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Hospitals participating in the breast cancer surgery case are those four hospitals which participated in the primary implementation strategy, covering four main organisational hospital settings in the Netherlands.
The cost-effectiveness analysis will use the same methodology as in the primary implementation study [ 19].
Again we will use the same inclusion and exclusion criteria as in the primary implementation study.
This time horizon will cover most costs related to surgical treatment and is also used in the primary implementation study.
Hospitals participating in the SUSHI study were selected from the 33 Dutch hospitals that initially participated in the primary implementation strategy.
The interviews will be held by one of the researchers (either SA or FG), who were not involved in the primary implementation process.
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These were the same hospitals as included in the SUSHI study, and were found to differ in the level of sustaining the primary implementation success (Table 2).
The SPASE data model specification32 includes a conceptual ontology, shown in Fig. 1, with the primary implementation as an XML schema.
Thus, in order to guide the patient to seek treatment in the primary HCs, the implementation of a 'gate-keeper' and an adequate referral process is needed, as well as improvements in the qualification of the HC health personnel and an increase in the HIC of the HC services.
In addition, there may be other moderating variables that either were not tested in this study or measured in the primary reports, such as implementation fidelity, whether the intervention was theoretically informed, and so on, which could account for the differences in effects between studies.
As it is a simple, rapid, inexpensive, and reliable method of screening asymptomatic patients for PAD, the ABI test is ideal for implementation in the primary care physician's office [93].
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