WP9 – Modelling of Care and Treatment

WP leaders

Maarten Lahr (UMCG) & Hester Lingsma (EMC)

The workpackage

Successfully implementing new treatment modalities and achieving optimal effectiveness and efficiency requires a close look at the organization of care, the workflow, the geographical dispersion, and routing of patients as well as a more personalized approach to treatment. The chain of events and care, including rehabilitation, needs to be scrutinized and optimally geared to achieve maximal utility. The current work-package aims to provide evidence and guidance on personalized and cost-effective stroke care.

The general aim of WP9 is to use an integrated modelling approach to assess the impact of innovations in acute stroke care triage and treatment and to inform optimal decision making. To do so, various modelling approaches will be combined, including (1) prognostic modelling, (2) simulation models and (3) (early) health technology assessment.


  1. Newly developed and updated prognostic models will refine the current prediction of individual treatment outcomes and may guide treatment decisions.
  2. Innovations in stroke triage and treatment may improve health outcomes in general, but their effectiveness depends on making best use of available resources, while accounting for patient population and pathway logistics.
  3. New interventions in acute stroke triage and treatment, and associated changes in stroke care organization, will be cost effective or even reduce costs compared to current standard care in the Dutch setting.


  1. To develop, update and validate prognostic models across stroke subtypes to predict individual treatment outcomes for decision making in the pre-hospital, acute and post-acute phase of (suspected) stroke patients.
  2. To develop, adapt and validate simulation models that reflect the workflow and patient journey of individuals during prehospital triage and acute treatment of stroke.
  3. To develop and validate a conceptual and simulation model for acute treatment of cerebral hemorrhages to evaluate pathway performance and logistics in terms of patient volumes, efficiency, and outcomes.
  4. To assess and subsequently optimize the organizational aspects of innovations in acute pre- and in-hospital stroke diagnostics and treatments on a regional and ultimately national scale.
  5. To develop an early health technology framework and a generic cost-effectiveness model to evaluate the economic and organizational consequences of the various innovations and practices in (hyper-) acute and long-term stroke care.