Adapting and validating diabetes simulation models across settings: Accounting for mortality differences using administrative data

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Authors: Hayes,A. J.;Davis,W. A.;Davis,T. M.;Clarke,P. M.

Publication: Journal of diabetes and its complications

Year: 2013

Volume: 27

Issue: 4

Start Page: 351

ABSTRACT:

Aims:To develop age and sex-specific risk equations for predicting mortality following major complications of diabetes, using a large linked administrative dataset from Western Australia (WA) and to incorporate these into an existing diabetes simulation model.

Methods: The study uses linked hospital and mortality records on 13,884 patients following a major diabetes-related complication with a mean (SD) duration of 2.62 (2.25) years. Risk equations for predicting mortality were derived and integrated into the UKPDS Outcomes Model. Estimates of life expectancy and incremental QALYs gained as a result of two theoretical therapies (a reduction of HbA1c of 1%, and reduction of systolic blood pressure of 10 mmHg) were determined using the original and adapted models.

Results: The two versions of the model generated differences in life expectancy following specific events; however there was little impact of using alternative mortality equations on incremental QALYs gained as a result of reducing HbA1c or systolic blood pressure, or on outcomes of life expectancy for a cohort initially free of complications.

Conclusions: Mortality following complications varies across diabetic populations and can impact on estimates of life expectancy, but appears to have less impact on incremental benefits of interventions that are commonly used in pharmoeconomic analyses. © 2013 Elsevier Inc.

  • Listing ID: 4598
  • Author/s: Hayes,A. J.;Davis,W. A.;Davis,T. M.;Clarke,P. M.
  • Publication: Journal of diabetes and its complications
  • Year: 2013
  • Volume: 27
  • Issue: 4
  • Start Page: 351
  • Article Keywords: hemoglobin A1c;aged;article;Australia;cerebrovascular accident;cohort analysis;diabetes mellitus;disease duration;disease simulation;female;finger amputation;heart failure;heart infarction;human;kidney failure;life expectancy;limb amputation;major clinical study;male;mortality;priority journal;quality adjusted life year;risk factor;skin ulcer;systolic blood pressure