Patient safety is a serious global public health problem affecting all countries. Estimates show that 1/10 patients are harmed during hospital care resulting in 23 million disability-adjusted life years lost per year. Research advancement is emphasized by all expert groups as a key precondition for safer care . The PATSAFE project will enhance Institute of Clinical Medicine of the University of Tartu (ICM-UT) research potential and capacities in patient safety in order to improve and strengthen knowledge and skills in methods, techniques and experience for patient safety research. Strategic partnership with Avedis Donabedian Foundation (FAD) from Spain and IQ Healthcare (IQ-HC) from The Netherlands, both international leaders in patient safety research, enables developing a long-lasting knowledge exchange alliance allowing ICM-UT to capitalise on its current achievements and to overcome gaps in scientific excellence in the field of patient safety research. To deliver maximum impact on the scientific excellence of ICM-UT and to contribute to the long-term sustainability of its research activities, the twining activities will: • Strengthen and raise the research profile of the ICM-UT academic staff and early stage researchers (ESRs), by implementing the hands-on training on the methods, techniques and experience in patient safety research; • Encourage the active participation of ESRs in patient safety research by increase their soft skills, to ensure the continuity and sustainability of patient safety research in ICM-UT; • Develop the research strategy on patient safety and establish the Estonian Patient Safety Research Network for the long-term sustainability of patient safety research in Estonia. To implement these activities, PATSAFE foresees a comprehensive strategy consisting of knowledge exchange (training materials, seminars, staff visits), soft research skills capacity building, strategic planning and strong dissemination and exploitation efforts.

Colorectal cancer (CRC) ranks fourth in cancer deaths worldwide. Between 20% and 30% of patients with advanced CRC have liver metastases (CRLM). Liver cancer ranks second in cancer deaths worldwide, including hepatocellular carcinoma (HCC). Despite recent advances, liver resection offers the only chance of cure for patients with liver metastases. However, the recurrence rate of these tumours is high even after post-resection. The presence of positive margins in the remaining liver after resection correlates with increased local recurrence and decreased overall survival, the only factor where prognosis could be influenced by the performance of surgery. However, at present, the extent of an R-negative status remains debatable and varies widely from one publication to another. Currently, there are radiofrequency ablation studies that, based on preliminary retrospective human clinical trials, are able to correlate an additional coagulation of tumor margins with a reduction on local recurrence. However, there is no prospective and pragmatic controlled study that accurately measures this additional margin and its impact on oncological outcomes. The aim of LIVERATION is to conduct an ambitious, pragmatic multicenter clinical trial with 720 patients with CRLM and HCC at 24 clinical centres in 6 different countries to determine whether additional ablated margin produced by radiofrequency can decrease the recurrence rate and improve patient survival. We will also evaluate the patient-centredness of the intervention and its comparativeness with other therapeutic alternatives in terms of quality of life and patient experience in real-world settings. To this end, the consortium has been formed by highly experienced, highly qualified and multidisciplinary entities to carry out the project successfully. The results will not only have a major impact on a social and scientific level but also on an economic level for the EU. This action is part of the Cancer Mission cluster of projects on ‘Diagnosis and treatment’.

COMPAR-EU aims to identify, compare, and rank the most effective and cost-effective self-management interventions (SMIs) for adults in Europe within four high-priority chronic conditions: type 2 diabetes, obesity, chronic obstructive pulmonary disease, and heart failure. This project addresses an important gap in current knowledge applying network meta-analysis, an extension of meta-analysis methodology that allows multiple (rather than pairwise) comparisons of intervention effectiveness, to randomised controlled trials (RCTs) that meet the study inclusion criteria. This centralised analysis of an estimated 4000 RCTs will substantially help to overcome current problems associated with the dispersion and duplication of evidence. The work will be based on a validated taxonomy of SMIs and will prioritise outcomes from the patients’ perspective. In addition, a cost-effectiveness of the most effective SMIs will be estimated to provide insights into the economic consequences of adopting SMIs for societies, healthcare budgets, and patients. Contextual factors associated with successful interventions will also be studied. Drawing on our results, we will develop and pilot decision-making tools to facilitate access to evidence-based information on the most effective SMIs to key users through a user-friendly interactive platform. A multiprong strategy for exploitation of the research findings will lead to clear business cases for implementing it in different contexts within the heterogeneous EU health system. The end goal of the project is to have an impact in supporting policy-makers, guideline developers, researchers, industry, professionals and patients to make informed decisions on the identification and implementation of the most suitable SMIs, therefore contributing to the diffusion of the knowledge, healthcare sustainability and equity and promoting EU competitiveness in a globally emerging market.

The significant increase of the older (65+) European population with complex care needs calls for a better integration and coordination between health care and social services. Existing socio-economic and gendered inequalities in LTC might worsen in the future due to demographic ageing and austerity measures in LTC provision. So far, person-centered integrated care (PC-IC), as one solution to tackle these challenges, has mostly been developed in a top-down logic, and community engagement and participatory co-design have hardly been explored to develop PC-IC solutions. The aim of BUILD is to develop a framework and toolbox that assists policy makers in implementing participatory co-design and community engagement as methods to develop socially inclusive and sustainable PC-IC solutions for older adults with complex care needs that can be evaluated by the social return on investment. BUILD will increase the understanding of PC-IC by mapping and analyzing existing eco-systems of IC across Europe and identifying their corresponding regulatory frameworks and current challenges. BUILD will then go beyond these challenges by conducting a longitudinal, cross-national study that investigates care integration on a practical level, developing scientific evidence on how social inequalities shape the access to, and the outcomes of diverse forms of care and their integration while also highlighting the needs and required skills for PC-IC from the patients’ and caregivers’ perspective. Throughout the project, BUILD will involve communities, older adults with complex care needs, in-/formal caregivers, stakeholders and policy makers on different regulatory levels in the participatory co-design of PC-IC solutions and develop policy recommendations based on the experiences gathered. Ultimately, BUILD will develop a co-design framework and toolbox, as the main outcome of the project, that supports the implementation of PC-IC through co-design and community engagement.