Objectives: Patients with head and neck cancer (HNC) are often highly affected by disease and treatment, resulting in impaired physical functioning and quality of life. Therefore, evaluation of... Show moreObjectives: Patients with head and neck cancer (HNC) are often highly affected by disease and treatment, resulting in impaired physical functioning and quality of life. Therefore, evaluation of patients' psychosocial and functional outcomes can be facilitated by patient-reported outcome measures (PROMs). By providing the patients' own perspectives, PROMs are crucial to improving patient-centered care. This study aimed to improve understanding of the perceived value of PROMs in HNC care and how to optimize their clinical value based on patients' and multidisciplinary healthcare professionals' (HCPs)Methods: Population-based surveys among patients with HNC through their patient association and among HCPs nationwide through the Dutch Head and Neck Audit.Results: A total of 54 patients and 40 multidisciplinary HCPs from all 14 nationwide HNC centers (100%) responded. For patients, the most important element of patient-reported outcome collection systems was including a call to action for those with worse-than-average scores (28%), whereas clinicians found discussing scores during clinical visits the most important (39%). Although 16% of clinicians found short completion time the most important element, none of the patients selected completion time as most important. Additionally, 17% of patients stated completion time was not an issue, provided clinicians would use the outcomes for clinical purposes.Conclusions: Although patients and clinicians acknowledged the value of patient-reported outcomes, patients would like to be more involved in the clinical implications of their outcomes. Enhancing patients' involvement by a call to action and providing feedback on their scores during outpatient clinic visits may improve the clinical value of PROMs. Show less
Gravesteijn, B.; Krijkamp, E.; Alphen, A. van; Busschbach, J.; Geleijnse, G.; Helmrich, I.R.; ... ; Jong, R.B. de 2022
Objectives: The ICEpop Capability Measure for Adults (ICECAP-A) assesses 5 capabilities (stability, attachment, autonomy, achievement, and enjoyment) that are important to one's quality of life and... Show moreObjectives: The ICEpop Capability Measure for Adults (ICECAP-A) assesses 5 capabilities (stability, attachment, autonomy, achievement, and enjoyment) that are important to one's quality of life and might be an important addition to generic health questionnaires currently used in economic evaluations. This study aimed to develop a Dutch tariff of the Dutch translation of the ICECAP-A. Methods: The methods used are similar to those used in the development of the UK tariff. A profile case best-worst scaling task was presented to 1002 participants from the general Dutch population. A scale-adjusted latent class analysis was performed to test for preferences of ICECAP-A capabilities and scale heterogeneity. Results: A 3-preference class 2-scale class model with worst choice as scale predictor was considered optimal and was used to calculate the resulting tariff. Results indicated that the capabilities stability, attachment, and enjoyment were considered more important aspects of quality of life than autonomy and achievement. Additionally, improving capabilities from low to moderate levels had a larger effect on quality of life than improving capabilities that were already at a higher level. Conclusions: The ICECAP-A tariffs found in this study could be used in economic evaluations of healthcare interventions in The Netherlands. Show less
Wester, V.; Groot, S. de; Versteegh, M.; Kanters, T.; Wagner, L.; Ardesch, J.; ... ; EPISODE Team 2021
Objectives: Cost-effectiveness analyses typically require measurement of health-related quality of life (HRQoL) to estimate quality-adjusted life-years. Challenges with measuring HRQoL arise in the... Show moreObjectives: Cost-effectiveness analyses typically require measurement of health-related quality of life (HRQoL) to estimate quality-adjusted life-years. Challenges with measuring HRQoL arise in the context of episodic conditions if patients are less likely-or even unable-to complete surveys when having disease symptoms. This article explored whether HRQoL measured at regular time intervals adequately reflects the HRQoL of people with epilepsy (PWE). Methods: Follow-up data from the Epilepsy Support Dog Evaluation study on the (cost-)effectiveness of seizure dogs were used in which HRQoL is measured in 25 PWE with the EQ-5D at baseline and every 3 months thereafter. Seizure count is recorded daily using a seizure diary. Regression models were employed to explore whether PWE were more likely to complete the HRQoL survey on a good day (ie, when seizures are absent or low in frequency compared with other days) and to provide an estimate of the impact of reporting HRQoL on a good day on EQ-5D utility scores. Results: A total of 111 HRQoL measurements were included in the analyses. Regression analyses indicated that the day of reporting HRQoL was associated with a lower seizure count (P,.05) and that a lower seizure count was associated with a higher EQ-5D utility score (P,.05). Conclusions: When HRQoL is measured at regular time intervals, PWE seem more likely to complete these surveys on good days. Consequently, HRQoL might be overestimated in this population. This could lead to underestimation of the effectiveness of treatment and to biased estimates of cost-effectiveness. Show less
Gravesteijn, B.; Krijkamp, E.; Busschbach, J.; Geleijnse, G.; Helmrich, I.R.; Bruinsma, S.; ... ; Value Based Operation Room Triage 2021
Objectives: Coronavirus disease 2019 has put unprecedented pressure on healthcare systems worldwide, leading to a reduction of the available healthcare capacity. Our objective was to develop a... Show moreObjectives: Coronavirus disease 2019 has put unprecedented pressure on healthcare systems worldwide, leading to a reduction of the available healthcare capacity. Our objective was to develop a decision model to estimate the impact of postponing semielective surgical procedures on health, to support prioritization of care from a utilitarian perspective. Methods: A cohort state-transition model was developed and applied to 43 semielective nonpediatric surgical procedures commonly performed in academic hospitals. Scenarios of delaying surgery from 2 weeks were compared with delaying up to 1 year and no surgery at all. Model parameters were based on registries, scientific literature, and the World Health Organization Global Burden of Disease study. For each surgical procedure, the model estimated the average expected disability-adjusted life-years (DALYs) per month of delay. Results: Given the best available evidence, the 2 surgical procedures associated with most DALYs owing to delay were bypass surgery for Fontaine III/IV peripheral arterial disease (0.23 DALY/month, 95% confidence interval [CI]: 0.13-0.36) and trans aortic valve implantation (0.15 DALY/month, 95% CI: 0.09-0.24). The 2 surgical procedures with the least DALYs were placing a shunt for dialysis (0.01, 95% CI: 0.005-0.01) and thyroid carcinoma resection (0.01, 95% CI: 0.01-0.02). Conclusion: Expected health loss owing to surgical delay can be objectively calculated with our decision model based on best available evidence, which can guide prioritization of surgical procedures to minimize population health loss in times of scarcity. The model results should be placed in the context of different ethical perspectives and combined with capacity management tools to facilitate large-scale implementation. Show less
Mouter, N.; Collewet, M.M.F.; Wit, G.A. de; Rotteveel, A.; Lambooij, M.S.; Kessels, R. 2021
Objectives: There is no generally accepted methodology to assess trauma system access. The goal of this study is to determine the influence of the number and geographical distribution of trauma... Show moreObjectives: There is no generally accepted methodology to assess trauma system access. The goal of this study is to determine the influence of the number and geographical distribution of trauma centers (TCs) on transport times (TT) using geographic information system (GIS)-technology.Methods: Using ArcGIS-PRO, we calculated differences in TT and population coverage in 7 scenarios with 1, 2, or 3 TCs during rush (R) and low-traffic (L) hours in a densely populated region with 3 TCs in the Netherlands.Results: In all 7 scenarios, the population that could reach the nearest TC within <45 minutes varied between 96% and 99%. In the 3-TC scenario, roughly 57% of the population could reach the nearest TC <15 minutes both during R and L. The hypothetical geographically well-spread 2-TC scenario showed similar results as the 3-TC scenario. In the 1-TC scenarios, the population reaching the nearest TC <15 minutes decreased to between 19% and 32% in R and L.In the 3-TC scenario, the average TT increased by about 1.5 minutes to almost 21 minutes during R and 19 minutes during L. Similar results were seen in the scenarios with 2 geographically well-spread TCs. In the 1-TC scenarios and the less well-spread 2-TC scenario, the average TT increased by 5 to 8 minutes (L) and 7 to 9 minutes (R) compared to the 3-TC scenario.Conclusions: This study shows that a GIS-based model offers a quantifiable and objective method to evaluate trauma system access under different potential trauma system configurations. Transport time from accident to TC would remain acceptable, around 20 minutes, if the current 3-TC situation would be changed to a geographically well-spread 2-center scenario. Show less
