Care Pathway Analysis to Inform the Earliest Stages of Technology Development: Scoping Oncological Indications in Need of Innovation

Mirre Scholte*, Jan Heidkamp, Gerjon Hannink, M A W Thijs Merkx, Janneke P C Grutters, Maroeska M Rovers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Identifying unmet needs for innovative solutions across disease contexts is challenging, but important for directing funding and research efforts and informing early-stage decisions during the innovation process. Our aim was to study the merits of care pathway analysis to scope disease contexts and guide the development of innovative devices. We used oncologic surgery as a case study, for which many intraoperative imaging techniques are under development. METHODS: Care pathway analysis is a mapping process which produces graphical maps of clinical pathways using important outcomes and subsequent consequences. We performed care pathway analyses for glioblastoma, breast, bladder, prostate, renal, pancreatic, and oral cavity cancer. Differences between a 'perfect' care pathway and the current care pathway in terms of percentage of inadequate margins, associated recurrences, quality of life, and 5-year overall survival were calculated to determine unmet needs. Data from the Netherlands cancer registry and literature was used. RESULTS: Care pathway analysis showed that highest percentages of inadequate margins were found in oral cavity cancer(72.5%), glioblastoma(48.7%), and pancreatic cancer(43.9%). Inadequate margins showed the strongest increase in recurrences in oral cavity, and bladder cancer(absolute increases of 43.5% and 41.2%, respectively). Impact on survival was largest for bladder, and oral cavity cancer with positive margins. CONCLUSIONS: Care pathway analysis provides overviews of current clinical paths in multiple indications. Disease contexts can be compared via effectiveness gaps that show the potential need for innovative solutions. This information can be used as basis for stakeholder involvement processes to prioritize care pathways in need of innovation.
Original languageEnglish
Pages (from-to)1744-1753
Number of pages10
JournalValue in Health
Volume26
Issue number12
Early online date25 Sept 2023
DOIs
Publication statusPublished - Dec 2023

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