Research

Technology Assessment for Health Systems Engineering

We assess and optimize the impact of health care innovations, during and after development, on health outcomes and on the healthcare systemErik Koffijberg; Associate Professor

What we do

Our goal is to optimize the value of new technologies and innovations in healthcare to society. We assess the impact of innovations during and after development, and from different perspectives (for example, developer, hospital, insurer, societal). Furthermore, we engineer health systems of the future by identifying how healthcare service provision will change – or needs to change – to maximize the value of healthcare innovations in a sustainable way. Our focus is the evaluation and optimization of diagnostic technologies, including biomarkers, imaging, prediction models and medical devices, in the fields of cardiology, neurology, and oncology.

In early design stages, we perform early assessments to guide further product development, for example based on expert elicitation, stakeholder analysis, headroom analysis, end user interviews, and early modelling. Following development, we support trial based and model based generation of evidence on health outcomes, healthcare costs and resource use, as well as on budget and system level impact. We use patient-level simulation models to accurately reflect clinical practice, and to develop innovative methods for optimizing the application and timing of personalized care and precision medicine interventions.

The results of our analyses support business models, reimbursement decisions, healthcare policymaking, and adoption of new technologies.

MOST RELEVANT PROJECTS  

TANGO

The TANGO project aims at expanding molecular profiling of tumours to improve immune- and targeted treatment selection in patients with advanced melanoma or non-small cell lung cancer (NSCLC). TANGO includes cost-effectiveness and budget impact analysis of whole genome sequencing (WGS) to facilitate responsible introduction. Our focus is on providing insight in the consequences of implementation of WGS in the Netherlands from a health systems perspective to support health services planning. Large scale facilities, which are required for WGS, can have a major impact on health outcomes and costs of clinical oncology services. Given the complexity of healthcare delivery systems, we use dynamic simulation models to analyse the various aspects (e.g. organizational, economic, and policy) that play a role in the nationwide implementation of WGS.

(early) Adoption and impact of point-of-care testing

Although a large set of point-of-care tests is currently available, only few are used in current clinical practice. Therefore, we aim to get insight in factors that affect the implementation and use of these point-of-care tests, by means of interviews with stakeholders, multi-criteria decision analysis, and health economic modeling. In turn, this will likely contribute to efficient implementation of cost-effective point-of-care tests. Finally, we will assess the consequences of increased uptake of point-of-care tests, for example, by general practitioners from a health system level perspective.

CREW project

We participate in the CREW project: Dutch national consortium to promote CardiovasculaR hEalthy aging in Women, funded by the Dutch Heart Foundation. In this study, target populations will be identified of women who may benefit from early, tailored interventions that delay cardiovascular disease (CVD) progression before clinical signs and symptoms are evident. CVD risk evaluation strategies are developed and validated. We contribute to the long-term impact analyses of the effects of implementing novel risk based prevention strategies on the health burden in the target female populations, to support policy making, modification of guidelines, and focused large scale intervention and implementation studies.

Optimizing personalized care in oncology

Due to the complex dynamics of current clinical pathways in oncology, traditional modeling methods are being questioned in terms of usefulness for translational research on personalized cancer care. Our work is dedicated to the application of operations research methods to optimize the delivery of cancer health services using decision models of genomics and other biomarkers, as well as treatment patterns and resource use. We address methodological challenges associated with the adoption of methods such as discrete event simulation, as well as provide valuable decisions tools that inform, for example, treatment decisions on patient level or strategic decisions on health system level regarding the optimal implementation of health care technologies.

Technology Developer, Health Care Organisation, Med Tech Company?
Want to know how new technology and interventions impact health outcomes, care pathways, healthcare delivery, and costs, and how this impact can be maximized?

Featured publications

Kip MMA, IJzerman MJ, Henriksson M, Merlin T, Weinstein MC, Phelps CE, Kusters R, Koffijberg H. Toward Alignment in the Reporting of Economic Evaluations of Diagnostic Tests and Biomarkers: The AGREEDT Checklist. Med Decis Making. 2018 Oct;38(7):778-788. doi: 10.1177/0272989X18797590

Degeling K, Schivo S, Mehra N, Koffijberg H, Langerak R, de Bono JS, IJzerman MJ. Comparison of Timed Automata with Discrete Event Simulation for Modeling of Biomarker-Based Treatment Decisions: An Illustration for Metastatic Castration-Resistant Prostate Cancer. Value Health. 2017 Dec;20(10):1411-1419. doi: 10.1016/j.jval.2017.05.024. Epub 2017 Jul 11.

Kip MMA, Koffijberg H, Moesker MJ, IJzerman MJ, Kusters R. The cost-utility of point-of-care troponin testing to diagnose acute coronary syndrome in primary care. BMC Cardiovasc Disord. 2017 Aug 2;17(1):213. doi: 10.1186/s12872-017-0647-6

IJzerman MJ, Koffijberg H, Fenwick E, Krahn M. Emerging Use of Early Health Technology Assessment in Medical Product Development: A Scoping Review of the Literature. Pharmacoeconomics. 2017 Jul;35(7):727-740. doi: 10.1007/s40273-017-0509-1.

van Giessen A, Moons KG, de Wit GA, Verschuren WM, Boer JM, Koffijberg H. Tailoring the implementation of new biomarkers based on their added predictive value in subgroups of individuals. PLoS One. 2015 Jan 26;10(1):e0114020. doi: 10.1371/journal.pone.0114020. eCollection 2015.

senior research staff

junior research staff