Prioritizing the Surgical Waiting List-Cosine Consistency Index: An Optimized Framework for Prioritizing Surgical Waiting List

Abstract

This paper aims to examine patient prioritization challenges faced by surgeons attending to patients awaiting surgery and proposes a decision-making framework named PSWL-CCI to prioritize patients in the surgical waiting list. The proposed framework deals with two critical issues: One, to prioritize patients from the surgical waiting list. Two, to refine and optimize cosine consistency index (CCI) of inconsistent pairwise comparison matrix (PCM) and obtain consistent priorities. The judgment of surgeons on identified parameters in the term of rating helps in determining priorities from the surgical waiting list. The cosine maximization method (CM), along with the analytic hierarchy process (AHP), is used to evaluate the resulting priority. To improve inconsistent pairwise comparison matrix (PCM), a novel hybrid algorithm HMWCA (Hybrid modified water cycle algorithm), is proposed and incorporated in PSWL-CCI. The proposed algorithm exploits the feature of three traditional algorithms, namely the evaporation-based water cycle algorithm (ER-WCA), genetic algorithm, and 2-opt heuristic. In this paper, the concept of salt concentration and absorption introduced into the evaporation rate (ER) that extends ER-WCA to a modified water cycle algorithm (MWCA). MWCA iteratively modifies the entries in PCM until PCM is optimized. The genetic algorithm helps MWCA to determine the evaporation rate and enhance the rate of convergence. The 2-OPT algorithm improvises the optimal solution. The proposed algorithm is tested with different datasets, and the improved CCI values are validated through paired sample t-test. Finally, the proposed PSWL-CCI framework is validated through a case study of a real patient dataset from an orthopedic surgery department of a multispecialty hospital in India. The experimental results obtained in this study reveal that the proposed methodology and algorithms significantly improve the CCI values, thus generating optimum priorities for the patients of the surgical waiting list.