A multiple criteria approach for building a pandemic impact assessment composite indicator: The case of COVID-19 in Portugal

Keywords Multiple criteria analysis; Composite indicator; Multi-attribute value theory (MAVT); Robustness and validation analyses; Deck of cards method Highlights * An impact assessment indicator of COVID-19 pandemic in Portugal. * Multi-attribute value theory (MAVT) tools for designing composite indicators, in a sociotechnical and co-constructive perspective. * Behavioural decision-making and the deck of cards method for assessing experts' judgments and for constructing a MAVT model. * Monte Carlo simulation and robustness analysis in multiple criteria decision aiding. Abstract The COVID-19 pandemic has caused major damage and disruption to social, economic, and health systems (among others). In addition, it has posed unprecedented challenges to public health and policy/decision-makers who have been responsible for designing and implementing measures to mitigate its strong negative impact. The Portuguese health authorities have used decision analysis techniques to assess the impact of the pandemic and implemented measures for counties, regions, or across the entire country. These decision tools have been subject to some criticism and many stakeholders requested novel approaches. In particular, those which considered the dynamic changes in the pandemic's behaviour due to new virus variants and vaccines. A multidisciplinary team formed by researchers from the COVID-19 Committee of Instituto Superior Técnico at the University of Lisbon (CCIST analyst team) and physicians from the Crisis Office of the Portuguese Medical Association (GCOM expert team) collaborated to create a new tool to help politicians and decision-makers to fight the pandemic. This paper presents the main steps that led to the building of a pandemic impact assessment composite indicator applied to the specific case of COVID-19 in Portugal. A multiple criteria approach based on an additive multi-attribute value theory aggregation model was used to build the pandemic assessment composite indicator. The parameters of the additive model were devised based on an interactive socio-technical and co-constructive process between the CCIST and GCOM team members. The deck of cards method was the adopted technical tool to assist in the assessment the value functions as well as in the assessment of the criteria weights. The final tool was presented at a press conference and had a powerful impact on the Portuguese media and on the main health decision-making stakeholders in the country. In this paper, a completed mathematical and graphical description of this tool is presented. Author Affiliation: (a) CEGIST, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, Lisboa 1049-001, Portugal (b) CAMGSD, Instituto Superior Técnico, Universidade de Lisboa, Portugal (c) CQE, Instituto Superior Técnico, Universidade de Lisboa, Portugal (d) IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Portugal (e) GCOM, Ordem dos Médicos, Portugal * Corresponding author. Article History: Received 23 September 2021; Accepted 14 January 2023 Byline: José Rui Figueira [figueira@tecnico.ulisboa.pt] (*,a), Henrique M. Oliveira (b), Ana Paula Serro (c), Rogério Colaço (d), Filipe Froes (e), Carlos Robalo Cordeiro (e), António Diniz (e), Miguel Guimarães (e)