Towards Open Science within Health Care Technology and Management Education - presentation Open Science Kitchen

This presentation provides an introduction to the "Towards Open Science in Health Care Technology and Management Education" Comenius Teaching fellowship. The presentation took place on the 14th of July 2022

Introducing Open Science in Teaching Health Economic Modelling

Open Science is gaining ground in all research fields, including health economics and outcomes research (HEOR). However, teaching Open Science is still in its infancy. This paper describes the design, implementation and evaluation of a teaching activity focusing on introducing Open Science during a Master’s course during which participants have to develop a discrete event simulation. The teaching activity was organised as a series of lectures introducing different aspects of the Open Science philosophy and practices, such as good software coding practices, version control systems and reproducible research. The participants’ increase in Open Science knowledge was elicited through a survey before and after the teaching innovation. After the teaching innovation, participants’ knowledge of Open Science increased and they reported an improvement in Open Science-related skills, such as using a script-based statistical software, identifying and re-using open data, and collaborative script development. During the evaluation at the end of the course, the course participants mentioned that the Open Science-related content was interesting but would fit better within a course in which broader research-related content is taught. Based on this feedback, we will most likely narrow the scope of the Open-Science-related content in this course to Open Source Modelling which may better fit the scope of the course. This paper contains links to the teaching activities we developed and other resources which may be used to design teaching activities on Open Science. Herewith, we hope to inspire other teachers in including Open Science into their teaching

Cost-effectiveness of CTC guided chemo- or endocrine therapy in ER+ HER2- metastatic breast cancer – results from a randomized controlled multicenter trial

Patients with metastatic, Estrogen Receptor (ER) positive, HER2-negative, breast cancer, before initiating CDK4/6 inhibitors, receive either single agent endocrine- or chemotherapy based on their clinical risk. In this first-ever trial-based economic evaluation of Circulating Tumor Cells (CTCs), the cost-effectiveness of standardizing the prescription of endocrine- or chemotherapy using a CTC count threshold (with >5 CTCs/7.5mL indicative of unfavorable disease outcomes) was compared to current clinical practice. N=755 ER+ HER2-patients, enrolled in 17 French centres, were randomized to CTC guided or standard of care and were treated according to either through the CTC score or clinical examination. Health state utilities were calculated by mapping the QLQ-C30 to EQ-5D utilities and used to calculate Quality-Adjusted Life Years (QALY) over a 2-year time horizon. Bootstrapping and additional sensitivity analyses were performed to quantify the impact of uncertainty. Health outcomes in both arms were similar, but costs were higher in the CTC guided arm (€19,403) compared to the usual care (€18,254), resulting in an ICER of €104,078/QALY in favor of usual care. However, when the analysis was performed for the clinically high- and low-risk groups separately, CTC enumeration could be a dominant strategy (cost saving) if treatment is de-escalated in clinically high-risk patients as indicated by CTC scores. However, the current analysis was based on the PFS and OS data reported in 2021 and long-term Overall Survival data is collected since then (JCO, 2023 in press). A further analysis of the health economic impact of CTC enumeration in clinically low and high-risk groups is therefore indicated

Exploring the Cost Effectiveness of Shared Decision Making for Choosing between Disease-Modifying Drugs for Relapsing-Remitting Multiple Sclerosis in the Netherlands:A State Transition Model

Background Up to 31% of patients with relapsing-remitting multiple sclerosis (RRMS) discontinue treatment with disease-modifying drug (DMD) within the first year, and of the patients who do continue, about 40% are nonadherent. Shared decision making may decrease nonadherence and discontinuation rates, but evidence in the context of RRMS is limited. Shared decision making may, however, come at additional costs. This study aimed to explore the potential cost-effectiveness of shared decision making for RRMS in comparison with usual care, from a (limited) societal perspective over a lifetime. Methods An exploratory economic evaluation was conducted by adapting a previously developed state transition model that evaluates the cost-effectiveness of a range of DMDs for RRMS in comparison with the best supportive care. Three potential effects of shared decision making were explored: 1) a change in the initial DMD chosen, 2) a decrease in the patient's discontinuation in using the DMD, and 3) an increase in adherence to the DMD. One-way and probabilistic sensitivity analyses of a scenario that combined the 3 effects were conducted. Results Each effect separately and the 3 effects combined resulted in higher quality-adjusted life years (QALYs) and costs due to the increased utilization of DMD. A decrease in discontinuation of DMDs influenced the incremental cost-effectiveness ratio (ICER) most. The combined scenario resulted in an ICER of euro17,875 per QALY gained. The ICER was sensitive to changes in several parameters. Conclusion This study suggests that shared decision making for DMDs could potentially be cost-effective, especially if shared decision making would help to decrease treatment discontinuation. Our results, however, may depend on the assumed effects on treatment choice, persistence, and adherence, which are actually largely unknown

Machine-learning-assisted selection of antibiotic prescription

Recent years have seen a worrying increase in the levels of antibiotic resistance of many bacterial infections. Antibiotic resistance not only makes treating bacterial infections difficult but also decreases the effectiveness of antibiotic prophylaxis needed for safe surgeries, organ transplantation and cancer treatment1. There is an urgent need for new effective antibiotics; however, the antibiotic-development pipeline is dry. Without government intervention, research to develop new antibiotics is rarely profitable, and consequently most major pharmaceutical companies have left the field1. Therefore, using the antibiotics that we have at our disposal in an optimized way is crucial, to avoid the risks of both treatment failure and further increasing resistance levels2. In this issue of Nature Medicine, Yelin et al.3 describe a strategy for combating the drug resistance caused by mismatched antibiotic prescriptions in urinary tract infections (UTIs)

Towards Open Science within Health Care Technology and Management Education

Lack of research reproducibility, restricted access to scientific knowledge to citizens, fake news (on social media) and limited citizens’ involvement during scientific knowledge generation are phenomena which negatively affect the relationship between Science and society. Unfortunately, students, who will be the next scientists, practitioners and citizens, are not educated to address these scientific and societal challenges. Teaching Open Science (OS) principles to students may equip them to deal with these challenges during their future career. OS refers to any endeavour aiming to make one’s research more open, inclusive, accessible, reproducible and replicable. Therefore, OS is expected to address these challenges by promoting: open and reproducible research, publicly available scientific knowledge, public engagement of (scientific) experts within society and greater citizens’ involvement in Science. OS consequently promises to transform the relationship between Science and society. This teaching innovation will introduce Health Care Technology and Management students with the theoretical underpinning of OS and will let students practise OS during a group project. The teaching activities will comprise a series of interactive lectures and practical assignments. Key topics of this teaching innovation are an introduction to OS and FAIR principles, pre-registration, performing open reproducible research, open peer-review and practise public outreach. The teaching materials and activities will be co-created with students who already participated in this course to ensure the OS content matches students’ knowledge, interests and needs. Dissemination efforts will be undertaken during the entire duration of the project to increase awareness concerning the importance of teaching OS within educational curricula

Introduction to R markdown - solution

This is R code that generates the .pdf document provided at: http://doi.org/10.5281/zenodo.7625710