BREATHING IN A NEW ERA
A COMPARATIVE ANALYSIS OF LUNG CANCER POLICIES ACROSS EUROPE
Appendices
Methods
Our research is in two phases. This document covers the first phase of our research, in which we
analyse the 11 countries: Austria, Belgium, Finland, France, the Netherlands, Norway, Poland, Romania,
Spain, Sweden and the United Kingdom. Germany and Greece were originally part of this phase but
due to workshop scheduling reasons, they will be included in the second phase of our study along with
an additional 14 countries which will be published in early 2020. Upon completion of phase 2, we will
have analysed 26 European countries plus Israel. Countries in phase 1 are all either upper-middle or
high income economies.
At the heart of the research project is a benchmarking exercise of scoring policies, programmes,
guidelines and approaches for patient-centred care. Its goal was to spur debate around the need
for a transformative change in lung cancer screening, diagnosis, treatment and supportive and
palliative care. An initial literature review, conducted via Embase.com, identified key frameworks and
programmes that have been previously used to prioritise policy approaches for the prevention and
control of lung cancer in a range of countries. Search results were limited to reviews and systematic
reviews published in the last five years. The 379 retrieved articles were first sifted based on title and
abstract, followed by full text appraisal.
From analysis of the most relevant articles identified, we derived a draft set of indicators with which
to benchmark policy and systems in European countries. The goal is to identify those policy and system
“building blocks” that are associated with high-quality care and good patient outcomes. These form the
basis of the indicators, which are clustered into domains.
An editorial advisory board was convened to review and advise on the development of the indicator
framework and the organising domains. Out of this process, we identified a set of 17 indicators to
evaluate each selected country across five domains. We created scoring schema, then researched,
assessed and scored countries. A range of international and national sources were used for the data
collection, and both primary and secondary research used to populate the country scorecard.
Scoring judgements were made based on the best information available. Because of the nature of
scoring—wherein complex matters are collapsed into simple scores—we note that not all readers will
agree with all scores. After draft scores were assigned, we attended workshops in each country with
external country-based experts, hosted by the sponsor, to discuss the scores and help us to develop
recommendations. The EIU retained editorial independence throughout the process.