Van Barneveld works as a physician-researcher in the group of Prof. dr. Lieve Tytgat, with Dr. Patrick Kemmeren as co-promotor. Her research helps analyze and improve care protocols. This makes treatments in childhood cancer more effective and improves children's quality of life. We spoke to her about her research and this award.
Astrid, what is your research about?
'I am investigating the use of process mining in pediatric oncology. Process mining is a technique often used in finance and business. With process mining, we analyze data from electronic systems to see exactly how patient treatments proceed.
Our care is based on protocols and standardized treatments. With process mining, we check whether these protocols are followed in practice. By analyzing these processes, we can detect deviations and improve care.
At Máxima, there is a large database with anonymized information about care. This database collects data from different systems and includes everything a patient has experienced. I use process mining software and an algorithm to analyze and logically represent this data.'
How can process mining contribute to better patient care?
'Process mining can help improve care protocols. We look at where we can optimize them so that the protocols become more effective, patient-friendly and cost-efficient. I like to use the example of a bend in a bike path. You're supposed to take the bend, but often people cut across because it's more convenient. You can put up a fence to prevent this, but you can also ask yourself whether the shorter route isn't smarter. In such a case, it might be better to move the cycle path.
Similarly in healthcare, a more convenient route can be a reason to deviate from protocol. Often, deviations from protocols are not ill-intentioned; they happen to improve care for the child with cancer. The GOAL of our research is to discover these differences between protocol and reality and understand why deviations occur. Is it problematic, or an improvement? And if it's problematic, how can we ensure it doesn't happen anymore?'
Where do you stand in your research now?
'We have shown that process mining has potential in pediatric oncology. I submitted these results to ASCO for the conference in Japan.
We took the treatment protocol for children with neuroblastoma and examined the treatments from the opening of the Máxima until 2023. We analyzed the data of 70 children. In this study, we worked closely with Matthijs Berkhout, a researcher at the Digital Ethics lectorate at the Utrecht University of Applied Sciences. He supported us technically in choosing and implementing the right algorithms and software.'
What were the results?
'That care regularly deviates from protocols. The question is whether that's a problem. We are moving more towards personalized care, where it’s no longer the intention for all children to receive exactly the same care.
In children who eventually passed away, we increasingly saw personalized care. In children who eventually passed away,. These children received different medications. We also found that we could trace certain pauses in treatment. In the clinic, these pauses are sometimes longer or shorter than the protocol states. We are investigating how these adjustments came about and whether they should be implemented in the protocol. Healthcare providers always make well-considered decisions, with the child at the center.’
What does winning this award mean to you?
‘When I heard I was going to receive this award, I was overjoyed. I was also surprised because ASCO focuses on cancer in its entirety, especially in adults. It was a shot in the dark, and winning such an award is truly amazing. Something to be incredibly proud of.
What I find particularly great is that this award shows the value of this work. In pediatric oncology, we are, as far as we know, the first to use process mining. Last year, we won another award for this project at the Innovation for Health conference. I find it incredibly exciting that it is receiving so much attention.’
What do you hope to achieve with your research?
‘I hope my research will improve the treatment of children with cancer by continuously evaluating and improving it. We do not want to give a child a treatment that is not effective. A trial or treatment protocol should really work. The burden on the child must be as low as possible, and children must benefit as much as possible with minimal discomfort. This technology is perfect for investigating if what we are doing is truly effective.
Now that we have shown that process mining has a lot of potential, this technique can be applied to specific procedures, such as biopsies, surgeries, and other significant events. We can investigate if it can be done better, smarter, faster, and easier, with less burden on the child. Evaluating our own actions has a positive effect on all care.
We do this to ultimately improve care for the children. Experience shows that most problems do not lie with the caregivers themselves but with the systems and support used. We can still improve these aspects, provided we are aware of them. Process mining helps us in that awareness.’
About the Conquer Cancer Merit Award
The Conquer Cancer Merit Award is presented to young researchers doing pioneering work in cancer research. The award includes a cash prize of 1,000 US dollars. Conquer Cancer is the foundation of the American Society of Clinical Oncology (ASCO) and focuses on funding and advancing cancer research and supporting patients worldwide. Van Barneveld will receive the award at the ASCO congress in Japan from August 8 to 10.
For more information, visit conquer.org.