D4.8 - Repository of use cases of the ecosystems
Abstract
The Strong-AYA consortium has developed an initial list of some priority ways in which our research (and the ecosystem that supports that research) will be used by each of some of our stakeholders.
Full text
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A new, in e disciplina y, mul i-s akeholde Eu opean ne wo k o imp o e
heal hca e se ices, esea ch and ou comes o Adolescen s and Young Adul s
wi h cance .
STRONG-AYA – No. 101057482 – D4.8
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Deli e able Repo
WP4– Ope a ion o STRONG-AYA ecosys ems, S akeholde and Pa ien
in ol emen , Dissemina ion, Exploi a ion, Communica ion
Deli e able D4.8
Reposi o y o use cases o he ecosys ems
Due da e o deli e able: 30/09/2023
Ac ual submission da e: 01/11/2023
P ojec : STRONG-AYA
Lead Con ibu o Dan S a k (UOL)
Email d.p.s a [email protected]
O he Con ibu o s
Emily Connea n (UOL); Pe ine Ma ec-Be a d (CLB); Helen Boyle (CLB); And ea
Fe a i (INT); Annalisa T ama (INT); Paolo Baili (INT); Ma in McCabe (UOM);
Wine e an de G aa (NKI); Olga Husson (NKI); Simone Hanebaum (NKI); Sil ie
Janssen (NKI); Na halie Gaspa (IGR); Benjamin Ve e (IGR); Siham Moulai (IGR);
Iwona Lugowska (MSCNRIO); Magdelena Rosinka (MSCNRIO); Anna Siko a-Kope ska
(MSCNRIO); Leona d Wee (UNIMAAS); Ane Appel (UOL); Richa d Fel bowe (UOL);
Nicola Hughes (UOL)
Emails
E.Connea [email protected]; pe ine.ma ec-be a d@ihope. ;
[email protected] . ; and ea. [email p o ec ed];
Annalisa.T ama@is i u o umo i.mi.i ; li _ ab@is i u o umo i.mi.i ;
ma in.mccabe@manches e .ac.uk; w. d.g [email p o ec ed]; o.huss[email p o ec ed];
[email p o ec ed]l; [email p o ec ed]; na halie.gaspa @gus a e oussy. ;
BENJAMIN.VERRET@gus a e oussy. ; Siham.MOULAI@gus a e oussy. ;
[email protected] .pl; magdalena. [email protected] .pl; anna.siko a-
[email p o ec ed]; leona d.wee@maas o.nl; A.L.A[email p o ec ed];
[email p o ec ed]k; n. .hu[email p o ec ed]
Due da e
30 09 2023
Deli e y da e
01/11/2023
STRONG-AYA – No. 101057482 – D4.8
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Deli e able ype
R
Dissemina ion le el SEN
Desc ip ion o Wo k Ve sion Da e
Fi s d a o e iew V1.0 09/10/2023
Desc ip ion:
Reposi o y o use cases use cases de eloped in collabo a ion wi h
WP3 ha will se e
o p o ide examples o use o he ecosys ems
summa y (max ½ page)
The S ong-AYA conso ium has de eloped an ini ial lis o some p io i y ways in which ou esea ch (and
he ecosys em ha suppo s ha esea ch) will be used by each o some o ou s akeholde s. He e we
epo ha :
Ou lis o ‘use cases’ will be placed in ou eams channels and ou websi es as i s ‘ eposi o y’.
I includes use cases and pa ame e s o high ele ance o se ice use s (pa ien s and hei ca e s),
heal hca e p o essionals, esea che s, heal h se ice manage s and heal hca e policy-make s. I
p io i ises pa ien -cen ed ques ions.
I includes examples o use cases ha can be deli e ed ela i ely soon in he p ojec , hose ha will
be deli e ed la e bu wi hin he S ong-AYA g an unding, and hose which will come o ui ion as
pa o ou sus ainabili y.
This ini ial se o use cases is a dynamic one, likely o e ol e o e ime. I will be iangula ed agains he
co e ou come a iables iden i ied in WP1. I can suppo some o he da a s uc u es and analysis unc ions
equi ed o deli e conclusions abou he pa ame e s in ou use cases. The use cases ha a e ma ched wi h
he co e ou come se will also now in o m he design o ou ini ial da ase design and analyses. They can
also be discussed as an e hics p ocess by expe conso ium membe s. They will also be mo e widely
dissemina ed la e , du ing ou communica ion s a egy.
STRONG-AYA – No. 101057482 – D4.8
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1 Table o Con en s
SUMMARY (MAX ½ PAGE) .......................................................................................................................................... 3
1 TABLE OF CONTENTS .......................................................................................................................................... 4
2 DEFINITIONS....................................................................................................................................................... 5
3 ABBREVIATIONS ................................................................................................................................................. 6
4 INTRODUCTION .................................................................................................................................................. 7
PROJECT BACKGROUND ........................................................................................................................................... 7
DELIVERABLE INTRODUCTION .................................................................................................................................... 9
5 METHOD ...........................................................................................................................................................10
6 USE CASES .........................................................................................................................................................10
7 UPCOMING ACTIONS .........................................................................................................................................14
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2 De ini ions
STRONG AYA conso ium membe s a e e e ed o as ollowing wi hin his ex :
1. NKI-AVL – S ich ing he Nede lands Kanke Ins i uu – An oni an Leeuwenhoek Ziekenhuis (NL)
2. YCE – You h Cance Eu ope (RO)
3. INT – Fondazione IRCCS Ins i u o Nazionale dei Tumo i (IT)
4. FFUND – FFUND BV (NL)
5. CLB – Cen e de Lu e Con e le Cance Leon Be a d (FR)
6. ECO – Eu opean Cance O ganisa ion (BE)
7. UNIMAAS – Uni e si ei Maas ich (NL)
8. IKNL – S ich ing In eg aal Kanke cen um Nede land (NL)
9. EORTC – Eu opean O ganisa ion o Resea ch and T ea men o Cance AISBL (BE)
10. IGR – Ins i u Gus a e Roussy (FR)
11. MSCNRIO – Na odowy Ins y u Onkologii im. Ma ii Sklodowskiej-Cu ie – Pans wowy Ins y u
Badawczy (Ma ie Sklodowska-Cu ie Na ional Resea ch Ins i u e o Oncology) (PL)
12. UOM – Uni e si y o Manches e (UK)
13. UOL – Uni e si y o Leeds (UK)
14. LTHT – Leeds Teaching Hospi als Na ional Heal h Se ice T us (UL)
15. SOUTHAMPTON – Uni e si y o Sou hamp on (UK)
G an Ag eemen (including i s annexes and amendmen s): he ag eemen signed be ween he
bene icia ies o he HORIZON Resea ch and Inno a ions Ac ions (he ea e e e ed o as Ho izon)
and he Eu opean Heal h and Digi al Execu i e Agency (he ea e e e ed o as HADEA) o he
unde aking o he STRONG AYA p ojec (G an Ag eemen no. 101057482).
Bene icia y: Signa o ies o he G an Ag eemen
Associa ed Pa ne : En i ies which pa icipa e in he ac ion bu wi hou he igh o cha ge cos s o
claim con ibu ions.
P ojec : he sum o all ac i i ies ca ied ou in he amewo k o he G an Ag eemen .
Conso ium: he STRONG AYA conso ium, including all he a o emen ioned pa ne s.
Conso ium Ag eemen : The ag eemen made be ween STRONG AYA membe s o he
implemen a ion and execu ion o he ac ion ou lined in he G an Ag eemen . The ag eemen shall
no a ec he pa ies’ obliga ions o HADEA on behal o he Eu opean Union, and/o o one ano he
a ising om he G an Ag eemen .
STRONG-AYA – No. 101057482 – D4.8
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3 Abb e ia ions
Ac onym/Abb e ia ion Meaning
HCP Heal h Ca e P o ide
PRO Pa ien Repo ed Ou come
PROM Pa ien Repo ed Ou come Measu e
COS Co e Ou come Se
WP Wo k Package
WPL Wo k Package Lead(s)
WP1 Wo k Package 1 (De elopmen Co e Ou come Se
AYA wi h cance & da a collec ion)
WP2 Wo k Package 2 (Go e nance, Da a Secu i y and
E hics)
WP3 Wo k Package 3 (In as uc u e and In e ope abili y)
WP4 Wo k Package 4 (Ope a ion o STRONG AYA
ecosys ems, s akeholde and pa ien in ol emen ,
dissemina ion, exploi a ion, communica ion)
WP5 Wo k Package 5 (Scien i ic coo dina ion and p ojec
managemen )
KPI Key Pe o mance Indica o
OA Open Access
PAB Pa ien Ad iso y Boa d
EC Eu opean Commission
HADEA Eu opean Heal h and Digi al Execu i e Agency
SC S ee ing Commi ee
MT Managemen Team
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4 In oduc ion
P ojec backg ound
Cance a adolescen and young adul (AYA) age is a e, al hough 4-6 imes mo e equen han paedia ic
cance (i.e. p epubescen pe iod). Howe e , his a i y does no e lec he signi ican pe sonal and socie al
cos s o cance in his popula ion, as e lec ed in he po en ial yea s o li e los o sa ed, he dec eased
p oduc i i y and quali y-o -li e due o he impac o he disease du ing o ma i e yea s, and he long- e m
complica ions o disabili ies1. AYAs wi h cance o m a unique g oup; hey ace age-speci ic issues (e.g.
In e ili y, unemploymen , inancial p oblems) and dec eased quali y o li e due o cance and i s ea men .
Unlike dedica ed heal hca e and ials o paedia ic cance pa ien s, AYA-speci ic heal hca e se ices a e
sca ce and a y ac oss Eu ope. AYAs who a e a he co e o socie y and economy need access o age-
app op ia e and high-quali y heal hca e.
De ining AYAs wi h cance as 15 o 39 yea s a ini ial cance diagnosis2, hei annual cance incidence is
42.2/100.000, wi h 156.431 cases in Eu ope and 1.231.007 cases wo ldwide epo ed in 2018 ( oge he 6.8%
o all cance s)3. Popula ion-based da a om 27 Eu opean coun ies suppo s ha AYAs ha e lowe su i al
han child en bu highe han adul s a ec ed by cance . Ad ances in cance ea men ha e led o inc eased
su i al a es o AYAs wi h cance , imp o ing by 82% o all cance s be ween 1990 and 20074.
Howe e , su i al imp o emen in AYA is mo e challenging han o child en and olde cance su i o s,
which migh be due o he ac ha AYA ha e he highes absolu e excess isk o second p ima y malignan
neoplasms5. AYA ace some dis inc challenges gi en ha hey do no belong o nei he paedia ic no adul
oncology g oups. Cha ac e is ic ea u es o his popula ion g oup include unique spec um o cance ypes,
di e en umou biology, unique complex psychological needs, dis inc la e sequelae, including impai ed
e ili y, and pallia i e ca e. These ai s imply ha clinical managemen , ea men , diagnosis, psychological
suppo will need o be designed and de eloped o AYA’s speci ic needs. Fo example, AYAs diagnosed wi h
b eas and p os a e ca cinomas ha e wo se su i al han olde pa ien s because o he biological di e ences
be ween hem, highligh ing he need o a ge sc eening me hodologies, ea men and policies o hei
needs6. AYAs wi h cance also ace signi ican psychological challenges, including subs ance abuse, men al
heal h issues, suicidal idea ions and inc eased emo ional bu den om cance and cance - ela ed mo bidi y.
Finally, ailo ing cance ca e o AYA’s needs is di icul and due o many di e en complex ac o s including
he low a e o pa icipa ion by AYAs in clinical ials and cance esea ch7.
Despi e he inc easing awa eness and a g owing body o he scien i ic li e a u e, hese unique issues emain
o be ully ecognised and add essed by he Eu opean heal h sys ems and AYAs wi h cance a e equen ly
unde se ed. In pa , his may ha e esul ed om he adi ional dicho omy be ween he in eg a ed
paedia ic (“pa ien / amily-cen ed”) ca e se ices e sus dispe sed (“disease- cen e ed”) adul oncology
1 S oneham SJ. AYA su i o ship: The nex challenge. Cance 2020; 126: 2116-2119.
2 Adolescen and Young Adul Oncology Re iew G oup. Closing he gap: Resea ch and Ca e Impe a i es o Adolescen s and Young Adul s wi h Cance . Na ional
Ins i u e o Heal h, Na ional Cance Ins i u e, and Li es ong Young Aul Alliance: Be hesda, MD, USA, 2006.
3 T ama A, Bo a L, S elia o a-Fouche E. Cance Bu den in Adolescen s and Young Adul s: A Re iew o Epidemiological E idence. Cance J 2018; 24: 256-266
4 T ama A, Bo a L, Foschi R e al. Su i al o Eu opean adolescen s and young adul s diagnosed wi h cance in 2000-07: popula ion-based da a om EUROCARE-
5. Lance Oncol 2016; 17: 896-906.
5 Keegan THM, Bleye A, Rosenbe g AS e al. Second P ima y Malignan Neoplasms and Su i al in Adolescen and Young Adul Cance Su i o s. JAMA Oncol
2017; 3: 1554-1557.
6 S a k D, Bielack S, B ugie es L e al. Teenage s and young adul s wi h cance in Eu ope: om na ional p og ammes o a Eu opean in eg a ed coo dina ed
p ojec . Eu opean Jou nal o Cance Ca e, 25(3), 419–427.
7 Hayashi RJ. Adolescen and young adul cance su i o ship: The new on ie o in es iga ion. Cance 2019; 125: 1976-1978.
STRONG-AYA – No. 101057482 – D4.8
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se ices8,9,10. Up o hal o AYAs wi h cance epo unme in o ma ional and se ice needs, impac ing
hei di ec (su i al a es) and indi ec (long e m e ec s and men al heal h) eco e y o pa icipa e in
socie y11.
Fu he mo e, aligned wi h his ba ie is he low a e o heal h ca e u ilisa ion by AYAs, especially p ima y
ca e, gi en hei challenges o sus ain heal h insu ance co e age12. Acco ding o a su ey conduc ed h ough
he ne wo ks o he AYA Wo king G oup o he Eu opean Socie y o Medical Oncology (ESMO) and he
Eu opean Socie y o Paedia ic Oncology (SIOP Eu ope), 67% o p ac i ione s do no ha e access o
specialised cen es o AYA wi h cance , 67% had no access o a specialis cance se ice o la e e ec s
managemen and 38% had no access o e ili y specialis s. Unde -p o ision and inequali y o AYA cance
ca e is common ac oss Eu ope and especially in he Eas e n and Sou he n-Eas . Fu he mo e, he Wo king
G oup also epo ed an absence o ou come measu es o moni o ing and e alua ing AYA cance ca e
p og ams and con ol13.
Among he ecommended u u e s eps, i has been iden i ied ha one o he mos impo an con ibu ions
o AYA esea ch would be o pool da a (e.g. pa ien - epo ed ou comes, clinical and ea men da a) ac oss
ins i u ions and coun ies and c ea e la ge coho s o esea che s o
Add ess he bu den o cance in AYA14. The e is a lack o da a s anda diza ion, da a in e ope abili y and
(p ospec i e) collec ion o ou comes o ele ance o AYAs wi h cance .
The STRONG-AYA p ojec aims o ackle he unde ep esen a ion o AYA’s expe iences and ou comes when
na iga ing he heal hca e sys em and in clinical ca e by de eloping na ional in as uc u es o ou come da a
managemen and clinical decision-making wi hin a pan-Eu opean ecosys em and es ablishing
communica ion eedback o AYAs wi h cance and he heal hca e sys ems. This will be key o imp o ing
heal hca e se ices, esea ch, ou comes and policies o AYAs and o ul ima ely be e cance ca e o his
pa ien g oup.
To his aim, STRONG-AYA b ings oge he an in e na ional mul i-disciplina y conso ium ac oss se en
Eu opean coun ies, led by he Ne he lands Cance Ins i u e (NKI) and composed o academic esea ch
o ganisa ions (Eu opean O ganisa ion o Resea ch and T ea men o Cance (EORTC), Uni e si y o
Sou hamp on, Uni e si y o Leeds, Uni e si y o Manches e , Maas ich Uni e si y, Ne he lands
Comp ehensi e Cance O ganisa ion (IKNL)), clinical pa ne s (I alian Na ional Tumou Ins i u e, Léon Bé a d
Cen e, Gus a e Roussy Ins i u e, Ma ia Sklodowska-Cu ie Na ional Resea ch Ins i u e o Oncology, he Leeds
Teaching Hospi als Na ional Heal h Se ice T us ), s akeholde and pa ien o ganisa ions (You h Cance
Eu ope, Eu opean Cance O ganisa ion) and a consul ing company (FFUND).
Building on p e ious ini ia i es, a STRONG-AYA da a ecosys em will be se up o alue-based ca e, esea ch
and policy o AYA wi h cance by:
1. De eloping a Co e Ou come Se (COS) speci ically o AYAs wi h cance , ia a pa icipa i e
consensus p ocess de ining mos impo an aspec s o hose di ec ly a ec ed by AYA cance ,
including pa ien s and heal hca e p o essionals.
8 Fe a i A, S a k D, Pecca o i FA e al. Adolescen s and young adul s (AYA) wi h cance : a posi ion pape om he AYA Wo king G oup o he Eu opean Socie y
o Medical Oncology (ESMO) and he Eu opean Socie y o Paedia ic Oncology (SIOPE). ESMO Open 2021; 6: 100096.
9 Osbo n M, Johnson R, Thompson K e al. Models o ca e o adolescen and young adul cance p og ams. Pedia Blood Cance 2019; 66: e27991.
10 Fa dell JE, Pa e son P, Wake ield CE e al. A Na a i e Re iew o Models o Ca e o Adolescen s and Young Adul s wi h Cance : Ba ie s and
Recommenda ions. J Adolesc Young Adul Oncol 2018; 7: 148-152.
11 Keegan TH, Lich ensz ajn DY, Ka o I e al. Unme adolescen and young adul cance su i o s in o ma ion and se ice needs: a popula ion-based cance
egis y s udy. J Cance Su i 2012; 6: 239-250.
12 Hayashi RJ. Adolescen and young adul cance su i o ship: The new on ie o in es iga ion. Cance 2019; 125: 1976-1978.
13 Salous os E, S a k D, Michailidou K e al. Repo on ESMO/SIOPE Eu opean Landscape p ojec key esul s: Mapping he s a us and needs in AYA cance ca e.
La e-b eaking and de e ed publica ion abs ac s public heal h 2017; 28, 5: V643.
14 Smi h AW, Seibel NL, Lewis DR e al. Nex s eps o adolescen and young adul oncology wo kshop: An upda e on p og ess and ecommenda ions o he
u u e. Cance 2016; 122: 988-999.
STRONG-AYA – No. 101057482 – D4.8
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2. Implemen ing he COS ac oss se e al na ional Eu opean heal hca e sys ems. Da a
will be collec ed a local le el and will hen be included in a da a in eg a ion pla o m. An o e all
ecosys em amewo k o da a analy ics and ou pu will be c ea ed suppo ing ede a ed
analyses and he c ea ion o epo s ac oss clinical and pa ien - epo ed da a and making
na ional eposi o ies o (pa ien - epo ed) heal h da a, a ailable o indi idual pa ien s, pa ien
o ganisa ions, egula o y au ho i ies, as well as he pa ien s’ heal h ca e p o ide s o in o m
clinical decision-making. The i e esul ing na ional ecosys ems will be connec ed o each o he
in o he pan-Eu opean ecosys em using a ede a ed app oach also u ilizing he o e all
ecosys em amewo k.
3. Dissemina ing he COS o a wide ange o local as well as pan-Eu opean s akeholde s, in
pa icula by de eloping analy ical ools o p ocess and p esen pa ien ou come da a and
es ablish eedback loops ha in o m pa ien s and clinicians.
Implemen ing hese p ojec objec i es a e i e wo k packages wi hin he STRONG-AYA p ojec :
WP1: De elopmen Co e Ou come Se AYA wi h cance and Da a Collec ion (Lead: SOUTHAMPTON)
WP2: Go e nance, Da a Secu i y and E hics (Lead: EORTC)
WP3: In as uc u e and In e ope abili y (Lead: UNIMAAS)
WP4: Ope a ion o STRONG-AYA ecosys ems, S akeholde and Pa ien in ol emen , Dissemina ion,
Exploi a ion, Communica ion (Lead: E.C.O.)
WP5: Scien i ic Coo dina ion and P ojec Managemen (Lead: NKI)
STRONG-AYA will enable AYA ca e and esea ch o bene i om collec ion and pooling o pa ien -cen e ed
da a and collabo a ion among all s akeholde s: pa ien s, heal hca e p o essionals, scien is s, and
policymake s. Mo e widely, he p ojec will le e age he ne wo k o in e es ed o ganisa ions and ne wo ks
es ablished unde STRONG-AYA o long- e m s eng hened p omo ion o he necessa y implemen a ion o
specialis AYA cance se ices ac oss Eu ope. This will ul ima ely b ing no el insigh s in o AYA cance ca e,
esea ch and policy, con ibu ing o he long- e m imp o emen o ou comes o people wi h AYA cance .
Deli e able in oduc ion
The pu pose o his deli e able is o de ine, sha e, and plan u he de elopmen o ini ial examples o how
he S ong-AYA ecosys em will be used, by ou ange o s akeholde s, o e ime, wi hin and ou side he
cu en S ong-AYA esea ch g an .
As desc ibed in mul iple p e ious deli e ables, AYA ha e speci ic aspec s du ing cance ca e. Thei clinical
managemen is no cu en ly well deli e ed by exis ing heal h se ices. S ong-AYA is a conso ium o 16
o ganisa ions ac oss Eu ope. We a e de ining he key ou comes ha mus be measu ed o e alua e he
ou comes o AYA cance ca e. We a e hen going o measu e hose ou comes in clinical p ac ice. Then we
will u ilise he indings o imp o e he quali y, equi y and anspa ency o AYA cance ca e bo h wi hin S ong-
AYA, and when expanding and sus aining ou wo k.
The conso ium has de eloped an ini ial lis o he ways in which ou da a should be used. These a e examples
o ques ions ha a e o ele ance o many s akeholde s in ou wo k and which ou analyses should answe .
These a e e med ‘use cases’. Once de ined hese will de ine ou analyses and da ase designs, be conside ed
by an e hical panel, and be dissemina ed mo e widely.