University of Twente Student Theses


Value Based Decision Support to prioritize Innovative Technologies for Vascular Surgery in the Hybrid Operating Theater

Heslinga, F.G. (2016) Value Based Decision Support to prioritize Innovative Technologies for Vascular Surgery in the Hybrid Operating Theater.

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Abstract:Introduction. The current hybrid operating theater (HOT) offers improved efficiency and health outcomes for (endo)vascular procedures, such as endovascular aneurysm repair (EVAR). Innovative technologies for minimally invasive interventions have the potential to further increase the value of the HOT. Restricted development budgets require prioritization of the development of these technologies. A structured methodology to deal with the (possibly conflicting) criteria of vascular surgeons in prioritizing the added value of new technologies has not yet been reported. Methods. We propose a multi-criteria decision analysis framework to evaluate the value of innovative technologies for the HOT based on the MACBETH methodology. The main surgical procedures are incorporated in the framework and interdependencies between the technologies are evaluated. The framework is applied to a specific case: the new HOT in the Medisch Spectrum Twente (MST) hospital, Netherlands. Three upcoming innovations (wound perfusion measurement, improved angiographic imaging technologies and guided steering assistance) are scored for three distinguished endovascular procedures (crural revascularization for peripheral aortic occlusive disease (PAOD), (Fenestrated) EVAR and Thoracic EVAR) based on six performance criteria. The criteria are based on a literature search towards outcome measures. Weights and performance scores for each criteria are based on interviews with two vascular surgeons from MST. The scores are multiplied with the fraction that procedure is performed to calculate overall value. Results. A wound perfusion measurement would add most value to the procedures for PAOD patients, while the other upcoming innovations would be about equally beneficial to the (F)EVAR and TEVAR procedures. Overall, the wound perfusion measurement technique would add most value to the current HOT. Conclusion. The novel framework proved useful to prioritize the development of innovative technologies for the HOT. When development costs would be similar, priority should be given to the development of a wound perfusion measurement technique.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:01 general works
Programme:Health Sciences MSc (66851)
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