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Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach. Twenty-four, good to high quality, evaluations were identified, representing different viewpoints, modelling techniques and willingness-to-pay thresholds. Studies show that in high-risk patients with symptomatic aortic stenosis, TAVI may be cost-effective compared with medical management (MM) across many health care settings. In contrast, studies of TAVI compared with surgical aortic valve replacement (SAVR) yield conflicting and inconclusive results. The limited data available show that TMVR may also be cost-effective relative to MM in mitral valve disease. Existing evidence indicates that transcatheter techniques may be cost-effective options, relative to MM, in high-risk patients with valvular disease. Nonetheless, more research is needed to establish their economic value further, to investigate the drives of cost-effectiveness, and to evaluate surgical with transcatheter techniques in aortic valvular disease.

We report on a novel evaluation framework to globally assess the footprint of smart cities and communities (SCC) projects, being also expandable to the case of smart grid related projects. The uniform smart city evaluation (USE) framework is constructed upon three complementary evaluation axes: the first one aims to weigh up the success of a SCC project based on performance metrics against pre-defined project-specific target values. The second axis focuses on the project’s impact towards the sustainability of a city and it is bench-marked against national and international key objectives arising from strategic plans. This bench-marking feeds the third axis which provides a more inclusive evaluation against four pre-defined and widely acclaimed sectors of interest. The steps to be followed for the uniform evaluation of each axis and corresponding index are presented in detail, including necessary key performance indicator (KPI) normalization, weighting, and aggregation methods. The resulting indices’ scores for each axis (namely project performance index, sustainability impact index, and sustainability performance index) can be post-processed with adequate data processing and visualization tools to extract important information on the extent to which the range of success of a SCC project contributes to the city sustainability progress. Illustrative examples from an on-going SCC project are provided to highlight the strengths of the approach. The proposed framework can be used to compare multiple projects within a city and sustainability and project performance in different cities, evaluate the interventions chosen per project against city needs, benchmark and design future projects (with, e.g., reverse engineering, projections), as well as evaluate various spatial and temporal scales.

As cities grow rapidly and energy needs increase, shaping an effective energy transition is a top priority towards urban sustainability and smart development. This study attempts to answer three key research questions that can help city authorities, planners and interested agents simplify and increase the transparency of Key Performance Indicators (KPIs) selection for smart city and communities (SCC) projects focusing on energy transition and creation of Positive Energy Districts (PEDs): Question 1: “What resources are available for extracting such KPIs?”; Question 2: “Which of those KPIs are the most suitable for assessing the energy transition of smart city projects and PED-related developments?” and Question 3: “How can a project-specific shortlist of KPIs be developed?”. Answering these questions can also serve as a major first step towards a “universal” KPI selection procedure. In line with this purpose, an experiential approach is presented, capitalizing on knowledge and lessons learned from an ongoing smart city project in Europe (POCITYF) that focuses on PED deployment. Under this framework, a) a review of smart city KPI frameworks has been conducted, resulting in a pool of 258 indicators that can potentially be adopted by smart city projects; b) eight key dimensions of evaluations were extracted, setting a holistic performance framework relevant to SCCs; c) a detailed evaluation process including pre-determined criteria and city-needs feedback was applied to shortlist the KPI pool, leading to a ready-to-be-used, project-specific list of 63 KPIs and d) KPIs were sorted and analyzed in different granularity levels to further facilitate the monitoring procedure. The experiential procedure presented in this study can be easily adapted to the needs of every smart city project, serving as a recommendation guide.

This study presents an experiential process and a market-oriented approach for realizing cities’ energy transition through smart solutions. The aim of this study is twofold: (a) present a process for defining a repository of innovative solutions that can be applied at building, district, or city level, for two European Union cities, Evora and Alkmaar, and support the deployment of positive energy districts enabling a sustainable energy transition, and (b) understand in a systematic way the attributes of value offered by energy-related smart city solutions, in order to facilitate the development of sustainable value propositions that can successfully address city needs. The repository is assessed against four elements of value, which include social impact, life-changing, emotional, and functional attributes, according to the value pyramid of Maslow. Results show that the value attributes of quality, motivation, integration, cost reduction, information, and organization are highly relevant to the proposed smart solutions. The results presented in this study are useful for city planners, decision-makers, public bodies, citizens, and businesses interested in designing their energy transition strategy and defining novel technologies that promote urban energy sustainability.