As the ESCAPE project advances its mission to improve care for multimorbid elderly patients, the contributions from the biostatistics and health economics teams are playing a pivotal role in ensuring the study's scientific and practical robustness. These teams are working behind the scenes to make sense of complex data, evaluate the effectiveness of interventions, and understand the financial implications of delivering more integrated care.
Biostatistics
The biostatistics team has been instrumental in managing and preparing the study’s extensive data for analysis. One major undertaking has been the data consolidation process, which includes translating patient-reported questionnaires from local languages back into English and calculating multiple scores essential for evaluating patient outcomes.
To ensure data integrity, a comprehensive data quality report was developed to guide the data cleaning process. Alongside this, the team has created a statistical analysis plan that outlines how the project's primary and secondary outcomes will be analysed.
Preparatory work has also included:
- Analyses of baseline characteristics of the study population.
- Drafting and updating critical reports such as the Data Safety Monitoring Board (DSMB) report.
- Conducting blinded sample size re-estimations and power analyses to ensure the trial remains statistically robust.
Throughout the project, there has been continuous collaboration with the health economics team and the clinical trial team to align methodologies and share relevant data insights.
Health Economics
On the health economics side, the team has made significant strides in developing tools to measure healthcare costs and resource use. A template for digitising patient receipt data has been created, with the digitisation process now actively underway.
In parallel, a cost questionnaire based on the iMCQ (iMTA Medical Consumption Questionnaire) framework has been designed. The team is currently refining details around specific healthcare services to ensure precise and relevant cost reporting. Another key development is the ongoing work on a Time-Driven Activity-Based Costing (TDABC) model. This model will provide a granular understanding of how time and resources are allocated in patient care, offering insights into where efficiencies can be introduced without compromising quality.
Collaboration with the clinical team in Göttingen has been crucial for testing these tools. Following the delivery of a test dataset, the health economics team has begun its review and data preparation phase.
A Holistic Approach to Care and Cost
Together, the efforts of the biostatistics and health economics teams contribute to a deeper understanding of both the clinical effectiveness and cost-efficiency of ESCAPE’s Blended Collaborative Care (BCC) model. By aligning rigorous data analysis with economic evaluation, ESCAPE is paving the way for a sustainable, scalable, and patient-centred approach to managing multimorbidity in older adults. These foundational efforts are essential in ensuring that the ESCAPE model not only improves quality of life but also demonstrates value for healthcare systems across Europe.
