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6. Author Correction: Clinical implementation of artificial-intelligence-assisted detection of breast cancer metastases in sentinel lymph nodes: the CONFIDENT-B single-center, non-randomized clinical trial (Nature Cancer, (2024), 5, 8, (1195-1205), 10.1038/s43018-024-00788-z)

Author

Speerpunt Cancer, Cancer, MS Urologische Oncologie, Pathologie Pathologen staf, Circulatory Health, Epi Methoden Team 2, HEE, Child Health, JC onderzoeksprogramma Methodologie, Pathologie Support, Pathologie, van Dooijeweert, C, Flach, R N, Ter Hoeve, N D, Vreuls, C P H, Goldschmeding, R, Freund, J E, Pham, P, Nguyen, T Q, van der Wall, E, Frederix, G W J, Stathonikos, N, van Diest, P J, Speerpunt Cancer, Cancer, MS Urologische Oncologie, Pathologie Pathologen staf, Circulatory Health, Epi Methoden Team 2, HEE, Child Health, JC onderzoeksprogramma Methodologie, Pathologie Support, Pathologie, van Dooijeweert, C, Flach, R N, Ter Hoeve, N D, Vreuls, C P H, Goldschmeding, R, Freund, J E, Pham, P, Nguyen, T Q, van der Wall, E, Frederix, G W J, Stathonikos, N, and van Diest, P J

Published
2024

7. Clinical implementation of artificial-intelligence-assisted detection of breast cancer metastases in sentinel lymph nodes: the CONFIDENT-B single-center, non-randomized clinical trial

Author

Speerpunt Cancer, Cancer, MS Urologische Oncologie, Pathologie Pathologen staf, Circulatory Health, HEE, Child Health, JC onderzoeksprogramma Methodologie, Pathologie Support, Pathologie, van Dooijeweert, C, Flach, R N, Ter Hoeve, N D, Vreuls, C P H, Goldschmeding, R, Freund, J E, Pham, P, Nguyen, T Q, van der Wall, E, Frederix, G W J, Stathonikos, N, van Diest, P J, Speerpunt Cancer, Cancer, MS Urologische Oncologie, Pathologie Pathologen staf, Circulatory Health, HEE, Child Health, JC onderzoeksprogramma Methodologie, Pathologie Support, Pathologie, van Dooijeweert, C, Flach, R N, Ter Hoeve, N D, Vreuls, C P H, Goldschmeding, R, Freund, J E, Pham, P, Nguyen, T Q, van der Wall, E, Frederix, G W J, Stathonikos, N, and van Diest, P J

Published
2024

9. Paravertebral catheter versus EPidural analgesia in Minimally invasive Esophageal resectioN: a randomized controlled multicenter trial (PEPMEN trial)

Author

Kingma, B. F., Eshuis, W. J., de Groot, E. M., Feenstra, M. L., Ruurda, J. P., Gisbertz, S. S., ten Hoope, W., Marsman, M., Hermanides, J., Hollmann, M. W., Kalkman, C. J., Luyer, M. D. P., Nieuwenhuijzen, G. A. P., Scholten, H. J., Buise, M., van Det, M. J., Kouwenhoven, E. A., van der Meer, F., Frederix, G. W. J., Cheong, E., al Naimi, K., van Berge Henegouwen, M. I., and van Hillegersberg, R.

Published
2020
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10. Rationale and design of the iCORONARY trial:improving the cost-effectiveness of coronary artery disease diagnosis

Author

Peper, J., Becker, L. M., Bruning, T. A., Budde, R. P.J., van Dockum, W. G., Frederix, G. W.J., Habets, J., Henriques, J. P.S., Houthuizen, P., Mohamed Hoesein, F. A.A., Planken, R. N., Voskuil, M., Bots, M. L., Leiner, T., Swaans, M. J., Peper, J., Becker, L. M., Bruning, T. A., Budde, R. P.J., van Dockum, W. G., Frederix, G. W.J., Habets, J., Henriques, J. P.S., Houthuizen, P., Mohamed Hoesein, F. A.A., Planken, R. N., Voskuil, M., Bots, M. L., Leiner, T., and Swaans, M. J.

Abstract

Background: In patients with stable coronary artery disease (CAD), revascularisation decisions are based mainly on the visual grading of the severity of coronary stenosis on invasive coronary angiography (ICA). However, invasive fractional flow reserve (FFR) is the current standard to determine the haemodynamic significance of coronary stenosis. Non-invasive and less-invasive imaging techniques such as computed-tomography-derived FFR (FFR-CT) and angiography-derived FFR (QFR) combine both anatomical and functional information in complex algorithms to calculate FFR. Trial design: The iCORONARY trial is a prospective, multicentre, non-inferiority randomised controlled trial (RCT) with a blinded endpoint evaluation. It investigates the costs, effects and outcomes of different diagnostic strategies to evaluate the presence of CAD and the need for revascularisation in patients with stable angina pectoris who undergo coronary computed tomography angiography. Those with a Coronary Artery Disease—Reporting and Data System (CAD-RADS) score between 0–2 and 5 will be included in a prospective registry, whereas patients with CAD-RADS 3 or 4A will be enrolled in the RCT. The RCT consists of three randomised groups: (1) FFR-CT-guided strategy, (2) QFR-guided strategy or (3) standard of care including ICA and invasive pressure measurements for all intermediate stenoses. The primary endpoint will be the occurrence of major adverse cardiac events (death, myocardial infarction and repeat revascularisation) at 1 year. Clinicaltrials.gov-identifier: NCT04939207. Conclusion: The iCORONARY trial will assess whether a strategy of FFR-CT or QFR is non-inferior to invasive angiography to guide the need for revascularisation in patients with stable CAD. Non-inferiority to the standard of care implies that these techniques are attractive, less-invasive alternatives to current diagnostic pathways.

Published
2023

11. Realizing the value of complex medical technology: Demonstrating cost-effectiveness is not enough

Author

Global Public Health & Bioethics, Global Health, Cancer, HEE, Child Health, JC onderzoeksprogramma Methodologie, MS Radiotherapie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Trialbureau Beeld, Hehakaya, C., Frederix, G. W.J., van der Voort van Zyp, J. RN, Grobbee, D. E., Verkooijen, H. M., Global Public Health & Bioethics, Global Health, Cancer, HEE, Child Health, JC onderzoeksprogramma Methodologie, MS Radiotherapie, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Trialbureau Beeld, Hehakaya, C., Frederix, G. W.J., van der Voort van Zyp, J. RN, Grobbee, D. E., and Verkooijen, H. M.

Published
2023

12. Rationale and design of the iCORONARY trial: improving the cost-effectiveness of coronary artery disease diagnosis

Author

Cardiologie, Researchgr. Cardiovasculaire Radiologie, Cancer, Onderwijs Public Health, HEE, Child Health, JC onderzoeksprogramma Methodologie, MS Radiologie, Team Medisch, Circulatory Health, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Peper, J., Becker, L. M., Bruning, T. A., Budde, R. P.J., van Dockum, W. G., Frederix, G. W.J., Habets, J., Henriques, J. P.S., Houthuizen, P., Mohamed Hoesein, F. A.A., Planken, R. N., Voskuil, M., Bots, M. L., Leiner, T., Swaans, M. J., Cardiologie, Researchgr. Cardiovasculaire Radiologie, Cancer, Onderwijs Public Health, HEE, Child Health, JC onderzoeksprogramma Methodologie, MS Radiologie, Team Medisch, Circulatory Health, Cardiovasculaire Epi Team 5, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Peper, J., Becker, L. M., Bruning, T. A., Budde, R. P.J., van Dockum, W. G., Frederix, G. W.J., Habets, J., Henriques, J. P.S., Houthuizen, P., Mohamed Hoesein, F. A.A., Planken, R. N., Voskuil, M., Bots, M. L., Leiner, T., and Swaans, M. J.

Published
2023

13. Rapid exome sequencing as a first-tier test in neonates with suspected genetic disorder: results of a prospective multicenter clinical utility study in the Netherlands

Author

Olde Keizer, Richelle A.C.M., Marouane, Abderrahim, Kerstjens-Frederikse, Wilhelmina S., Deden, A. Chantal, Lichtenbelt, Klaske D., Jonckers, Tinneke, Vervoorn, Marieke, Vreeburg, M., Henneman, Lidewij, de Vries, Linda S., Sinke, Richard J., Pfundt, Rolph, Stevens, Servi J.C., Andriessen, Peter, van Lingen, Richard A., Nelen, Marcel, Scheffer, Hans, Stemkens, Daphne, Oosterwijk, Cor, van Amstel, Hans Kristian Ploos, de Boode, W. P., van Zelst-Stams, W., Frederix, Geert W.J., Vissers, L. E.L.M., Henneman, L., van Haelst, M. M., Sistermans, E. A., Cornel, M. C., Misra-Isrie, M., Mannens, M. M.A.M., Waisfisz, Q., van Hagen, J. M., Brooks, A. S., Barakat, T. S., Hoefsloot, E. H., van Lingen, R. A., Ruivenkamp, C. A.L., Koene, S., Rutten, J. W., de Koning, B., Stevens, S. J.C., van den Wijngaard, A., Stegmann, A. P.A., Deden, A. C., Rodenburg, W., Sinke, R. J., van der Velde, K. J., de Vries, L. S., Frederix, G. W.J., Oegema, R., Clinical Genetics, Pediatric Surgery, Radiology & Nuclear Medicine, Internal Medicine, Department of Finance, Cell biology, Cardiothoracic Surgery, Molecular Genetics, Pathology, Erasmus School of Law, and Health Economics (HE)

Abstract

The introduction of rapid exome sequencing (rES) for critically ill neonates admitted to the neonatal intensive care unit has made it possible to impact clinical decision-making. Unbiased prospective studies to quantify the impact of rES over routine genetic testing are, however, scarce. We performed a clinical utility study to compare rES to conventional genetic diagnostic workup for critically ill neonates with suspected genetic disorders. In a multicenter prospective parallel cohort study involving five Dutch NICUs, we performed rES in parallel to routine genetic testing for 60 neonates with a suspected genetic disorder and monitored diagnostic yield and the time to diagnosis. To assess the economic impact of rES, healthcare resource use was collected for all neonates. rES detected more conclusive genetic diagnoses than routine genetic testing (20% vs. 10%, respectively), in a significantly shorter time to diagnosis (15 days (95% CI 10–20) vs. 59 days (95% CI 23–98, p < 0.001)). Moreover, rES reduced genetic diagnostic costs by 1.5% (€85 per neonate). Conclusion: Our findings demonstrate the clinical utility of rES for critically ill neonates based on increased diagnostic yield, shorter time to diagnosis, and net healthcare savings. Our observations warrant the widespread implementation of rES as first-tier genetic test in critically ill neonates with disorders of suspected genetic origin.What is Known:• Rapid exome sequencing (rES) enables diagnosing rare genetic disorders in a fast and reliable manner, but retrospective studies with neonates admitted to the neonatal intensive care unit (NICU) indicated that genetic disorders are likely underdiagnosed as rES is not routinely used.• Scenario modeling for implementation of rES for neonates with presumed genetic disorders indicated an expected increase in costs associated with genetic testing.What is New:• This unique prospective national clinical utility study of rES in a NICU setting shows that rES obtained more and faster diagnoses than conventional genetic tests.• Implementation of rES as replacement for all other genetic tests does not increase healthcare costs but in fact leads to a reduction in healthcare costs.

Published
2023

14. Evaluation of PET and laparoscopy in STagIng advanced gastric cancer: a multicenter prospective study (PLASTIC-study)

Author

Brenkman, H. J. F., Gertsen, E. C., Vegt, E., van Hillegersberg, R., van Berge Henegouwen, M. I., Gisbertz, S. S., Luyer, M. D. P., Nieuwenhuijzen, G. A. P., van Lanschot, J. J. B., Lagarde, S. M., de Steur, W. O., Hartgrink, H. H., Stoot, J. H. M. B., Hulsewe, K. W. E., Spillenaar Bilgen, E. J., van Det, M. J., Kouwenhoven, E. A., van der Peet, D. L., Daams, F., van Sandick, J. W., van Grieken, N. C. T., Heisterkamp, J., van Etten, B., Haveman, J. W., Pierie, J. P., Jonker, F., Thijssen, A. Y., Belt, E. J. T., van Duijvendijk, P., Wassenaar, E., van Laarhoven, H. W. M., Wessels, F. J., Haj Mohammad, N., van Stel, H. F., Frederix, G. W. J., Siersema, P. D., Ruurda, J. P., and on behalf of the PLASTIC Study Group

Published
2018
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15. Implementation of Whole-Genome and Transcriptome Sequencing Into Clinical Cancer Care

Author

Cuppen, E, Elemento, O, Rosenquist, R, Nikic, S, IJzerman, M, Zaleski, ID, Frederix, G, Levin, L-A, Mullighan, CG, Buettner, R, Pugh, TJ, Grimmond, S, Caldas, C, Andre, F, Custers, I, Campo, E, van Snellenberg, H, Schuh, A, Nakagawa, H, von Kalle, C, Haferlach, T, Froehling, S, Jobanputra, V, Cuppen, E, Elemento, O, Rosenquist, R, Nikic, S, IJzerman, M, Zaleski, ID, Frederix, G, Levin, L-A, Mullighan, CG, Buettner, R, Pugh, TJ, Grimmond, S, Caldas, C, Andre, F, Custers, I, Campo, E, van Snellenberg, H, Schuh, A, Nakagawa, H, von Kalle, C, Haferlach, T, Froehling, S, and Jobanputra, V

Abstract

PURPOSE: The combination of whole-genome and transcriptome sequencing (WGTS) is expected to transform diagnosis and treatment for patients with cancer. WGTS is a comprehensive precision diagnostic test that is starting to replace the standard of care for oncology molecular testing in health care systems around the world; however, the implementation and widescale adoption of this best-in-class testing is lacking. METHODS: Here, we address the barriers in integrating WGTS for cancer diagnostics and treatment selection and answer questions regarding utility in different cancer types, cost-effectiveness and affordability, and other practical considerations for WGTS implementation. RESULTS: We review the current studies implementing WGTS in health care systems and provide a synopsis of the clinical evidence and insights into practical considerations for WGTS implementation. We reflect on regulatory, costs, reimbursement, and incidental findings aspects of this test. CONCLUSION: WGTS is an appropriate comprehensive clinical test for many tumor types and can replace multiple, cascade testing approaches currently performed. Decreasing sequencing cost, increasing number of clinically relevant aberrations and discovery of more complex biomarkers of treatment response, should pave the way for health care systems and laboratories in implementing WGTS into clinical practice, to transform diagnosis and treatment for patients with cancer.

Published
2022

16. Cost-effectiveness analysis of 1.5T MRI-guided radiotherapy: A survey in the MR-Linac Consortium

Author

Cancer, Trialbureau Beeld, MS Radiotherapie, Global Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, HEE, Child Health, JC onderzoeksprogramma Methodologie, Hehakaya, C., van Zijp, J. R. van der Voort, Grobbee, D. E., Verkooijen, H. M., Frederix, G. F., Cancer, Trialbureau Beeld, MS Radiotherapie, Global Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, HEE, Child Health, JC onderzoeksprogramma Methodologie, Hehakaya, C., van Zijp, J. R. van der Voort, Grobbee, D. E., Verkooijen, H. M., and Frederix, G. F.

Published
2022

18. Mainstream germline genetic testing for patients with epithelial ovarian cancer leads to higher testing rates and a reduction in genetics-related healthcare costs from a healthcare payer perspective

Author

Genetica Sectie Oncogenetica, Cancer, HEE, Child Health, JC onderzoeksprogramma Methodologie, Genetica, MS Gynaecologische Oncologie, Genetica Sectie Genoomdiagnostiek, Genetica Klinische Genetica, Bokkers, K, Frederix, G W J, Velthuizen, M E, van der Aa, M, Gerestein, C G, van Dorst, E B L, Lange, J G, Louwers, J A, Koole, W, Zweemer, R P, Ausems, M G E M, Genetica Sectie Oncogenetica, Cancer, HEE, Child Health, JC onderzoeksprogramma Methodologie, Genetica, MS Gynaecologische Oncologie, Genetica Sectie Genoomdiagnostiek, Genetica Klinische Genetica, Bokkers, K, Frederix, G W J, Velthuizen, M E, van der Aa, M, Gerestein, C G, van Dorst, E B L, Lange, J G, Louwers, J A, Koole, W, Zweemer, R P, and Ausems, M G E M

Published
2022

22. Clinical trial protocol for PSMA-SELECT: Dutch National Randomized study of PSMA-PET/ CT as a triage tool for pelvic lymph node dissection in prostatectomy patients

Author

Wever, L., primary, Soeterik, T.F.W., additional, Dijksman, L.M., additional, Frederix, G., additional, Van Melick, H.H.E., additional, Monninkhof, E.M., additional, Verkooijen, H.M., additional, Beerlage, H., additional, Van Basten, J-P.A., additional, and Van Den Bergh, R.C.N., additional

Published
2021
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25. Medical Costs of Children Admitted to the Neonatal Intensive Care Unit: the Role and Possible Economic Impact of WES in Early Diagnosis

Author

Frederix G, Amstel JPv, Marouane A, Vissers L, de Boode W, Zelst-Stams Wv, Keizer Ro, Keusters W, Henneman L, and Deden A

Subjects
medicine.medical_specialty, Neonatal intensive care unit, business.industry, medicine, Economic impact analysis, Intensive care medicine, business, Medical costs
Abstract

Objective: The objective of this study is to provide an overview of average healthcare costs for patients admitted to the Neonatal Intensive Care Unit (NICU) and to assess possible impact of implementing Whole Exome Sequencing (WES) on these total healthcare costs.Methods: We retrospectively collected postnatal healthcare data of all patients admitted to the level IV NICU at the Radboudumc (October 2013-October 2015) and linked unit costs to these healthcare consumptions. Average healthcare costs were calculated and a distinction between patients was made based on performance of genetic tests and the presence of congenital anomalies (CAs).Results: Overall, €26,627 was spend per patient. Genetic costs accounted for 2.3% of all costs. Healthcare costs were higher for patients with CAs compared to patients without CAs. Patients with genetic diagnostics were also more expensive then patients without genetic diagnostics. When performing trio-WES for all patients instead of current diagnostics, overall healthcare costs will increase with 22.2%. In case only patients with CAs receive trio-WES, average per patient healthcare costs will increase with 5.3%. Performing trio-WES only for patients with multiple CAs did not result in any cost changes.Conclusions: Genetic diagnostic testing accounted for a small fraction of total costs. By implementing trio-WES as genetic diagnostic test for all patients with CAs there is a limited increase in overall healthcare budget. Not only the diagnostic yield of this cohort will increase, but implementing trio-WES for all patients with CAs may also allow for improved personalized treatments options guided by the diagnoses made.

Published
2021
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28. Multi-use disease models : A blueprint for application in support of health care insurance coverage policy and a case study in Diabetes Mellitus

Author

Wang, J, Pouwels, X, Ramaekers, B, Frederix, G, van Lieshout, C, Hoogenveen, R, Li, X, de Wit, GA, Joore, M, Koffijberg, H, van Giessen, A, Feenstra, T, Wang, J, Pouwels, X, Ramaekers, B, Frederix, G, van Lieshout, C, Hoogenveen, R, Li, X, de Wit, GA, Joore, M, Koffijberg, H, van Giessen, A, and Feenstra, T

Abstract

RIVM rapport:Zorginstituut Nederland adviseert de minister van VWS onder andere over vergoedingen van medicijnen en andere behandelingen in het basispakket van de ziektekostenverzekering. Het Zorginstituut gebruikt daarvoor onder andere dossiers van medicijnenfabrikanten waarin zij de gezondheidswinst en kosten inschatten op basis van beslismodellen. Met deze beslismodellen wordt bekeken of medicijnen en andere behandelingen op de lange termijn effect hebben op de gezondheid. Bijvoorbeeld wat een betere bloedsuikerspiegel bij mensen met diabetes betekent voor complicaties, zoals hart- en vaatziekten en amputaties. Ook brengt het model de kosten van een behandeling met een nieuw medicijn in kaart. Denk aan de kosten van het medicijn zelf, maar ook besparingen omdat het medicijn de kans op complicaties met hoge behandelkosten kan verkleinen. Op dit moment beoordeelt het Zorginstituut voor bijna elk medicijn of behandeling een dossier waarvoor een apart beslismodel is gebruikt. Hierdoor zijn de effecten van verschillende medicijnen voor dezelfde ziekte niet goed te vergelijken. Daarnaast is het Zorginstituut veel tijd kwijt om de kwaliteit van elk beslismodel te toetsen. Het is daarom aantrekkelijk om voor elke ziekte één model te hebben, de zogenaamde meervoudig gebruik-modellen. Hiermee kunnen betere en consistentere beslissingen genomen worden. Het RIVM heeft met de universiteiten van Twente, Maastricht, Groningen en Utrecht verkend hoe het Zorginstituut met meervoudig gebruikmodellen kan gaan werken. Mede op basis van dit rapport beslist het Zorginstituut of en hoe zij verder gaan met meervoudig gebruikmodellen. Bovendien is een meervoudig gebruik beslismodel gemaakt voor diabetes en als casus uitgewerkt. Het RIVM heeft vijf business cases ontwikkeld om het werken met meervoudig gebruik-modellen op te zetten, en de voor- en nadelen beschreven. In deze opties verschillen de rol en verantwoordelijkheid van betrokken partijen, zoals het Zorginstituut, onderzoeksinstituten en consu, The National Health Care Institute (hereinafter referred to as ZIN) advises the Minister of Health, Welfare and Sport (VWS) on a variety of topics, including reimbursements for medicines and other treatments in the mandatory health insurance package. For this purpose, among other things, ZIN uses dossiers from pharmaceutical companies, in which they estimate the health benefits and costs based on decision models. These decision models are used to examine whether medicines and other treatments improve the health of individuals in the long term. For example, they calculate how better blood glucose levels in people with diabetes translate to less complications, such as cardiovascular diseases and amputations. The models incorporate the costs of the medicine, but also the savings made because the medicine reduces the likelihood of complications and the resulting high treatment costs. ZIN is currently assessing decision models dossier by dossier, with a different decision model being used for almost every medicine or treatment. Therefore, it is difficult to compare the effects of a number of medicines for the same disease. ZIN also spends a lot of time testing the quality of each decision model. It would be better to have a single model for each disease, or multi-use models, as such models meant for repeated use might be called. This would enable those involved to make better and more consistent decisions. RIVM and the Universities of Twente, Maastricht, Groningen and Utrecht have carried out a study into how ZIN could work with multi-use models. This report will assist ZIN in making the decision of whether to switch to multi-use models and, if so, how. By way of case study, RIVM has also created a multi-use model for diabetes. RIVM and its partners have developed five business cases for working with multi-use models and described their advantages and disadvantages. The roles and responsibilities of the parties involved, i.e. ZIN, other research institutes, academic grou

Published
2021

29. Early Health Economic Analysis of 1.5T MRI-guided Radiotherapy for Localized Prostate Cancer

Author

Trialbureau Beeld, Cancer, MS Radiotherapie, Global Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, HEE, Child Health, JC onderzoeksprogramma Methodologie, Hehakaya, C., van Zyp, J. R. van der Voort, Vanneste, B. G., Grutters, J. P., Grobbee, D. E., Verkooijen, H. M., Frederix, G. W., Trialbureau Beeld, Cancer, MS Radiotherapie, Global Health, Circulatory Health, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, HEE, Child Health, JC onderzoeksprogramma Methodologie, Hehakaya, C., van Zyp, J. R. van der Voort, Vanneste, B. G., Grutters, J. P., Grobbee, D. E., Verkooijen, H. M., and Frederix, G. W.

Published
2021

30. Case-studies of displacement effects in Dutch hospital care

Author

Wammes, J.J.G., Frederix, G., Govaert, P., Determann, D., Evers, S, Paulus, A., Stadhouders, N.W., Jeurissen, P.P., Oortwijn, W.J., Adang, E.M.M., Wammes, J.J.G., Frederix, G., Govaert, P., Determann, D., Evers, S, Paulus, A., Stadhouders, N.W., Jeurissen, P.P., Oortwijn, W.J., and Adang, E.M.M.

Abstract

Contains fulltext : 218258.pdf (publisher's version ) (Open Access), BACKGROUND: Under a constrained health care budget, cost-increasing technologies may displace funds from existing health services. However, it is unknown what services are displaced and how such displacement takes place in practice. The aim of our study was to investigate how the Dutch hospital sector has dealt with the introduction of cost-increasing health technologies, and to present evidence of the relative importance of three main options to deal with cost-increases in health care: increased spending, increased efficiency, or displacement of other services. METHODS: We conducted six case-studies and interviewed 84 professionals with various roles and responsibilities (practitioners, heads of clinical department, board of directors, insurers, and others) to investigate how they experienced decision making in response to the cost pressure of cost-increasing health technologies. Transcripts were analyzed thematically in Atlas.ti on the basis of an item list. RESULTS: Direct displacement of high-value care due to the introduction of new technologies was not observed; respondents primarily pointed to increased spending and efficiency measures to accommodate the introduction of the cost-increasing technologies. Respondents found it difficult to identify the opportunity costs; partly due to limited transparency in the internal allocation of funds within a hospital. Furthermore, respondents experienced the entry of new technologies and cost-containment as two parallel processes that are generally not causally linked: cost containment was experienced as a permanent issue to level costs and revenues, independent from entry of new technologies. Furthermore, the way of financing was found important in displacement in the Netherlands, especially as there is a separate budget for expensive drugs. This budget pressure was found to be reallocated horizontally across departments, whereas the budget pressure of other services is primarily reallocated vertically within department

Published
2020

31. Paravertebral catheter versus EPidural analgesia in Minimally invasive Esophageal resectioN : a randomized controlled multicenter trial (PEPMEN trial)

Author

Kingma, B F, Eshuis, W J, de Groot, E M, Feenstra, M L, Ruurda, J P, Gisbertz, S S, Ten Hoope, W, Marsman, M, Hermanides, J, Hollmann, M W, Kalkman, C J, Luyer, M D P, Nieuwenhuijzen, G A P, Scholten, H J, Buise, M, van Det, M J, Kouwenhoven, E A, van der Meer, F, Frederix, G W J, Cheong, E, Al Naimi, K, van Berge Henegouwen, M I, van Hillegersberg, R, Kingma, B F, Eshuis, W J, de Groot, E M, Feenstra, M L, Ruurda, J P, Gisbertz, S S, Ten Hoope, W, Marsman, M, Hermanides, J, Hollmann, M W, Kalkman, C J, Luyer, M D P, Nieuwenhuijzen, G A P, Scholten, H J, Buise, M, van Det, M J, Kouwenhoven, E A, van der Meer, F, Frederix, G W J, Cheong, E, Al Naimi, K, van Berge Henegouwen, M I, and van Hillegersberg, R

Published
2020

32. Paravertebral catheter versus EPidural analgesia in Minimally invasive Esophageal resectioN: a randomized controlled multicenter trial (PEPMEN trial)

Author

MS CGO, Cancer, Medische staf Anesthesiologie, Other research (not in main researchprogram), Brain, Circulatory Health, HEE, Child Health, JC onderzoeksprogramma Methodologie, Divisie Beeld & Oncologie, Kingma, B F, Eshuis, W J, de Groot, E M, Feenstra, M L, Ruurda, J P, Gisbertz, S S, Ten Hoope, W, Marsman, M, Hermanides, J, Hollmann, M W, Kalkman, C J, Luyer, M D P, Nieuwenhuijzen, G A P, Scholten, H J, Buise, M, van Det, M J, Kouwenhoven, E A, van der Meer, F, Frederix, G W J, Cheong, E, Al Naimi, K, van Berge Henegouwen, M I, van Hillegersberg, R, MS CGO, Cancer, Medische staf Anesthesiologie, Other research (not in main researchprogram), Brain, Circulatory Health, HEE, Child Health, JC onderzoeksprogramma Methodologie, Divisie Beeld & Oncologie, Kingma, B F, Eshuis, W J, de Groot, E M, Feenstra, M L, Ruurda, J P, Gisbertz, S S, Ten Hoope, W, Marsman, M, Hermanides, J, Hollmann, M W, Kalkman, C J, Luyer, M D P, Nieuwenhuijzen, G A P, Scholten, H J, Buise, M, van Det, M J, Kouwenhoven, E A, van der Meer, F, Frederix, G W J, Cheong, E, Al Naimi, K, van Berge Henegouwen, M I, and van Hillegersberg, R

Published
2020

34. Evaluation of PET and laparoscopy in STagIng advanced gastric cancer : A multicenter prospective study (PLASTIC-study)

Author

Brenkman, H. J.F., Gertsen, E. C., Vegt, E., van Hillegersberg, R., van Berge Henegouwen, M. I., Gisbertz, S. S., Luyer, M. D.P., Nieuwenhuijzen, G. A.P., van Lanschot, J. J.B., Lagarde, S. M., de Steur, W. O., Hartgrink, H. H., Stoot, J. H.M.B., Hulsewe, K. W.E., Spillenaar Bilgen, E. J., van Det, M. J., Kouwenhoven, E. A., van der Peet, D. L., Daams, F., van Sandick, J. W., van Grieken, N. C.T., Heisterkamp, J., van Etten, B., Haveman, J. W., Pierie, J. P., Jonker, F., Thijssen, A. Y., Belt, E. J.T., van Duijvendijk, P., Wassenaar, E., van Laarhoven, H. W.M., Wessels, F. J., Haj Mohammad, N., van Stel, H. F., Frederix, G. W.J., Siersema, P. D., Ruurda, J. P., on behalf of the PLASTIC Study Group, Brenkman, H. J.F., Gertsen, E. C., Vegt, E., van Hillegersberg, R., van Berge Henegouwen, M. I., Gisbertz, S. S., Luyer, M. D.P., Nieuwenhuijzen, G. A.P., van Lanschot, J. J.B., Lagarde, S. M., de Steur, W. O., Hartgrink, H. H., Stoot, J. H.M.B., Hulsewe, K. W.E., Spillenaar Bilgen, E. J., van Det, M. J., Kouwenhoven, E. A., van der Peet, D. L., Daams, F., van Sandick, J. W., van Grieken, N. C.T., Heisterkamp, J., van Etten, B., Haveman, J. W., Pierie, J. P., Jonker, F., Thijssen, A. Y., Belt, E. J.T., van Duijvendijk, P., Wassenaar, E., van Laarhoven, H. W.M., Wessels, F. J., Haj Mohammad, N., van Stel, H. F., Frederix, G. W.J., Siersema, P. D., Ruurda, J. P., and on behalf of the PLASTIC Study Group

Published
2018

35. Evaluation of PET and laparoscopy in STagIng advanced gastric cancer: A multicenter prospective study (PLASTIC-study)

Author

MS CGO, Cancer, Divisie Beeld & Oncologie, MS Radiologie, MS Medische Oncologie, Verplegingswetenschap, Other research (not in main researchprogram), JC onderzoeksprogramma Methodologie, HEE, Child Health, Brenkman, H. J.F., Gertsen, E. C., Vegt, E., van Hillegersberg, R., van Berge Henegouwen, M. I., Gisbertz, S. S., Luyer, M. D.P., Nieuwenhuijzen, G. A.P., van Lanschot, J. J.B., Lagarde, S. M., de Steur, W. O., Hartgrink, H. H., Stoot, J. H.M.B., Hulsewe, K. W.E., Spillenaar Bilgen, E. J., van Det, M. J., Kouwenhoven, E. A., van der Peet, D. L., Daams, F., van Sandick, J. W., van Grieken, N. C.T., Heisterkamp, J., van Etten, B., Haveman, J. W., Pierie, J. P., Jonker, F., Thijssen, A. Y., Belt, E. J.T., van Duijvendijk, P., Wassenaar, E., van Laarhoven, H. W.M., Wessels, F. J., Haj Mohammad, N., van Stel, H. F., Frederix, G. W.J., Siersema, P. D., Ruurda, J. P., on behalf of the PLASTIC Study Group, MS CGO, Cancer, Divisie Beeld & Oncologie, MS Radiologie, MS Medische Oncologie, Verplegingswetenschap, Other research (not in main researchprogram), JC onderzoeksprogramma Methodologie, HEE, Child Health, Brenkman, H. J.F., Gertsen, E. C., Vegt, E., van Hillegersberg, R., van Berge Henegouwen, M. I., Gisbertz, S. S., Luyer, M. D.P., Nieuwenhuijzen, G. A.P., van Lanschot, J. J.B., Lagarde, S. M., de Steur, W. O., Hartgrink, H. H., Stoot, J. H.M.B., Hulsewe, K. W.E., Spillenaar Bilgen, E. J., van Det, M. J., Kouwenhoven, E. A., van der Peet, D. L., Daams, F., van Sandick, J. W., van Grieken, N. C.T., Heisterkamp, J., van Etten, B., Haveman, J. W., Pierie, J. P., Jonker, F., Thijssen, A. Y., Belt, E. J.T., van Duijvendijk, P., Wassenaar, E., van Laarhoven, H. W.M., Wessels, F. J., Haj Mohammad, N., van Stel, H. F., Frederix, G. W.J., Siersema, P. D., Ruurda, J. P., and on behalf of the PLASTIC Study Group

Published
2018

36. Changing costs of metastatic non small cell lung cancer in the Netherlands

Author

Keusters, W R, de Weger, Vincent A, Hövels, A, Schellens, J H M, Frederix, G W J, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology, and Pharmacoepidemiology and Clinical Pharmacology

Subjects
Male, Cancer Research, Lung Neoplasms, medicine.medical_treatment, 0302 clinical medicine, Cost of Illness, Non-small cell lung cancer, Carcinoma, Non-Small-Cell Lung, Outcome Assessment, Health Care, Disease management, 80 and over, 030212 general & internal medicine, Non-Small-Cell Lung, Case report form, Average cost, Netherlands, Aged, 80 and over, Health Policy, Disease Management, Health Care Costs, Middle Aged, Oncolytic drugs, Oncology, Cost driver, 030220 oncology & carcinogenesis, Healthcare policy, Cost of illness, Female, Immunotherapy, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, Antineoplastic Agents, 03 medical and health sciences, Outcome Assessment (Health Care), Internal medicine, medicine, Journal Article, Humans, Intensive care medicine, Lung cancer, Aged, Retrospective Studies, business.industry, Carcinoma, Cancer, Retrospective cohort study, Length of Stay, medicine.disease, Oncolytic virus, Radiation therapy, business, Delivery of Health Care
Abstract

Objectives The primary objective of this study was to identify the total intramural cost of illness of metastatic non-small cell lung cancer (NSCLC) in the Netherlands between 2006–2012. Secondary objective was to identify whether changes in cost patterns of metastatic NSCLC have occurred over the last years. Methods Patients diagnosed with metastatic NSCLC between 1-1-2006 and 31-12-2012, who had follow-up to death or the date of data cut-off and no trial participation were included. A structured chart review was performed using a case report form. Data collection started after diagnosis of metastatic NSCLC and ended at death or April first, 2015. Data regarding outpatient visits, clinical attendance, oncolytic drug use, imaging, lab tests, radiotherapy and surgery were collected. Results Sixty-seven patients were included with a median age of 67 years. The median follow-up was 234 days. On average patients had 28 outpatient visits and 11 inpatient days. Oncolytic drugs were administered to 76% of the patients. Mean per patient expenditures amounted up to €17,463, with oncolytic drugs (€6,390) as the main cost driver. In comparison with the time-period of 2003–2005 total per patient per year expenses decreased by 44%. The contribution to total yearly costs of oncolytic drugs increased from 18% to 35%, while costs for inpatient stay decreased from 52% to 28% of total expenditures. Conclusion Outcomes in this study demonstrate that average treatment costs for metastatic NSCLC in the Netherlands Cancer Institute amount to €17,463. Compared to a prior study the average cost for metastatic NSCLC over time in the Netherlands has decreased. A shift of main cost drivers seems to have occurred from inpatient stay, to oncolytic drugs as main contributor. The shift towards treatment cost might become more visible with the introduction of immunotherapy. These results mark the importance of up-to-date cost of illness studies.

Published
2017

40. Changing costs of metastatic non small cell lung cancer in the Netherlands

Author

Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Keusters, W R, de Weger, Vincent A, Hövels, A, Schellens, J H M, Frederix, G W J, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Keusters, W R, de Weger, Vincent A, Hövels, A, Schellens, J H M, and Frederix, G W J

Published
2017

41. Changing costs of metastatic non small cell lung cancer in the Netherlands

Author

HEE, Child Health, JC onderzoeksprogramma Methodologie, Keusters, W R, de Weger, Vincent A, Hövels, A.M., Schellens, Jan H M, Frederix, G W J, HEE, Child Health, JC onderzoeksprogramma Methodologie, Keusters, W R, de Weger, Vincent A, Hövels, A.M., Schellens, Jan H M, and Frederix, G W J

Published
2017

44. Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study

Author

Conraads, V., Pattyn, N., de Maeyer, C., Beckers, P., Coeckelberghs, E., Cornelissen, V.A., Denollet, J., Frederix, G., Goetschalckx, K., Hoymans, V.Y., Possemiers, N., Schepers, D., Shivalkar, B., Voigt, J.U., van Craenenbroeck, E.M., Vanhees, L., Conraads, V., Pattyn, N., de Maeyer, C., Beckers, P., Coeckelberghs, E., Cornelissen, V.A., Denollet, J., Frederix, G., Goetschalckx, K., Hoymans, V.Y., Possemiers, N., Schepers, D., Shivalkar, B., Voigt, J.U., van Craenenbroeck, E.M., and Vanhees, L.

Abstract

Background Exercise-based cardiac rehabilitation increases peak oxygen uptake (peak VO2), which is an important predictor of mortality in cardiac patients. However, it remains unclear which exercise characteristics are most effective for improving peak VO2 in coronary artery disease (CAD) patients. Proof of concept papers comparing Aerobic Interval Training (AIT) and Moderate Continuous Training (MCT) were conducted in small sample sizes and findings were inconsistent and heterogeneous. Therefore, we aimed to compare the effects of AIT and Aerobic Continuous Training (ACT) on peak VO2, peripheral endothelial function, cardiovascular risk factors, quality of life and safety, in a large multicentre study. Methods Two-hundred CAD patients (LVEF > 40%, 90% men, mean age 58.4 ± 9.1 years) were randomized to a supervised 12-week cardiac rehabilitation programme of three weekly sessions of either AIT (90–95% of peak heart rate (HR)) or ACT (70–75% of peak HR) on a bicycle. Primary outcome was peak VO2; secondary outcomes were peripheral endothelial function, cardiovascular risk factors, quality of life and safety. Results Peak VO2 (ml/kg/min) increased significantly in both groups (AIT 22.7 ± 17.6% versus ACT 20.3 ± 15.3%; p-time < 0.001). In addition, flow-mediated dilation (AIT +34.1% (range –69.8 to 646%) versus ACT +7.14% (range –66.7 to 503%); p-time < 0.001) quality of life and some other cardiovascular risk factors including resting diastolic blood pressure and HDL-C improved significantly after training. Improvements were equal for both training interventions. Conclusions Contrary to earlier smaller trials, we observed similar improvements in exercise capacity and peripheral endothelial function following AIT and ACT in a large population of CAD patients.KeywordsExercise intensity, Training modality, Coronary artery disease, Secondary preventionCardiac rehabilitationEndothelial function

Published
2015

48. Show me what you mean / PARISS a CBIR-interface

Author

Schouten, Ben, Pauwels, E.J., Caenen, G., Frederix, G., and Kuijk, A.A.M.

Subjects
ambient intelligence
Abstract

We outline the architecture of a CBIR-interface that allows the user to interactively classify images by dragging and dropping them into different piles and instructing the interface to come up with features that can mimic this classffication. Logistic regression and Sammon projection are used to support this search mode.

Published
2000

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