| CLL Problem 1 | CLL Problem 2 | ICU Problem 1 | ICU Problem 2 | Diabetes |
---|---|---|---|---|---|
Clinically relevant problem | Variations in treatment response to 1st and 2nd line | Imperfect algorithms for identifying newly diagnosed, high-risk CLL patients | Identifying patients with ineffective efforts at risk of poor outcomes | Diagnosing catheter related bloodstream infections (CRBSI) | Unknown variation in response to treatment with SGLTs + GLPs |
Assess data for development | – NGS data available – Follow-up probably sufficient – Large variation in treatments | – NGS data available – Follow-up sufficient | – Monitoring & EHR data available – Sufficient sample size, sufficient follow-up, limited missing data | – EHR & biosignal data available & continued prospectively – Limited missing data anticipated | – EHR data available from secondary care – Large amounts of missing follow-up data |
Identify critical barriers for successful development and implementation | – | P: Newly diagnosed CLL patients without treatment indication I: Analytics that identify high risk patients followed by treatment with ibrutinib C: Stratification using clinical symptoms without receiving treatment O: Costs, LYG, QALYs Barriers: – Site-specific validation required – Reimbursement of novel treatment | P: Patients on assisted mechanical ventilation I: Identify patients at risk of poor outcomes with analytics and intervene to avoid ineffective efforts C: Care in which ineffective efforts are not identified O: Mortality, LOS, costs, LYG, QALYs Barriers: – Availability of monitor that identifies ineffective efforts – Site-specific validation | P: Patients with central venous catheter I: Early identification of CRBSI, catheter removal & antibiotics C: Late identification of CRBSI, catheter removal & antibiotics O: Mortality, LOS, costs, LYG, QALYs Barriers: – Varying prevalence of CRBSI – Integration of analytics in an EHR – Site-specific validation | – |
Economic Evaluation | – | Benefits: 0.13 QALYs, + €89,985 | Benefits: − 3% mortality, 0.21 QALYs, − €264 [58] | Benefits: − 0.5% mortality, + 0.06 QALYs, − €886 | – |
Continue development | Not feasible. Sample size too small and large variations in prescribing practices | Not feasible. High costs of treatment offset benefits gained | Feasible. Invest in research into the effectiveness of intervention and the price of the analytics [58] | Feasible. If the target market extends beyond Greece the impact of the prevalence of CRBSI on benefits should be considered | Not feasible. Small sample size and large amount of missing follow-up data |