University of Twente Student Theses


Development and validitation of a Dutch version of the EVIDEM framework

Uelderink, F.C. (2014) Development and validitation of a Dutch version of the EVIDEM framework.

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Abstract:It is difficult for decision makers in health care to assess which interventions will work well and are cost effective in healthcare. Therefore there are different ways to look at the distribution of the health budget, for example the Health Technology Assessment (HTA). In HTA, cost-effectiveness is one of the components, but the problems in health care are broader than just looking at the most cost-effective intervention. One tool that will have a broader perspective to look at is the Multi-Criteria Decision Analysis (MCDA). MCDA can check several criteria of the intervention combined with the health problem and is able to draw a conclusion based on these multiple criteria. However, also this method has its limitations. A relatively new framework designed to make decisions about the allocation of the health budget is the EVIDEM framework. By using the EVIDEM framework the intervention gets a score for the effectiveness and the costs of the intervention, which allows the cost-effectiveness of the intervention to be compared with other interventions. Evaluation of this tool is still on going, and not all pros and cons are yet known at this time. The framework is currently used in several languages around the world, so it was important for this research to translate the framework into Dutch. The aim of this study was to look at the impact of different response scales within the framework. Three different response scales have been used to see whether these scales have a different outcome and whether respondents have a preference for a particular scale. To investigate if the questionnaire is reliable a retest of the framework has been done as well. The respondents were asked whether they wanted to complete the same framework test a few days later, to see if they would give the same answers to the same questions. Respondents were recruited through the Internet and through contacts of the researcher. The researcher asked his network to complete the questionnaire. The respondents needed to be a student at the University of Twente or the Saxion Highschool Enschede, and needed to attend one of the following studies: Technical Medicine, Health Sciences, Biomedical Engineering and Nursing. All respondents completed the questionnaire via the Internet, using the software program Lime Survey. 38 Respondents participated in this study, of which 11 have completed the same framework again to measure the retest validity. Based on the survey data the mean, the standard deviation and the confidence interval of the performances were measured in order to be able to determine the scatter. Based on these outcomes an ANOVA test has been performed to determine the significance of the data. The outcome of the survey shows significant differences for five of the 13 criteria of the framework between the three response scales. For the other eight criteria no significant deviation could be found. This difference is indication that there is a difference in performance between the three response scales, but it is not a significant difference. The retest of the framework is measured with the ICC. The ICC was for all three scales >0.05, which means that the performance of all three scales is good. Only 11 respondents participated in the retest, which is 28.9% of the first test. No significant difference is found in the performance of the three different response scales, but there is a preference for scale 0-6. The retest values were good for all three scales. All three response scales are equally suited to use for the framework, but the respondents have a slight preference for the response scale of 0 to 6. Further research needs to be done on the retest validity of the framework.
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:44 medicine
Programme:Health Sciences BSc (56553)
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