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Psychosocial Research and Epidemiology: Wim van Harten

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Wim van Harten, MD., Ph.D. professorGroup leader, Professor

About Wim van Harten

Introduction

In this group three research topics are covered: Early Stage Technology Assessment, Improving Oncology Services and Cancer Rehabilitation.

Early Stage Technology Assessment

As healthcare costs are continuously increasing and demographics and technologic developments in oncology cause especially service challenges and financial burdens on health systems, sustainability of future oncology services will inevitably become an issue. Gradually we can expect Health Technology Assessment (HTA) not only to be involved in policy- and coverage decisions, but also in an earlier stage in the translational research process.

As one of the first examples in precision medicine, for the introduction of the 70-gene micro array test (MammaPrint®) as a prognostic tool in the treatment of node negative breast cancer, a technology assessment study was conducted. As the course of development of technologies in an early stage of the translation from bench to bedside and the diffusion process are not easy to predict, we developed an early stage evaluation approach that takes the technology dynamics into account, using constructive technology assessment (CTA). The CTA consisted of besides health economics, also organizational, ethical and patient related issues which were evaluated during the RASTER-study and as a side study of the European RCT MINDACT-trial (see PhD thesis Valesca Retèl).

Additionally, in cooperation with the University of Twente, we have initiated an early stage technology assessment to introduce the Tumor Infiltrating Lymphocyte (TIL)-treatment technology in advanced melanoma (Valesca Retèl, Lotte Steuten). Furthermore, we performed early stage technology assessment in the application of diagnostic/prognostic markers in neo-adjuvant breast cancer treatment (Anna Miquel-Cases).

Currently, PhD candidate Melanie Lindenberg works on a range of early HTA projects such as Image Guided Surgery, Coverage with Evidence Development in TIL-treatment, and robot assisted surgeries. We foresee to be increasingly involved in translational and clinical research projects.

As part of the Next Generation Sequencing project, a postdoc (Valesca Retèl) is working on early stage HTA in order to accompany implementation- and coverage decisions. She is partly employed by The University of Twente (Health Services and Technology Research).   

Operations Improvement in Oncology

In cooperation with the University of Twente, a Ph.D student (Bruno Vieira) works on a mathematical analysis and scheduling of capacity use and care pathways within the radiotherapy setting. This 5 year project is intended to lead to implementation efforts in at least 5 RT departments/hospitalsTogether with the University of Twente and the "Integraal Kanker Centrum Noord-Oost", a Ph.D student worked on a project to evaluate the added value of accrediting oncology departments in General Hospitals and the first paper proving surprising value was published in the British Journal of Cancer in 2014.

As part of the Eurocan Platform project, we developed a designation system for excellent Comprehensive Cancer Centers. This project has drafted a pilot Excellence Designation System that was be piloted in 2015 and approved and adopted by the European Academy of Cancer Scientists.

Benchmarking is a possibly powerful tool to inform management on improvement options and patients on the quality of services. In 2013 the EU-subsidized project BENCH-CAN started a pilot on a European benchmarking system on comprehensive cancer care for which a Ph.D student (Anke Wind) is localized  in the NKI. The Benchmark system will be launched at the OECI annual meeting of 2016

Rehabilitation, Physical Activity and Cancer

Survivorship care and rehabilitation are important elements of a cancer centre's program. In 2009, a multidisciplinary rehabilitation program was started for breast cancer survivors receiving adjuvant treatment. In addition, a rehabilitation program for head-and-neck cancer patients has been approved by health insurers and was rolled out beginning of 2010. Finally, a major Alpe d'Huzes KWF project was started early 2011, focusing on patient empowerment, return to work, tele-monitoring and implementation of relevant findings and programs related to physical exercise and supported by innovative IT (the ACARE2 project). This program totalling up to 2,8 million Euro, runs? for 6 years. Presently Ph.D student (Charlotte IJsbrandy) is working on an implementation project aiming to introduce as much as possible of the R&D results from the ACARE2 project in max. 10 hospitals in the Netherlands. The direct supervision is done by R. Hermens Ph.D, located at IQ HealthCare UMC St Radboud, NIjmegen. Wim van Harten is the first supervisor.

As follow up on the ACARE2 project, Laura Kooij is working on e-health and IT supported shared care, web-consulting and stepped care.

Recently an RCT on a Blended Care intervention (e-health with or without personal contact) aiming to stimulate Physical Activity in Cancer Patients (the PABLO study) was granted almost € 600.000 by the Dutch Cancer Society to employ a postdoc (Dr. Wim Groen) and a PHD student (Hester van de Wiel). The study involves both breast cancer and prostate cancer patients and will be conducted in the NKI, UMCU and Rijnstate hospital (Arnhem).

Finally, a combination of HTA and rehabilitation is currently performed by PhD candidate Ann-Jean Beck. She specializes in broad HTA in the rehabilitation of Head and Neck cancer patients in Europe.

Co-workers

Wim Groenfoto

Dr. Wim Groen

Postdoctoral fellow

Experience

I was trained as a human movement scientist and obtained my PhD for studying (measurement of) functional ability of hemophilia patients.

My research interests are in the area of exercise and eHealth in cancer survivorship. In the past years, we have developed and implemented a patient portal in the NKI to support cancer patients and survivors. Recently we obtained funding for a multicenter trial to further study the effects of an online physical activity support program for survivors.  I am also involved in a project that aims to develop exercise programs for metastatic breast cancer patients.

Lastly, I initiated an exercise testing facility in the NKI that is used for measurement of cardiorespiratory fitness for clinical and research purposes.

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Valesca (postdoc)

Valesca Retèl, Ph.D.

Postdoctoral fellow

Experience

Valesca Retèl has a MSc degree in Health Sciences and a PhD degree in Health Economics. Currently, she is working as a postdoc for 50% at the PSOE department and 50% at the University of Twente (department of Health Technology and Services Research (HTSR)). Her research is focused on early Health Technology Assessments regarding Next Generation Sequencing, Immunotherapy, big data, Image Guided Surgery and Rehabilitation, all in the field of oncology. Some of these projects are in a Coverage with Evidence Development program.
Valesca uses mathematical modeling to combine information on besides cost-effectiveness, organizational issues, ethical-legal, and patient related aspects of promising new technologies in early stages of development. In the early stages, broad spectrum scenario drafting is a key element in these early assessments. She currently supervises 2 PhD students, on early HTA in combination with translational research and on broad HTA in relation to cancer rehabilitation.

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Melanie Lindenberg

Melanie Lindenberg

Ph.D. student

Experience

After the bachelor Healthcare and Technology (BN) I finished the master Health Sciences at the University of Twente (Health Services and Management) in 2015. In September 2015 I started my PhD project "Health Technology Assessments on Early Stage Innovative Technology used in Oncology" in which three main projects, currently running at the NKI-AVL, are included: The Coverage with Evidence Development (CED) program for Tumor Infiltrating Lymphocyte (TIL) treatment, Image Guided technologies used in oncologic surgeries and Robot Assisted Surgeries. We aim to conduct (early) Health Technology Assessments in which we will focus on organizational, ethical, societal, clinical, safety, financial and technological issues in order to facilitate the translational process (from bench to bedside) of these technologies.

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532309 Franzen

Nora Franzen

PhD-student

Experience

Nora Franzen has started working at the NKI as a PhD student in September 2017. Her research focuses on the topic of patents and pricing of oncology drugs. She is using mathematical modelling to create evidence for alternative, more social responsible, pharmaceutical pricing systems.

Nora Franzen has obtained a MSc in Health Sciences from Maastricht University and a BA in Public Health from the University of California, Berkeley. Prior to joining the Prof Wim van Harten research group, she has worked for 4 years as a research analyst in healthcare system research at an international consultancy company.

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Ann -Jean Beck

PhD-student

Experience

In 2014 I obtained my medical degree at the University of Leiden. I started working as a resident at the Department of Surgery in the BovenIJ Hospital in Amsterdam. In September 2015 I started my PhD project in the NKI-AVL at the Psychosocial and Epidemiology department (PSOE) and Department of Head and Neck Surgery. My PhD project concerns  a broad Health Technology Assessment (HTA) for the rehabilitation of head and cancer patients in European countries. The project focusses mainly on reimbursement of medical devices, cost-effectiveness analysis of head and neck cancer treatment and rehabilitation modalities, and quality of life of head and neck cancer patients (with special attention to laryngectomy patients). In addition, I work as a resident at the outpatient clinic of the Department of Head and neck Surgery.

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Kooij, Laura

Project leader / Staff employee / PhD-student

Experience

I have a background in Communication Science and received my Master degree in 2010 at the University of Amsterdam. Since 2010 I work at the Antoni van Leeuwenhoek as a project leader/staff employee focusing on patient communication and eHealth. Since February 2015 I started as a PhD student, investigating the impact of eHealth on Shared Care for cancer patients and survivors. This includes for example shared care between primary and secondary care, barriers and facilitators for patient portal implementation and evaluation of other eHealth applications.

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Bruno Vieira

OIO

Experience

I received a BSc degree in Electrical Engineering and Computer Science in 2011, and a MSc degree in Systems Engineering and Industrial Planning in 2013, both from the Polytechnic Institute of Porto. My research interests are about applying Operations Research (OR) methods to solve complex real-life decision-making problems. After working 2 years in INESC Porto as a research assistant, I started a PhD project (February 2015) called 'Advanced Logistical Optimization of the Radiotherapy Treatment' (ALORT). In this project, we will develop optimization models based on OR methods to study how operations, personnel and equipment can be efficiently coordinated to ensure patient-centeredness and timeliness when delivering radiotherapy.  

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Inge Eekhout

Inge Eekhout

Project coordinator / Research assistant

Experience

In my career, I have worked several times in the NKI-AVL. Immediately after obtaining my Nurse diploma I went to work in the NKI-AVL at the head / neck and internal department. After working for 5 years, I changed the AVL for the AMC to work on the neonatology department and did the training neonatology. Soon I missed the contact with the oncology patient and the VUMC became my new employer. Through the VUMC food team, I came in contact with Sorgente (specialist in food care at home), where I started as a nurse practitioner (actually specialist nurse) to organize the nursing care. With the emergence of the function of a nursing practitioner, I decided to do this training and I came back to the NKI-AVL. 12.5 years I worked as a nurse practitioner with specialism breast cancer surgery. Within this 12.5 year I was for approximately 4 years coordinator of the MINDACT study, together with Stella Mook. Through the MINDACT study I came in contact with science. After my trip outside the hospital last year as location manager of a private small elderly house, I am back in the NKI-AVL again. Over the next 2 years, I will be a research assistant / project coordinator of the TANGO study where Valesca Retèl as a project manager is working.

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Recent publications View All Publications

  • The impact of organisational external peer review on colorectal cancer treatment and survival in the Netherlands

    (2014) British Journal of Cancer

    Kilsdonk MJ, van Dijk BA, Otter R, Siesling S, van Harten WH.

    Link to Pubmed
  • Assessing excellence in translational cancer research: a consensus based framework

    (2013) Journal of Translational Medicine

    Rajan A, Caldas C, van Luenen H, Saghatchian M, van Harten WH.

    Link to Pubmed
 

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