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

A.J. Hayes, Wendy Davis, Timothy Davis, P.M. Clarke

    Research output: Contribution to journalArticle

    2 Citations (Scopus)

    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.
    Original languageEnglish
    Pages (from-to)351-356
    JournalJournal of Diabetes and Its Complications
    Volume27
    Issue number2013
    Early online date13 Jun 2013
    DOIs
    Publication statusPublished - Jul 2013

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    Life Expectancy
    Blood Pressure
    Quality-Adjusted Life Years
    Mortality
    Diabetes Complications
    Western Australia
    Hospital Records
    Hospital Mortality
    Population
    Therapeutics

    Cite this

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    title = "Adapting and validating diabetes simulation models across settings: Accounting for mortality differences using administrative data",
    abstract = "AimsTo 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.MethodsThe 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.ResultsThe 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.ConclusionsMortality 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.",
    author = "A.J. Hayes and Wendy Davis and Timothy Davis and P.M. Clarke",
    year = "2013",
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    doi = "10.1016/j.jdiacomp.2012.12.006",
    language = "English",
    volume = "27",
    pages = "351--356",
    journal = "Journal of Diabetes and Its Complications",
    issn = "1056-8727",
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    number = "2013",

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    TY - JOUR

    T1 - Adapting and validating diabetes simulation models across settings: Accounting for mortality differences using administrative data

    AU - Hayes, A.J.

    AU - Davis, Wendy

    AU - Davis, Timothy

    AU - Clarke, P.M.

    PY - 2013/7

    Y1 - 2013/7

    N2 - AimsTo 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.MethodsThe 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.ResultsThe 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.ConclusionsMortality 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.

    AB - AimsTo 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.MethodsThe 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.ResultsThe 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.ConclusionsMortality 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.

    U2 - 10.1016/j.jdiacomp.2012.12.006

    DO - 10.1016/j.jdiacomp.2012.12.006

    M3 - Article

    VL - 27

    SP - 351

    EP - 356

    JO - Journal of Diabetes and Its Complications

    JF - Journal of Diabetes and Its Complications

    SN - 1056-8727

    IS - 2013

    ER -