Decision making under conflicting criteria — A case study

In this paper, an actual case study in health planning is presented to illustrate the principles involved in solving optimization problems under conflicting criteria. The case study involves the planning and implementation of a comprehensive health maintenance program by the U.S. Air Force. At the request of USAF School of Aerospace Medicine, both analytical and simulation studies were carried out to aid them in implementing an Air Force wide cardiovascular disease control (CVD) program. In this program, all Air Force personnel are screened for CVD risk and those at high risk are placed in a therapy program and treated. A bicriterion optimization model was developed to determine optimal strategies for therapy selection and treatment. Since the effectiveness of treatment for CVD was a random variable, one of the objective functions was stochastic and had to be determined with the help of a simulation model. The bicriterion model was solved using an interactive optimization method.