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Transparent and explicit approaches to decisionmaking help produce decisions that are sound and acceptable to stakeholders [ 4- 7].
It calls for well-defined criteria to avoid confusion and ensure sound application of multicriteria approaches to decisionmaking [ 11, 73].
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The framework promotes a consistent approach to decisionmaking that can help legitimize decisions and be aligned with the A4R framework set forth by Daniels [ 79, 80].
MCDA is widely used to support decisions in environmental engineering, agriculture, and marketing[ 13] and is a promising approach to healthcare decisionmaking [ 69- 74].
While these provide a rigorous scientific basis for quality assessment of evidence, additional elements were identified that could integrate scientific judgment into a practical approach to healthcare decisionmaking.
The EVIDEM framework can be applied to assess the value of a screening intervention in the South African private health plan context, providing a practical tool for integrating HTA with an MCDA approach to support decisionmaking.
One committee member stated that the framework adds clarity to decisionmaking but repeated use may be required to fully capture its utility and get acquainted with its application.
Finally, this study was not designed to directly compare EVIDEM to other approaches used by decisionmaking bodies, such as cost-utility thresholds, and field studies comparing the EVIDEM approach to current decisionmaking processes are being developed.
The ultimate objective is to develop sound multicriteria approaches to enlighten healthcare decisionmaking and priority-setting.
Further testing and validation are needed to advance MCDA approaches in healthcare decisionmaking.
The current debate on transparency and legitimacy of healthcare decisionmaking [ 41, 42] calls for a more systematized approach to evidence review and decisionmaking.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com