Presentation (CTI)

OBJECTIVES: The implementation of complex health technologies, such as advanced therapy medicinal products (ATMPs), genomics, and AI in diagnostics, increasingly requires systemic changes in healthcare delivery. Traditional Health Technology Assessment (HTA) methods, relying on linear and isolated effects, often fail to capture system-level implications and operational complexities crucial for successful implementation. To address these limitations, systems-level modelling techniques (e.g., discrete-event simulation, system dynamics, agent-based modelling) are increasingly used to simulate dynamic interactions, assess operational feasibility , and inform national and international policies. This systematic review synthesises current evidence on the use of modelling to inform assessment and implementation of complex health technologies at the health system level.
METHODS: A systematic review is currently in progress to identify empirical applications of systems-level modelling techniques in the context of complex health technology implementation. Searches were conducted in PubMed, Web of Science, Embase, and Scopus. Eligible studies include peer-reviewed empirical articles applying simulation methods to healthcare delivery systems.
RESULTS: 3,899 articles have been identified; screening and extraction are ongoing. Data extraction will focus on: (1) types and contexts of models used; (2) the extent to which model designs reflect characteristics of complex systems, assessed using a the predefined SIMULATE checklist (system, interactions, multilevel, understanding, loops, agents, time, emergence); and (3) reflections on model limitations and real-world applicability.
CONCLUSIONS: This review contributes to our understanding of how systems-level modelling is applied and current methodological limitations. Findings are intended to inform future modelling efforts and provide methodological guidance for HTA in complex healthcare settings, such as gene therapies.