Quantitative evaluation the rationality of the use of FOLFOX regimen in patients with metastatic colorectal cancer based on AHP weighted TOPSIS method

Abstract

Abstract Purpose Adopts Analytic Hierarchy Process (AHP) and Technique for Order Preference by Similarity to Ideal Situation (TOPSIS) to assess and rank different indicators of evaluation index and evaluate the rationality of the use of FOLFOX regimen in patients with metastatic CRC. Methods The evaluation criteria for the rationality of the use of FOLFOX regimen was established with reference to the dispensatory and application guidelines by using AHP weight, and TOPSIS method was adopts to retrospectively analyze and evaluate the rationality of the use of FOLFOX regimen in 176 cases in the medical records of our hospital from July to December 2022. Results Established evaluation criteria included 3 primary indexes (indication, medication process, management indicator) and 18 secondary parameters. Chemotherapy regimens selection, therapeutic evaluation and discontinuation of drug indications ranked top 3 secondary parameters (relative weight coefficient were 0.08352, 0.06257, 0.06217, respectively). The primary inappropriate types and scores of FOLFOX regimen were preconditioning, dose selection and therapeutic evaluation (deducted scores were 429.44, 416.97, 306.59 respectively). Among 176 cases, 49 cases (27.84%) had a relative proximity (Ci) equal to 100%, 87 cases (49.43%) 100%-80%, 29 cases (16.48%) 80%-60% and 11 cases (6.25%) below to 60%. The major problems were vomiting risk was not assessed (16.13%), insufficient dose of cytotoxic agents (15.66%) and treatment effects were not evaluated according to WHO standards (11.52%). Conclusions The evaluation criteria of the rationality of clinical application of FOLFOX regimen were established by AHP-TOPSIS method. The evaluation results obtained by this method were quantifiable, scientific and credible. The phenomenon of irrational use of these drugs in our hospital is relatively common, and the management should be strengthened in clinical application. Implications for cancer survivors AHP weighted TOPSIS method can quantitatively evaluate the rationality of anti-cancer drugs by integrating multiple indicators.