TY - JOUR
T1 - What is the impact of innovation on output in healthcare with a special focus on treatment innovations in radiotherapy? A literature review
AU - Jacobs, Maria
AU - Boersma, Liesbeth
AU - Dekker, Andre
AU - Swart, Rachelle
AU - Lambin, Philippe
AU - De Ruysscher, Dirk
AU - Verhaegen, Frank
AU - Stultiens, Joost
AU - Ramaekers, Bram
AU - Merode, Fritsvan
PY - 2017
Y1 - 2017
N2 - Objective: To analyse how often innovations in healthcare 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. Advances in knowledge: This study is the first of its kind measuring how innovations are evaluated in scientific literature, before implementation in clinical practice.
AB - Objective: To analyse how often innovations in healthcare 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. Advances in knowledge: This study is the first of its kind measuring how innovations are evaluated in scientific literature, before implementation in clinical practice.
U2 - 10.1259/bjr.20170251
DO - 10.1259/bjr.20170251
M3 - Review article
C2 - 28782377
AN - SCOPUS:85031855243
VL - 90
JO - British Journal of Radiology
JF - British Journal of Radiology
SN - 0007-1285
IS - 1079
M1 - 20170251
ER -