfill the prespecified criteria,and judging the importance of the criteria relative to the decision goal.calculate the relative priority weights for the(sub-)criteria,calculate the criteria's global priority weights and combine the alternatives' priorities.(3).Control for inconsistency.(4).Perform sensitivity analysis.The Expert Choice software was used for the sensitivity analysis.Results:Retrieved related literature of Meta-analysis from the databases,the main efficacy and safety were analyzed and evaluated.The comprehensive scores of Mirtazapine,Venlafaxine,Citalopram and Sertraline were 0.277,0.273,0.223 and 0.227,respectively.The benefit value of Mirtazapine,Venlafaxine,Citalopram and Sertraline were 0.313,0.313,0.313 and 0.063,respectively.The risk value of Mirtazapine,Venlafaxine,Citalopram and Sertraline were 0.196,0.282,0.354 and 0.169,respectively.The consistency ratio(CR)of judgment matrix were less than 0.1,which passed the consistency inspection.Conclusion:The highest comprehensive scores was Mirtazapine and the lowest one was Sertraline.Sertraline has the lowest benefit value and Citalopram has the highest risk value.The criteria of risk and benefit should be considered as sensitive factor,the calculation results show that the choice of outcome will be different if the weight set is changed.The effective rate of 2,6 weeks after onset of medication range from0.077-0.265,0.078-0-262,respectively.The number of ADR range from 0.242-0.314,the severity of ADR range from 0.021-0.268.