About the Authors: Axel C. Mühlbacher Roles Conceptualization, Methodology, Project administration, Writing – original draft, Writing – review & editing * E-mail: muehlbacher@hs-nb.de Affiliations Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany, Gesellschaft für Empirische Beratung GmbH (GEB), Freiburg, Germany ORCID logo https://orcid.org/0000-0003-4402-9211 Andrew Sadler Roles Writing – review & editing Affiliation: Health Economics and Health Care Management, Hochschule Neubrandenburg, Neubrandenburg, Germany Introduction The author of the paper to be discussed claims to have reanalyzed a case study on the efficiency frontier (EF). ...there are several rather significant differences in the methodological approaches which are described and presented in detail in the papers 2, 3. ...we acknowledge that our reporting on the methods used for identification of included studies was incomplete (due to the limited number of studies available at the time of publication). In accordance to the Multi-Criteria Decision Analysis (MCDA) literature we applied and described the following steps in our VAF 9: 1. definition of the decision problem to identify alternatives and decision tasks; 2. identification of relevant indicators and specification of the decision model; 3. performance measurement of each indicator; 4. scoring of indicators (normalization); 5. weighting of normalized indicators; 6. aggregation of indicators; 7. interpretation and analysis of uncertainty.