ESTRO 2024 - Abstract Book

S2845

Interdisciplinary - Health economics & health services research

ESTRO 2024

Integrating findings from phase 1 and 2 on the concept of value-based healthcare in radiotherapy and aspects of categorisation during a co-creation workshop with the multidisciplinary expert group in phase 3, resulted in essential decision and endpoint nodes for a first version of the categorisation decision tree. Synthesis and re synthesis in multiple iterative rounds by the expert group in phase 4 led to improved phrasing and definition of the decision and categorisation nodes. Phase 5 was initiated by inviting selected ESTRO committee members to participate in a categorisation exercise. Eighteen out of 20 invited participants completed the exercise. Analysis of these results and comments by the expert group resulted in a preliminary version of the decision tree for categorisation of radiotherapy interventions as shown in Figure 2.

Fig. 2: Working version of categorisation decision tree for radiotherapy interventions

A first decision node is proposed to separate interventions that impact on a patient level from those at the organisational level. Three distinct groups (potential categories) have been proposed, separating clinical interventions, technology and operational interventions. The proposed terminology, further subdivisions and phrasing of decision nodes are subject to further validation, using previously identified radiotherapy-specific characteristics (such as radiobiological properties to define clinical interventions, or types of equipment for technology interventions) (5). Technology interventions may be identified as a separate group, while endpoints and evidence may or may not be similar to those required for either clinical or operational interventions, depending on the primary aim.

Conclusion:

This abstract presents the preliminary results of a mixed-method design to develop a categorisation system for radiotherapy interventions in a value-based healthcare context. Interventions can be categorised primarily based on their impact on either patient or organisational level. Further subdivision of patient-level interventions is ongoing based on radiotherapy-specific characteristics and subject to further validation, using both qualitative input and quantitative data. An ongoing bibliometrics study of radiotherapy literature will analyse endpoints and study designs for a range of representative interventions, encompassing the proposed (sub)categories. This data will be used in further validation and assist in determining minimum outcomes and level of evidence, required for appraisal or clinical implementation of each (sub)category. Establishing these determinants will involve stakeholder from within and beyond the broad radiation oncology community. Eventually, implementation of such a categorisation tool into practice will form the basis of a VBHC framework allowing dynamic appraisal of new radiotherapy interventions in view of their clinical introduction in the health care system.