Evidence map›Paper›PMID 42484770›Full record

ArticleCanadian journal of public health = Revue canadienne de sante publique2026

Adapting multi-criteria decision analysis of drug harms to reflect population-level health outcomes: An innovation in public health policy.

Jean-François Crépault, Brian Emerson, Elaine Hyshka, Jürgen Rehm

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Article in Canadian journal of public health = Revue canadienne de sante publique, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Jean-François CrépaultCentre for Addiction and Mental Health (CAMH), Toronto, ON, Canada. JeanFrancois.Crepault@camh.ca.ORCID http://orcid.org/0000-0003-0448-560X
Brian EmersonPublic Health Medical Consultant, Duncan, BC, Canada.
Elaine HyshkaSchool of Public Health, University of Alberta, Edmonton, AB, Canada.
Jürgen RehmCentre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

settingAdvocates of a public health approach to psychoactive substances need actionable evidence. In several countries, multidisciplinary groups have used multi-criteria decision analysis (MCDA) to generate harm scores and rankings for commonly used psychoactive substances; however, these did not fully reflect substances' prevalence of use. Public health policy decisions around psychoactive substances should be informed by population-level outcomes, which are driven by use prevalence.

interventionLed by a policy practitioner, a multidisciplinary group from across Canada conducted a MCDA of harms caused by 16 commonly used psychoactive substances. To make the analysis more relevant to public health policy, we adapted it to account for not only the severity of harms associated with a substance, but also prevalence of use. This adaptation was applied across harm criteria. OUTCOMES: Adapting MCDA this way allowed for the generation of harm scores that represent total population-level harm caused by each substance rather than individual-level harm. As a result, they provide clear evidence of the relative population-level harm caused by different substances. This evidence can inform prioritization of public health efforts and be used by policy practitioners advocating for a public health approach to substances. IMPLICATIONS: Adapting MCDA to reflect population-level outcomes is a practical innovation for public health policy and practice. Prevalence-adjusted MCDA produces evidence that is well aligned with how public health policy decisions are made and evaluated, and may be applicable to other public health issues characterized by multiple data sources and competing policy objectives.

Indexed as

Multi-criteria decision analysisPopulation health approachPsychoactive substancesPublic health policy

Identifiers

PMID42484770

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.