An analysis of the activities and impact of the DCVA pillars Valorisation, Implementation, Infrastructure, and Talent was conducted (see ESM). Using a developed checklist, a qualitative assessment of the potential health economic impact of the 32 consortia was conducted, followed by a quantitative assessment of the health economic impact as measured by quality-adjusted life years (QALYs) and costs. Finally, an exploratory analysis of the contribution of the consortia to the goal of reducing the CVD burden (see ESM, Tab S3).

Part A) Qualitative assessment of consortia

The NWO Impact Plan Approach describes the connection between research output and productive interactions/knowledge utilisation, and how these would ultimately create societal impact [11]. Using these definitions, a checklist was developed to evaluate impact, in consultation with the DCVA HTA Steering Committee and invited principal investigators of the consortia. The checklist was developed to capture the expected health and economic impact of the wide range of consortia. Care was taken to ensure that all facets of impact were captured, such as reductions in morbidity, improvements in patient experience, and healthcare workforce capacity.

The checklist is shown in the ESM Tab S4. Using the originally submitted project proposals from the consortia, the checklist was completed by HTSR, and reviewed by the DCVA HTA Steering committee on behalf of the individual consortia.

Part B) Quantitative assessment of consortia in terms of health benefits from QALYs

The next step was a quantitative assessment of a snapshot of DCVA consortia (n = 4) as expressed in QALYs and costs. Based on the results of Question 2 ‘Pathway’ and Question 3 ‘Clinical Area’ from the qualitative assessment in Part A (Tab S1), four consortia were selected for the in-depth quantitative impact analysis. These consortia were chosen in consultation with the DCVA HTA Steering Committee to represent a breadth of projects, with Check@Home, LoDoCo2, IMPRESS, CONTRAST 2.0, representing Screening (CVD, chronic kidney disease (CKD), Diabetes), Treatment (coronary artery disease (CAD)), Diagnosis (CAD-women), and Treatment (Stroke), respectively (refer to ESM Tab S5).

The analysis was performed from a healthcare perspective. The incident patient numbers (prevalent for screening) were based on the Dutch population and extrapolated, based on a historical trend, to the year 2023. Costs were converted to Euros (€) [12] and inflated to 2023 Euros using the Dutch consumer price index [13]. A summary of the main steps taken to estimate the health economic impact of research in the consortia is shown in the Infobox. The key inputs and assumptions for the four studies are described in the ESM, Tables S6–S10.

Infobox Steps to measure the health economic impact of a consortium 1.

Estimate the number of patients using prevalence (if applicable), screened population (if applicable) and/or incidence (if applicable). If applicable, adjust for the percentage of patients with a certain disease/condition, and the percentage of patients eligible for inclusion.

2.

Estimate health outcomes with usual care vs. intervention, including estimations of:

a.

The potential effect on the primary outcome measure that is studied;

b.

The potential effect on resource utilisation and/or translation into health events (e.g. MACE events); and

c.

The potential effect on health outcome expressed in QALYs (if applicable).

3.

Use the findings from step 2b to estimate the costs of usual care vs. the cost of the intervention.

4.

Estimate the additional costs and health benefits adjusted for the percentage of implementation of the intervention.

MACE myocardial infarction, stroke, or cardiovascular death, with or without coronary revascularisation, QALYs quality adjusted life year

Part C) Estimation of CVD burden and contribution of the consortia to the goal

A crude exploratory analysis was also performed, to extrapolate consortia impact and estimate how all DCVA consortia combined could contribute to reducing the CVD burden (see ESM).