The transferability and validity of a population-level simulation model for the economic evaluation of interventions in diabetes: the MICADO model.

Autor: Emamipour S; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. s.emamipour@umcg.nl., Pagano E; Unit of Clinical Epidemiology, 'Città della Salute e della Scienza' Hospital and CPO Piemonte, Turin, Italy., Di Cuonzo D; Unit of Clinical Epidemiology, 'Città della Salute e della Scienza' Hospital and CPO Piemonte, Turin, Italy., Konings SRA; Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van der Heijden AA; Department of General Practice, Amsterdam UMC, Location VUMC, Amsterdam Public Health Institute, Amsterdam, The Netherlands.; Department of Epidemiology and Data Science, Amsterdam UMC, Location VUMC, Amsterdam Public Health Institute, Amsterdam, The Netherlands., Elders P; Department of General Practice, Amsterdam UMC, Location VUMC, Amsterdam Public Health Institute, Amsterdam, The Netherlands., Beulens JWJ; Department of Epidemiology and Data Science, Amsterdam UMC, Location VUMC, Amsterdam Public Health Institute, Amsterdam, The Netherlands., Leal J; Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Oxford, UK., Feenstra TL; Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.; National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Jazyk: angličtina
Zdroj: Acta diabetologica [Acta Diabetol] 2022 Jul; Vol. 59 (7), pp. 949-957. Date of Electronic Publication: 2022 Apr 21.
DOI: 10.1007/s00592-022-01891-2
Abstrakt: Aims: Valid health economic models are essential to inform the adoption and reimbursement of therapies for diabetes mellitus. Often existing health economic models are applied in other countries and settings than those where they were developed. This practice requires assessing the transferability of a model developed from one setting to another. We evaluate the transferability of the MICADO model, developed for the Dutch 2007 setting, in two different settings using a range of adjustment steps. MICADO predicts micro- and macrovascular events at the population level.
Methods: MICADO simulation results were compared to observed events in an Italian 2000-2015 cohort (Casale Monferrato Survey [CMS]) and in a Dutch 2008-2019 (Hoorn Diabetes Care Center [DCS]) cohort after adjusting the demographic characteristics. Additional adjustments were performed to: (1) risk factors prevalence at baseline, (2) prevalence of complications, and (3) all-cause mortality risks by age and sex. Model validity was assessed by mean average percentage error (MAPE) of cumulative incidences over 10 years of follow-up, where lower values mean better accuracy.
Results: For mortality, MAPE was lower for CMS compared to DCS (0.38 vs. 0.70 following demographic adjustment) and adjustment step 3 improved it to 0.20 in CMS, whereas step 2 showed best results in DCS (0.65). MAPE for heart failure and stroke in DCS were 0.11 and 0.22, respectively, while for CMS was 0.42 and 0.41.
Conclusions: The transferability of the MICADO model varied by event and per cohort. Additional adjustments improved prediction of events for MICADO. To ensure a valid model in a new setting it is imperative to assess the impact of adjustments in terms of model accuracy, even when this involves the same country, but a new time period.
(© 2022. The Author(s).)
Databáze: MEDLINE
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