TRANSCEND-XR
A project for: European Health and Digital Executive Agency (HaDEA)
BRIEF
The Challenge
Testicular cancer is the most common cancer diagnosed among adolescents and young adults (AYAs) assigned male at birth, aged 15–39 years. Facing cancer at such a formative stage brings profound challenges, including confronting mortality at a young age and coping with both immediate and long-term effects of treatment. Many AYA testicular cancer survivors experience ongoing symptoms and late effects, with gaps in education, support, and access to relevant resources. Despite advances in treatment, AYAs who survive testicular cancer often struggle with reduced quality of life, insufficient information about late effects, and unmet supportive care needs. There is a pressing need for innovative and accessible interventions that address these disparities, empower survivors, and help them navigate the physical, emotional, and practical consequences of their cancer journey.
The project aims to:
• To co-create, test, and implement a digital intervention using extended reality (XR) technology that educates AYA testicular cancer survivors about late effects of treatment and addresses their unique supportive care needs.
• To ensure that the project is developed ethically and inclusively, involving survivors, care partners, and healthcare professionals throughout the project and its activities.
• To rigorously evaluate the intervention’s effectiveness, cost-effectiveness, and acceptability in real-world settings.
• To translate evidence and learnings into practice and policy, ensuring the sustainability and long-term impact of the solution for AYA survivors across Europe.
FOCUS
The Approach
The Project will co-create, validate, and implement an innovative extended reality (XR) intervention addressing the unmet supportive care needs of AYA testicular cancer (TC) survivors. The project’s approach integrates principles of inclusivity, equity, and evidence-based digital health innovation across:
• Systematically exploring the lived experiences, needs, and disparities faced by AYA TC survivors, their care partners, and healthcare professionals. Using an inductive and iterative co-creation methodology (e.g., World cafes).
• A prototype XR intervention will be developed and subjected to usability testing, refinement, and validation with diverse users in selected real-life clinical settings. A robust trial protocol, data management and statistical analysis plan (DMSAP), and health economic analysis plan (HEAP) will guide evaluation.
• The feasibility of XR will be assessed through implementation studies, followed by a randomised controlled trial (pRCT) evaluating its effectiveness in enhancing survivors’ knowledge of late effects, improving quality of life, and supporting shared decision-making. Cost-effectiveness analyses will compare XR to conventional strategies, generating actionable evidence for clinical and policy decision-making.
• The project will integrate mixed-method evaluations of reach, adoption, fidelity, and engagement to assess how the intervention operates in practice. A multidisciplinary stakeholder network spanning survivors, clinicians, policymakers, industry, and the public will facilitate collaboration and maximise European-wide impact.
CONCLUSIONS
The Envisioned Result
An innovative XR-based digital intervention which is ethically co-created, tested, and scaled in real-life healthcare settings to increase adolescents’ and young adults’ (AYA) testicular cancer (TC) survivors’ knowledge of treatment-related late effects and to address unmet supportive care needs.
Additional outputs which will contribute to the final intervention:
• Evidence-based co-creation methodology: deploying the World Café method, ensuring that survivors, care partners, healthcare professionals, and survivor organisations contribute to intervention design and refinement.
• Evaluation outputs, including:
o Results from a pragmatic randomised controlled trial (RCT) assessing effectiveness and acceptability.
o A health economic analysis determining cost-effectiveness.
o A mixed-method process evaluation exploring feasibility, delivery processes, and participant experiences.
• Ethical and sociocultural insights: documenting survivors’ values, equity considerations, and policy implications of using XR in digital health, with particular attention to disparities in access and engagement.
• Scalable implementation framework: providing guidelines and knowledge for wider integration of XR interventions into survivorship care across diverse healthcare systems
PREDICTBY
Our Role
PredictBy is responsible for multiple tasks in this project as experts in health economics and stakeholder engagement
Our role in the project consists of conducting the following tasks:
Rapid evidence assessment (REA)
Cost-effectiveness analysis: MAFEIP
Discrete Choice Experiments (assessing willingness to pay (WTP) and willingness to accept (WTA)
Determine economic impact and develop guidelines
Mapping of key stakeholders and engagement roadmap
Development of a long-term sustainability plan