HTA game Radboudumc v1.05

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[img[images/logo.png]] <I> Version 1.05, July 2018 </I> <span style="color:#00AFDC"><h1>Welcome to the interactive HTA game</h1></span> You, as a researcher in the field of health technology assessment (HTA), decide which of the three innovations has the most added value for Dutch society. The three innovations are: a new diagnostic test for prostate cancer, a new localized treatment of prostate cancer and a new robot-assisted surgery technique for prostate cancer. Your budget is limited, namely € 400,000, which you can spend on different types of research. Using this research, it can become clear which innovation has the most added value for Dutch society, if you decide correctly! Pick an innovation, you can always pick another when the results of a study are not as positive as you hoped. Please play this game with a partner and discuss the different options and outcomes. Summary: -Choose your innovation out of 3 innovations -You can always swap between innovations! -Available budget: €400.000 per team -Three types of research -Goal: to gain the most health (=impact on healthcare) Good luck! <<button [[Start the game|intro]]>><</button>> <<button [[More information|info]]>><</button>> If you want to provide us with feedback at the end of the game, please use the feedback form: <a href="https://goo.gl/forms/kCR9R4mxfm3gBQP33">Click here</a> <<set $budget = 400000>>\ <<set $innovation = "None">>\ <<set $reimbA = 0>>\ <<set $reimbB = 0>>\ <<set $reimbC = 0>>\ <<set $study = 0>>\ <<set $cs = 0>>\ <<set $inno = "">>\ <<set $first = "">>\ <<set $second = "">>\ <<set $third = "">>\ <<set $fourth = "">>\ <<set $fifth = "">>\ <<set $st = 0>>\ <<set $s1 = "">>\ <<set $s2 = "">>\ <<set $s3 = "">>\ <<set $s4 = "">>\ <<set $s5 = "">>\ <<set $s6 = "">>\ <<set $s7 = "">>\ <<set $s8 = "">>\ <<set $resultQR = "<h5>Needs assessment:</h5> Innovations A and B best meet the needs of stakeholders">>\ <<set $resultDMa = "<h5>Decision Model (Innovation A): </h5> Eliminating overtreatment yields 0.04 QALYs per patient. For the total population (n=40.000), this innovation has a maximum yield of 1600 QALYs.">>\ <<set $resultDMb = "<h5>Decision Model (Innovation B):</h5> Eliminating side effects: 0.41 QALYs per patient. For the total population this implies a yield of 2050 QALYs.">>\ <<set $resultDMc = "<h5>Decision Model (Innovation C):</h5> The robot does not result in health gain.">>\ <<set $resultCSa = "<h5>Clinical Study (Innovation A):</h5> Compared to usual care, the innovation results in 0.015 QALYs gained per patient. For the total population this implies a yield of 600 QALYs.">>\ <<set $resultCSb = "<h5>Clinical Study (Innovation B):</h5> Compared to usual care, the innovation results in 0.20 QALYs per patient. For the total population this implies a yield of 1000 QALYs.">>\ <<set $resultCSc = "<h5>Clinical Study (Innovation C):</h5> Compared with the current robot, innovation C shows identical quality of life and survival, and thus no difference in QALYs.">>\

<<set $study= 0>>\ <<set $reimb = 0>>\ <h1>Choose an innovation:</h1> <B>Innovation A:</B> A new diagnostic strategy for detecting prostate cancer.If it has added value, it will benefit: <B><I> 40.000 patients per year </I> </B> [img[images/innoA.jpg]] <<button [[Pick Innovation A|Inno]]>><<set $innovation to "A">><</button>> <B>Innovation B: </B> A new treatment for localized prostate cancer. If it has added value, it will benefit: <B><I>5.000 patients per year</I></B> [img[images/innoB.jpg]] <<button [[Pick Innovation B|Inno]]>><<set $innovation to "B">><</button>> <B>Innovation C: </B> A robot that allows more precise surgery. If it has added value, it will benefit: <B><I>7.000 patients per year </I></B> [img[images/innoC.jpg]] <<button [[Pick Innovation C|Inno]]>><<set $innovation to "C">><</button>> [[Back|intro]]

<<widget "diaglogclose2">><<script>>UI.close()<</script>><</widget>>\ <<diaglogclose2>>\ <<if $innovation is "A">><<set $inno to "A new diagnostic strategy for detecting prostate cancer.">>\ <<elseif $innovation is "B">><<set $inno to "A new treatment for localized prostate cancer.">>\ <<elseif $innovation is "C">><<set $inno to "A robot that allows more precise surgery.">>\ <</if>>\ <H1>Types of research</H1> To investigate the cost-effectiveness of the innovation, you can perform 3 different types of research. Click on the link below every type of research to gain more information. Thereafter, you can decide if you want to fund that type of reseach. [img[images/studychoice.png]] <b>- Clinical study </b> You can perform a clinical study to determine the actual health gain the innovation has compared with the current standard of care. <<button [[More information about a clinical trial|cs]]>><</button>> <B>- Decision modelling study</B> A decision modelling study can be used to quantify the room for improvement: the maximum health gain the innovation may have. <<button [[More information about a decision modeling study|dms]]>><</button>> <B>- Needs assessment</B> A needs assessment is used to explore the needs of stakeholders (e.g. patients, urologists, radiologists, radiation oncologists, policy makers) for improvement in the current care pathway for diagnosing and treating prostate cancer. <<button [[More information about a needs assessment|qr]]>><</button>> [[Back|Choose]]

<H1>Clinical study </H1> [img[images/cs.jpg]] You can perform a clinical study to determine the actual health gain the innovation has compared with the current standard of care. The results of a clinical trial are (often) reliable, however, performing a clinical study is expensive because they take years to finish. In order to receive reimbursement for your innovation, a clinical trial is necessary to prove the effectiveness of your innovation. <B>Costs: €250.000 per study</B> If you perform a clinical study, your budget will be €<<print $budget-250000>> <<popup "<B><h2><U>-> Perform a clinical trial <- </U></h2></B>" "promptcs">> <<button [[Go back to other research|Inno]]>><</button>> [[Or finish the game ->finishcode]]

<h1>Decision modelling study</h1> [img[images/dt.png]] A decision model compares the usual care treatment with a hypothetical situation in which the innovation is implemented in healthcare using literature, hospital databases and/or expert opinion. If can be used to quantify the room for improvement: the maximum health gain the innovation may have. A decision model is much cheaper then a clinical trial, because you do not need patients, decreasing the research time. However, a clinical trial is always needed to 'prove' the effectiveness of the innovation. Costs: €40.000 per model If you perform a modelling study, your budget will be €<<print $budget-40000>> <<popup "<B><h2><U>-> Perform a modelling study <- </U></h2></B>" "promptdms">> <<button [[Go back to other research|Inno]]>><</button>> [[Or finish the game ->finishcode]]

<h1>Needs assessment</h1> [img[images/qr.png]] A needs assessment is used to explore the needs of stakeholders (e.g. patients, urologists, radiologists, radiation oncologists, policy makers) with interviews. These interviews can be used to detect the room for improvement in the current care pathway for all innovations at the same time.(diagnosing and treating prostate cancer) A needs assessment is cheaper compared to a clinical study or a decision model. However, a clinical trial is always needed to 'prove' the effectiveness of the innovation. Costs: €30.000 per study If you perform a needs assessment, your budget will be €<<print $budget-30000>> <<popup "<B><h2><U>-> Perform a needs assessment <- </U></h2></B>" "promptqr">> <<button [[Go back to other research|Inno]]>><</button>> [[Or finish the game ->finishcode]]

[img[images/complete.jpg]] <H2> You have performed a clinicial trial! </H2> <<set $cs to 1>> <<if $innovation is "A">> <B>Results from the clinical trial for innovation A:</B> Compared with the current diagnostic strategy, the innovative strategy results in 0.015 quality-adjusted life years (QALYs) gained per patient. For the total population (n=40.000), this implies that innovation A yields 600 QALYs. Your current budget is € $budget. <<set $reimbA to $reimbA+30>>\ The positive result of the clinical trial increased the reimbursement probability of your innovation by <B>30%</B>. <<elseif $innovation is "B">><B>Results from the clinical trial for innovation B:</B> Compared with the current treatment for localized prostate cancer, innovation B yields 0.20 quality-adjusted life years (QALYs) per patient. For the total population (n=5.000), innovation B yields 1000 QALYs. Your current budget is € $budget. <<set $reimbB to $reimbB+30>>\ The positive result of the clinical trial increased the reimbursement probability of your innovation by <B>30%</B>. <<elseif $innovation is "C">> <B>Results from the clinical trial for innovation C:</B> Compared with the current robot, innovation C shows identical quality of life and survival, and thus no difference in quality-adjusted life years (QALYs). Your current budget is € $budget. A clinical trial with positive results would increase the chance on reimbursement by <b>30%</b>. However, because your innovation does not show an increase in QALYs, this trial does not increase your chance on reimbursement.” <</if>>\ <<button [[Do you want to perform more research on your current innovation?|Inno]]>><</button>> <<button [[Do you want to choose another innovation?|Choose]]>><</button>> [[Or finish the game|finishcode]]

[img[images/complete.jpg]] <H2> You have performed a needs assessment! </H2> <B>Results from the needs assessment: </B> The results of the needs assessment show that stakeholders identify two main problems where improvement is needed: -Overtreatment of prostate cancer due to suboptimal diagnostics -Side effects (e.g. impotence, incontinence and bowel problems) due to suboptimal treatment of localized prostate cancer <u>Conclusion: Innovations A and B best meet the needs of stakeholders </U> Your budget is: € $budget <<set $reimbA to $reimbA+10>><<set $reimbB to $reimbB+10>>\ <<if ($innovation is "A" or $innovation is "B")>>The positive result of the needs assessment increased the reimbursement probability of your innovation by <B>10%</B>. <<elseif $innovation is "C">>A needs assessment with positive results would raise the chance of reimbursement of your innovation by <B>10%</B>. However, because the needs assessment does not show a positive result for innovation, this assessment does not increase your chance of reimbursement. Due to the positive findings on innovation A and B, the reimbursement probability for both innovations is <B>increased by 10%.</B><</if>> <<button [[Do you want to perform more research on your current innovation?|Inno]]>><</button>> <<button [[Do you want to choose another innovation?|Choose]]>><</button>> [[Or finish the game|finishcode]]

[img[images/complete.jpg]] <H2> You have performed a decision model! </H2> <<if $innovation is "A">> \ <B>Results from the decision model for innovation A:</B> Eliminating overtreatment yields 0.04 quality-adjusted life years (QALYs) per patient. For the total population (n=40.000), this innovation has a <U>maximum yield of 1600 QALYs. </U> Your current budget is € $budget. <<set $reimbA to $reimbA+20>>\ The positive result of the decision model increased the reimbursement probability of your innovation by <B>20%</B>. <<elseif $innovation is "B">><B>Results from the decision model for innovation B:</B> Eliminating side effects yields 0.41 quality-adjusted life years (QALYs) per patient. For the total population (n=5.000), this innovation has a <U>maximum yield of 2050 QALYs. </U> Your current budget is € $budget. <<set $reimbB to $reimbB+20>>\ The positive result of the decision model increased the reimbursement probability of your innovation by <B>20%</B>. <<elseif $innovation is "C">> <B>Results from the clinical trial for innovation C:</B> The current surgery results in blood loss due to imprecision. The robot can potentially lower the blood loss. As this blood loss does not affect the health of the patient, eliminating this blood loss <U>would not result in any health gain.</U> Your current budget is € $budget. A decision model with positive results would raise the chance of reimbursement by <b>20%</b>. However, because the model does not show that the innovation leads to more QALYs, this study does not increase your chance of reimbursement.” <</if>> <<button [[Do you want to perform more research on your current innovation?|Inno]]>><</button>> <<button [[Do you want to choose another innovation?|Choose]]>><</button>> [[Or finish the game|finishcode]]

<h1>You have finished the HTA game.</h1> [img[images/finished.jpeg]] Your innovation was innovation: $innovation ; $inno Your final budget was <B>€ $budget </B>. <b>Final score: $score out of 4 points.</b> <<if $innovation is "B">> <B>Congratulations!</B> You have picked the innovation with the most health and therefore the highest impact on healthcare. \ The probability for reimbursement is increased by <B>$reimbB %</B>. <<if $reimbB <40>>Because you have not performed enough research your reimbursement probability is low. Your innovation will <b>not</B> be reimbursed.<</if>> \ <<if $reimbB >40 >>Because your reimbursement probability is high, your innovation is <B>likely to be reimbursed!</B><</if>> \ <<if $cs is 1>>You have performed a clinical study. It is possible to start implementing your innovation in healthcare. Well done!<</if>><<if $cs is 0>>You have not performed a clinical study. There is no evidence that your innovation is effective and implementation will be very difficult.<</if>> \ \ <<else>> Your innovation did not have the highest impact on healthcare. Discuss why you choose innovation $innovation. Try again and keep the following questions in mind: "Why do you think stakeholders want innovation $innovation?" "Do I have enough evidence for innovation $innovation?" "Is it possible to increase the reimbursement probability?" <<if $budget > 150000>> You still had some money left to perform more research on other innovations. Try again. <</if>> <<if $cs is 1 and $innovation is "C">>You also performed a clinical study. If you had performed a decision model study or qualitative study you could have saved money because you would have known that the innovation did not had a large impact on health.<</if>> <<if $cs is 1 and $innovation is "A">>You also performed a clinical study. Although the clinical study shows that innovation A does have effect, another innovation provides the most health.<</if>> <<if $innovation is "A">> The reimbursement probability for your innovation was <B>$reimbA %</B><<elseif $innovation is "C">>The reimbursement probability for your innovation was <B>$reimbA %</B> <</if>>\ <</if>>\ [[Retry|start]] If you want to provide us with feedback, please use the feedback form: <a href="https://goo.gl/forms/kCR9R4mxfm3gBQP33">Click here</a> Thank you for your time and effort [[Do you want to see all the results?|results]]

<H1>All results of the HTA game </H1> <B>Qualitive research:</B> The results of the qualitative study show that stakeholders identify two main problems where improvement is needed: Overtreatment of prostate cancer due to suboptimal diagnostics Side effects (e.g. impotence, incontinence and bowel problems) due to suboptimal treatment of localized prostate cancer <B>Conclusion: Innovations A and B best meet the needs of stakeholders</B> <B>Decision modelling study</B> Innovation A: Eliminating overtreatment yields 0.04 quality-adjusted life years (QALYs) per patient. For the total population (n=40.000), this innovation has a maximum yield of 1600 QALYs. Innovation B: Eliminating side effects yields 0.41 quality-adjusted life years (QALYs) per patient. For the total population (n=5.000), this innovation has a maximum yield of 2050 QALYs. Innovation C: The current robot results in blood loss due to imprecision. As this blood loss does not affect the health of the patient, eliminating this blood loss would not result in any health gain. <B>Conclusion: Innovation B has largest room for improvement</B> <B>Clinical study:</B> Innovation A: Compared with the current diagnostic strategy, the innovative strategy results in 0.015 quality-adjusted life years (QALYs) gained per patient. For the total population (n=40.000), this implies that innovation A yields 600 QALYs. Innovation B: Compared with the current treatment for localized prostate cancer, innovation B yields 0.20 quality-adjusted life years (QALYs) per patient. For the total population (n=5.000), innovation B yields 1000 QALYs. Innovation C: Compared with the current robot, innovation C shows identical quality of life and survival, and thus no difference in quality-adjusted life years (QALYs). <B>Conclusion: Innovation B yields most health and therefore has the highest impact on healthcare </B> [[Restart|start]]

<H1>What research do you want to fund?</H1> [img[images/studychoice2.png]] <<if $study is 1>> You can only choose between: -[[Decision modeling study on your innovation|dms]] -[[Needs assessment|qr]] <<elseif $study is 2>> You can only choose between: -[[Clinical study on your innovation|cs]] -[[Needs assessment|qr]] <<elseif $study is 3>> You can only choose between: -[[Clinical study on your innovation|cs]] -[[Decision modeling study on your innovation|dms]] <</if>> [[Do you want to choose another innovation?|Choose]] [[Or finish the game|finishcode]]

<H1>What research do you want to fund next?</H1> [img[images/studychoice2.png]] <<if ($study is 201)>> You can only perform: -[[Needs assessment|qr]] <<elseif ($study is 301)>> You can only perform: -[[Decision modeling study on your innovation|dms]] <<elseif ($study is 102)>> You can only perform: -[[Needs assessment|qr]] <<elseif ($study is 103)>> You can only perform: -[[Decision modeling study on your innovation|dms]] <<elseif ($study is 302)>> You can only perform: -[[Clinical study on your innovation|cs]] <<elseif ($study is 203)>> You can only perform: -[[Clinical study on your innovation|cs]] <</if>> [[Do you want to choose another innovation?|Choose]] [[Or finish the game|finishcode]]

<h1> General information </h1> This game was developed by the Radboudumc (Nijmegen, the Netherlands) to provide more insight in the research choices prior to release of an innovation. Limiting the budget for research provides the participant with an option: Do I want to spend more money on research or are the current results sufficient to be sure that your innovation will give the most value for money. Original concept by Dr. Janneke Grutters & Prof. Maroeska Rovers; Evidence based surgery, Nijmegen, The Netherlands Game build by Drs. Stan Wijn; Evidence based surgery, Nijmegen, The Netherlands. For more information about this game, please contact: stan.wijn@radboudumc.nl <<button [[Back|start]]>><</button>> Change notes: v1.04 - Fixed progression trail in status bar. Introduced feedback form v1.03 - Added final score system & reimbursement per innovation v1.02 - Bug fixes & restructured the reimbursement system v1.01 - Buttons, changed QR to needs assessment, new complete image v1.0 - Full image embedding, removed back button v0.5 - Internet images v0.1 - Basic

<<widget "dialogclose">><<click $args[0]>><<script>>UI.close()<</script>><</click>><</widget>><<if ($budget - 250000) >= 0 >>\ <span style="color:white;">Are you sure you want to invest money on a clinical study?</span> [img[images/geld.gif]] /* Usage */ <<button [[Yes|cscode]]>><</button>> <<dialogclose "No">> <<elseif ($budget >= 30000)>> <span style="color:white;">You do not have enough money to perform this research, but you can still perform something else.</span> [img[images/nomoney.jpg]] <<button [[Go back|Inno]]>><</button>> [[or finish the game|finishcode]] <<elseif ($budget < 30000)>> <span style="color:white;">You have no budget left and are not able to affort more research </span> [img[images/nomoney.jpg]] [[Finish the game|finishcode]] <</if>>

<<widget "dialogclose">><<click $args[0]>><<script>>UI.close()<</script>><</click>><</widget>><<if ($budget - 40000) >= 0 >>\ <span style="color:white;">Are you sure you want to invest money on a decision modelling study?</span> [img[images/geld.gif]] /* Usage */ <<button [[Yes|dmscode]]>><</button>> <<dialogclose "No">> <<elseif ($budget >= 30000)>> <span style="color:white;">You do not have enough money to perform this research, but you can still perform something else.</span> [img[images/nomoney.jpg]] <<button [[Go back|Inno]]>><</button>> [[or finish the game|finishcode]] <<elseif ($budget < 30000)>> <span style="color:white;">You have no budget left and are not able to affort more research </span> [img[images/nomoney.jpg]] [[Finish the game|finishcode]] <</if>>

<<widget "dialogclose">><<click $args[0]>><<script>>UI.close()<</script>><</click>><</widget>><<if ($budget - 30000) >= 0 >>\ <span style="color:white;">Are you sure you want to invest money on a needs assessment?</span> [img[images/geld.gif]] /* Usage */ <<button [[Yes|qrcode]]>><</button>> <<dialogclose "No">> <<elseif ($budget >= 30000)>> <span style="color:white;">You do not have enough money to perform this research, but you can still perform something else.</span> [img[images/nomoney.jpg]] <<button [[Go back|Inno]]>><</button>> [[or finish the game|finishcode]] <<elseif ($budget < 30000)>> <span style="color:white;">You have no budget left and are not able to affort more research </span> [img[images/nomoney.jpg]] [[Finish the game|finishcode]] <</if>>

<I>Status: Active innovation: $innovation $inno Budget= €$budget Reimbursement:<<if $innovation is "A">>+$reimbA %<<elseif $innovation is "B">>+$reimbB %<<elseif $innovation is "C">>+$reimbC %<<elseif $innovation is "None">><</if>> Number of studies: $st </I><<if $st is 0>><<else>> <B>Result 1: </B> $s1 <</if>> <<if $st <2 >> <<else>><B>Result 2:</B><</if>> $s2 <<if $st <3 >> <<else>><B>Result 3:</B><</if>> $s3 <<if $st <4 >> <<else>><B>Result 4:</B><</if>> $s4 <<if $st <5 >> <<else>><B>Result 5:</B><</if>> $s5 <<if $st <6 >> <<else>><B>Result 6:</B><</if>> $s6 <<if $st <7 >> <<else>><B>Result 7:</B><</if>> $s7

<H1>Introduction</H1> To research which innovation has the most health you first have to pick an innovation. You can choose between: -<B>Innovation A:</B> A new diagnostic strategy for detecting prostate cancer. If it has added value, it will benefit: <B><I>40.000 patients per year </I> </B> [img[images/innoA.jpg]] -<B>Innovation B: </B> A new treatment for localized prostate cancer. If it has added value, it will benefit: <B><I>5.000 patients per year</I></B> [img[images/innoB.jpg]] -<B>Innovation C: </B> A robot that allows more precise surgery. If it has added value, it will benefit: <B><I>7.000 patients per year </I></B> [img[images/innoC.jpg]] Thereafter, you can perform three types of research. You can perform multiple studies with the €400.000 that you have available for your team, but you can only spend your money once. The three types of research are: <b>- Clinical study </b> You can perform a clinical study to determine the actual health gain the innovation has compared with the current standard of care. <B>- Decision modelling study</B> A decision modelling study can be used to quantify the room for improvement: the maximum health gain the innovation may have. <B>- Needs assessment</B> A needs assessment is used to explore the needs of stakeholders (e.g. patients, urologists, radiologists, radiation oncologists, policy makers) for improvement in the current care pathway for diagnosing and treating prostate cancer. The results of your studies are <B>saved on the left side of the screen</B>, so you can compare different results. <<button [[Click here to choose your (first) innovation|Choose]]>><</button>> [[Back|start]] Note: You can always change to another innovation at a later time.

<<widget "diaglogclose2">><<script>>UI.close()<</script>><</widget>>\ <<diaglogclose2>> <<if $innovation is "A">> <<if $st is 0>> <<set $s1 to "$resultDMa">> <<elseif $st is 1>> <<set $s2 to "$resultDMa">> <<elseif $st is 2>> <<set $s3 to "$resultDMa">> <<elseif $st is 3>> <<set $s4 to "$resultDMa">> <<elseif $st is 4>> <<set $s5 to "$resultDMa">> <<elseif $st is 5>> <<set $s6 to "$resultDMa">> <<elseif $st is 6>> <<set $s7 to "$resultDMa">> <</if>> <<elseif $innovation is "B">> <<if $st is 0>> <<set $s1 to "$resultDMb">> <<elseif $st is 1>> <<set $s2 to "$resultDMb">> <<elseif $st is 2>> <<set $s3 to "$resultDMb">> <<elseif $st is 3>> <<set $s4 to "$resultDMb">> <<elseif $st is 4>> <<set $s5 to "$resultDMb">> <<elseif $st is 5>> <<set $s6 to "$resultDMb">> <<elseif $st is 6>> <<set $s7 to "$resultDMb">> <</if>> <<elseif $innovation is "C">> <<if $st is 0>> <<set $s1 to "$resultDMc">> <<elseif $st is 1>> <<set $s2 to "$resultDMc">> <<elseif $st is 2>> <<set $s3 to "$resultDMc">> <<elseif $st is 3>> <<set $s4 to "$resultDMc">> <<elseif $st is 4>> <<set $s5 to "$resultDMc">> <<elseif $st is 5>> <<set $s6 to "$resultDMc">> <<elseif $st is 6>> <<set $s7 to "$resultDMc">> <</if>> <</if>> <<set $budget to $budget-40000>> <<set $st to $st+1>> <<goto [[dms1]]>>

<<widget "diaglogclose2">><<script>>UI.close()<</script>><</widget>>\ <<diaglogclose2>> <<if $st is 0>> <<set $s1 to "$resultQR">> <<elseif $st is 1>> <<set $s2 to "$resultQR">> <<elseif $st is 2>> <<set $s3 to "$resultQR">> <<elseif $st is 3>> <<set $s4 to "$resultQR">> <<elseif $st is 4>> <<set $s5 to "$resultQR">> <<elseif $st is 5>> <<set $s6 to "$resultQR">> <<elseif $st is 6>> <<set $s7 to "$resultQR">> <</if>> <<set $budget to $budget-30000>> <<set $st to $st+1>> <<goto [[qr1]]>>

<<widget "diaglogclose2">><<script>>UI.close()<</script>><</widget>>\ <<diaglogclose2>> <<set $budget to $budget-250000>> <<if $innovation is "A">> <<if $st is 0>> <<set $s1 to "$resultCSa">> <<elseif $st is 1>> <<set $s2 to "$resultCSa">> <<elseif $st is 2>> <<set $s3 to "$resultCSa">> <<elseif $st is 3>> <<set $s4 to "$resultCSa">> <<elseif $st is 4>> <<set $s5 to "$resultCSa">> <<elseif $st is 5>> <<set $s6 to "$resultCSa">> <<elseif $st is 6>> <<set $s7 to "$resultCSa">> <</if>> <<elseif $innovation is "B">> <<if $st is 0>> <<set $s1 to "$resultCSb">> <<elseif $st is 1>> <<set $s2 to "$resultCSb">> <<elseif $st is 2>> <<set $s3 to "$resultCSb">> <<elseif $st is 3>> <<set $s4 to "$resultCSb">> <<elseif $st is 4>> <<set $s5 to "$resultCSb">> <<elseif $st is 5>> <<set $s6 to "$resultCSb">> <<elseif $st is 6>> <<set $s7 to "$resultCSb">> <</if>> <<elseif $innovation is "C">> <<if $st is 0>> <<set $s1 to "$resultCSc">> <<elseif $st is 1>> <<set $s2 to "$resultCSc">> <<elseif $st is 2>> <<set $s3 to "$resultCSc">> <<elseif $st is 3>> <<set $s4 to "$resultCSc">> <<elseif $st is 4>> <<set $s5 to "$resultCSc">> <<elseif $st is 5>> <<set $s6 to "$resultCSc">> <<elseif $st is 6>> <<set $s7 to "$resultCSc">> <</if>> <</if>> <<set $st to $st+1>> <<goto [[cs1]]>>

<<widget "diaglogclose2">><<script>>UI.close()<</script>><</widget>>/ <<diaglogclose2>> <<set $score to 0>> <<if $innovation is "B">><<set $score to $score + 1>><</if>> <<if ($budget>39999) >><<set $score to $score +1>><</if>> <<if $cs is 1>><<set $score to $score +1>><</if>> <<if $innovation is "A" and $reimbA > 40>> <<set $score to $score +1>> <<elseif $innovation is "B" and $reimbB > 40>> <<set $score to $score +1>> <<elseif $innovation is "C" and $reimbC > 40>> <<set $score to $score +1>> <</if>> <<goto [[finish]]>>