PhD defence F.G. (Fernando) França Pereira Albuquerque de Almeida

The main objective of this thesis was to study the methodology used in the economic evaluation of early warning systems for chronic disease management, with a focus on the decision modelling methods used in this framework. Considering that early warning systems, regardless of their target disease, have in common that they are aimed at monitoring patients’ health status through periodically measuring individual patient characteristics in order to anticipate health deterioration and to trigger prompt clinical intervention, the possibility to develop a more generic decision model for assessing the cost-effectiveness of early warning systems was explored.
A systematic literature review revealed that published models had some variability with regards to their general study characteristics and they displayed satisfactory methodological quality overall. However, the consideration and discussion of any competing theories regarding model structure and disease progression, identification of key parameters and the use of expert opinion, and uncertainty analyses were identified as key areas for improvement in the development of future decision models. The largest contribution of this thesis for the methodology used in the economic evaluation of early warning systems for chronic disease management was the development and validation of a discrete event simulation model able to model heart failure patients and to account for the impact of individual patient characteristics in their health outcomes. Using this model, we found that home telemonitoring with the addition of a diagnostic algorithm extendedly dominated home telemonitoring and it had an incremental cost-effectiveness ratio of €27,712 per quality-adjusted life year against usual care.

The public defence will take place at the Senate Hall, 1st floor Erasmus Building, location campus Woudestein. The ceremony will begin exactly at 15.30 PM. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.