Health Technology Assessment (HTA) in Innovative Neurosurgical Care

Innovative minimally invasive technologies are rapidly changing neurosurgical care. Emerging interventions, including minimally invasive treatment of intracerebral haemorrhage and chronic subdural haematoma, minimally invasive brain tumour surgery, and focused ultrasound-enhanced liquid biopsy for brain tumours, have the potential to improve patient outcomes and increase the efficiency of neurosurgical care pathways. However, evidence regarding their clinical value, cost-effectiveness, and implementation requirements remains limited.

This interdisciplinary four-year PhD project, embedded within the European Innovative Health Initiative (IHI)-funded project SEamless Integration of image guidance to break down the barrierS and enhance the efficiency of Minimally Invasive and hybrid neurosurgical care (SESIMIC), aims to evaluate and facilitate the implementation of these emerging technologies. The project combines methodologies from Health Technology Assessment (HTA), health economics, and implementation science.

Using a mixed-methods approach, the PhD candidate will conduct early health economic evaluations, decision-analytic modelling, and analyses of operating room efficiency and care pathways. In addition, qualitative studies with clinicians, patients, healthcare managers, and industry partners will identify barriers and facilitators to successful implementation and large-scale adoption.

The project will generate evidence on the clinical, organisational, and economic value of innovative neurosurgical technologies and provide recommendations to support their sustainable and evidence-based integration into routine neurosurgical care.

Health Technology Assessment, Early HTA, Neurosurgery, Implementation Science, Minimally Invasive Surgery, Health Economics, Healthcare Innovation

Healthcare systems increasingly face the challenge of adopting innovative medical technologies while maintaining affordability, efficiency, and equitable access. In neurosurgery, several promising minimally invasive and image-guided interventions have recently emerged, including minimally invasive surgery for intracerebral haemorrhage (ICH) and chronic subdural haematoma (cSDH), minimally invasive brain tumour surgery, and focused ultrasound-enhanced liquid biopsy for brain tumours. These technologies have the potential to improve patient outcomes, reduce complications, shorten hospital stays, and enhance recovery.

Despite their promise, introducing innovative neurosurgical technologies into routine clinical practice remains challenging. Novel technologies often require substantial investments in equipment, training, workflow redesign, and organisational change. Moreover, evidence on their clinical effectiveness and cost-effectiveness is frequently limited during the early stages of development. As a result, healthcare providers and policymakers face uncertainty regarding whether, when, and how these innovations should be implemented.

Early Health Technology Assessment (HTA) provides a systematic framework to evaluate emerging technologies before widespread adoption. Early HTA can support decision-making by assessing potential clinical benefits, economic consequences, organisational implications, and implementation barriers at an early stage of innovation. However, there is still limited evidence on how to best evaluate innovative neurosurgical technologies and integrate these assessments into implementation strategies.

This PhD project aims to address these knowledge gaps by evaluating innovative minimally invasive neurosurgical interventions within the SESIMIC consortium. The project will investigate not only whether these technologies are likely to provide value for patients and healthcare systems, but also under which circumstances successful implementation and scale-up can be achieved.

Specific research questions may include:

1. What are the expected impacts of innovative minimally invasive neurosurgical interventions compared with current standards of care?
2. How do these innovations influence operating room efficiency and overall neurosurgical care pathways?
3. Which organisational, behavioural, and contextual factors facilitate or hinder successful implementation and adoption?
4. Under which scenarios are these technologies likely to become cost-effective and sustainable within healthcare systems?
5. How can early HTA and implementation science approaches be combined to support evidence-based decision-making for the emerging neurosurgical technologies?

The project will employ a mixed-methods approach combining quantitative and qualitative research methodologies.

The quantitative component may include:

• Early health economic evaluations and decision-analytic modelling;
• Cost-effectiveness and budget impact analyses;
• Process and workflow analyses of operating room efficiency;
• Analysis of clinical and health economic data generated within the SESIMIC consortium;
• Scenario analyses and uncertainty analyses to evaluate different implementation pathways. 

The qualitative component will include:

• Semi-structured interviews and focus groups with clinicians, patients, healthcare managers, and industry partners;
• Identification of barriers and facilitators for implementation using implementation science frameworks

We are looking for a highly motivated and ambitious candidate with:

• A Master's degree in Health Economics, Health Sciences, HTA, Epidemiology, Medicine, Public Health, Biomedical Sciences, Healthcare Management, or a related discipline;
• Experience in Health Technology Assessment, implementation science, and/or healthcare innovation;
• Experience with quantitative and/or mixed-methods research;
• Excellent academic writing and communication skills in English;
• Ability to work independently and within an interdisciplinary and international consortium;
• Experience with health economic modelling and economic evaluation is considered an advantage. 

Required by ERIM

All application documents required by ERIM can be found here. 

The expected start date of the position will be between November 2026 to January 2027.

Followings are the expected output of the PhD position within this research project: 

• Peer-reviewed scientific publications.
• A doctoral dissertation in Health Technology Assessment and Implementation Science.
• Development of methodological frameworks for early HTA in neurosurgery.
• Evidence on cost-effectiveness and implementation of innovative neurosurgical technologies.
• Policy recommendations for healthcare providers, innovators, and decision-makers.
• Presentations at national and international scientific conferences.
• Contributions to the SESIMIC consortium deliverables and dissemination activities.

This PhD project is embedded within the international SESIMIC consortium funded by the Innovative Health Initiative (IHI) and involves close collaboration between

Rotterdam School of Management (RSM), Erasmus University Rotterdam, and Erasmus School of Health Policy & Management (ESHPM) with International academic and industrial partners and Clinical experts in neurosurgery across Europe. The PhD candidate will participate in consortium meetings, and multidisciplinary collaborations across Europe.

The PhD candidate will be based at  Erasmus University Rotterdam (EUR), which is an internationally oriented university with a strong social orientation in its education and research, as expressed in our mission ‘Creating positive societal impact’. EUR is home to 4.100 academics and professionals and almost 33.000 students from more than 140 countries. 

RSM is one of Europe’s top-ranked business schools at EUR. RSM provides ground-breaking research and education furthering excellence in all aspects of management. RSM offers a broad portfolio of bachelor, master, MBA, PhD, and executive education programmes and is internationally recognised for its strong focus on innovation, sustainability, leadership, and societal impact.

ESHPM is an internationally leading faculty for education and research in health policy & management at EUR. As a multidisciplinary school, it aims to contribute to improve health and health systems. ESHPM harbours internationally renowned research groups in the field of health economics and health technology assessment. 

Neurosurgical disorders such as stroke and brain tumours impose substantial burdens on patients and healthcare systems. By identifying technologies that improve outcomes while remaining affordable and implementable, this project will contribute to more efficient healthcare delivery, improved patient outcomes, and evidence-based adoption of innovation in neurosurgery.

This project contributes to the growing field of early HTA and implementation science by developing and applying methodologies to evaluate emerging neurosurgical technologies. The findings will advance understanding of how health economic and implementation evidence can support the adoption of innovative technologies in complex healthcare settings.

Data Sources

• Clinical and operational data generated within the SESIMIC project.
• Hospital administrative and cost databases.
• Prospective data collection within participating centres.
• Stakeholder interviews and survey data.
• Published literature and registry data for model parameterisation.

ERIM offers fully-funded and salaried PhD positions, which means that accepted PhD candidates become employees (promovendi) of Erasmus University Rotterdam. Salary and benefits are in accordance with the Collective Labour Agreement for Dutch Universities (CAO).

Erasmus University Rotterdam aspires to be an equitable and inclusive community. We nurture an open culture, where everyone is supported to fulfil their full potential. We see inclusivity of talent as the basis of our successes, and the diversity of perspectives and people as a highly valued outcome. EUR provides equal opportunities to all employees and applicants regardless of gender identity or expression, sexual orientation, religion, ethnicity, age, neurodiversity, functional impairment, citizenship, or any other aspect which makes them unique. We look forward to welcoming you to our community.

For questions regarding the PhD application and selection procedure, please check the Admissions or send us an e-mail via phdadmissions@erim.eur.nl.