What is the impact of innovation on output in healthcare with a special focus on treatment innovations in radiotherapy? A literature review

Maria Jacobs*, Liesbeth Boersma, Andre Dekker, Rachelle Swart, Philippe Lambin, Dirk de Ruysscher, Frank Verhaegen, Joost Stultiens, Bram Ramaekers, Frits van Merode

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Objective: To analyse how often innovations in health-care are evaluated regarding output, especially in radiotherapy. Output was defined as either survival, toxicity, safety, service, efficiency or cost-effectiveness.

Methods: A systematic literature review was conducted, using three search strategies: (1) innovations in general healthcare; (2) radiotherapy-specific innovations, i.e. organizational innovations and general implementation of innovations; (3) innovations per tumour group/radiotherapy technique. Scientific levels were classified according to the system used in European Society for Medical Oncology guidelines. Finally, we calculated the percentage of implemented innovations in Dutch radiotherapy centres for which we found evidence regarding output in the literature review.

Results: Only 94/1072 unique articles matched the inclusion criteria. Significant results on patient outcome, service or safety were reported in 65% of papers, which rose to 76% if confined to radiotherapy reviews. A significant technological improvement was identified in 26%, cost-effectiveness in 10% and costs/efficiency in 36% of the papers. The scientific level of organizational innovations was lower than that of clinical papers. Dutch radiotherapy treatment innovations were adequately evaluated on outcome data before implementation in clinical routine in a minimum of 64-92% of cases.

Conclusion: Only few studies report on output when considering innovations in general, but radiotherapy reviews give a reasonably good insight into innovation output effects, with a higher level of evidence. In Dutch radiotherapy centres only small improvements are possible regarding evaluation of treatment innovations before implementation.

Original languageEnglish
Article number20170251
Number of pages12
JournalBritish Journal of Radiology
Issue number1079
Publication statusPublished - 2017



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