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Welphi
Published in: Blog

Scenarios for Population Health (PH) inequalities in 2030: The Euro-Healthy Project Experience

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Health inequalities have been consistently reported across and within European countries, placing major challenges to policy-making. There are several challenges in the design and implementation of policies for reducing health inequalities, not only on how to assist policy-makers to holistically evaluate policies’ benefits but particularly on how to anticipate the extent to which future events may affect those policies. 
 
Scenarios development, regarding what could affect the population health inequalities, is considered critical to help policy-makers and the scientific community to prepare and better cope with fast-evolving challenges. Within this context, the Euro-Healthy Research Project (2015-2017) proposed a multicriteria Population Health Index, which took the construction of population health scenarios as a key challenge to inform the evaluation of policies in the context of health inequalities evolution.

Method

In this study, the Welphi platform was used to set up a 2-round Web-Delphi process for driver’s identification with a panel of 51 experts and other stakeholders: 
 
Round 1: open-ended questions for idea-generation regarding the reasons for possible evolutions in population health in Europe. 

Source: Alvarenga et al (2019)

Round 2: participants to state their agreement regarding the potential drivers obtained in round 1. The answers were given on a five-level Likert scale (‘Strongly Disagree’, ‘Disagree’, ‘Neither Agree nor Disagree’, ‘Agree’, ‘Strongly Agree’). With the support of the Welphi platform, approval and rejection rules were applied to lead to a final set of 49 drivers. 
 
The results of the web-Delphi were then used in two face-to-face workshops with a strategic group of 13 experts where three scenario narratives were elaborated regarding the evolution of PH inequalities in Europe until 2030: ‘Failing Europe’ (worst-case but plausible picture of the future), ‘Sustainable Prosperity’ (best-case but a plausible picture of the future) and Stuck’ (best of our knowledge’ evolution). 

Source: Alvarenga et al (2019)

Conclusion

The experts reached a consensus regarding the use of factor VIII (FVIII) replacement therapy in combination with emicizumab, an antibody prophylaxis in the treatment of high-risk hemophilia patients.  

This includes the appropriate use of FVIII in combination with emicizumab during and immediately post-surgery for patients with elective surgery and episodic FVIII followed by emicizumab for newborns with post-circumcision bleeding.

Most of the panelists preferred FVIII over emicizumab due to established evidence on safety and efficacy.

These recommendations complement existing treatment guidelines and support physicians in the management of hemophilia A patients without inhibitors.

For further detail, you can access the study publication here. To learn more about our Welphi Platform, visit our website or send us a message!By using the Welphi platform, this scenario-building process allowed to include the views and perspectives of a diverse and geographically dispersed group of experts, stakeholders and policy-makers. This not only contributes for their validity but particularly meets the challenge of enhancing participation in scenario building. 

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