A cardiovascular disease policy model that predicts life expectancy taking into account socioeconomic deprivation.
Heart
; 101(3): 201-8, 2015 Feb.
Article
en En
| MEDLINE
| ID: mdl-25324535
ABSTRACT
OBJECTIVES:
A policy model is a model that can evaluate the effectiveness and cost-effectiveness of interventions and inform policy decisions. In this study, we introduce a cardiovascular disease (CVD) policy model which can be used to model remaining life expectancy including a measure of socioeconomic deprivation as an independent risk factor for CVD.DESIGN:
A state transition model was developed using the Scottish Heart Health Extended Cohort (SHHEC) linked to Scottish morbidity and death records. Individuals start in a CVD-free state and can transit to three CVD event states plus a non-CVD death state. Individuals who have a non-fatal first event are then followed up until death. Taking a competing risk approach, the cause-specific hazards of a first event are modelled using parametric survival analysis. Survival following a first non-fatal event is also modelled parametrically. We assessed discrimination, validation and calibration of our model.RESULTS:
Our model achieved a good level of discrimination in each component (c-statistics for men (women)-non-fatal coronary heart disease (CHD) 0.70 (0.74), non-fatal cerebrovascular disease (CBVD) 0.73 (0.76), fatal CVD 0.77 (0.80), fatal non-CVD 0.74 (0.72), survival after non-fatal CHD 0.68 (0.67) and survival after non-fatal CBVD 0.65 (0.66)). In general, our model predictions were comparable with observed event rates for a Scottish randomised statin trial population which has an overlapping follow-up period with SHHEC. After applying a calibration factor, our predictions of life expectancy closely match those published in recent national life tables.CONCLUSIONS:
Our model can be used to estimate the impact of primary prevention interventions on life expectancy and can assess the impact of interventions on inequalities.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
1_doencas_nao_transmissiveis
/
2_cobertura_universal
/
2_muertes_prematuras_enfermedades_notrasmisibles
/
6_cardiovascular_diseases
Asunto principal:
Prevención Primaria
/
Enfermedades Cardiovasculares
/
Esperanza de Vida
/
Modelos Cardiovasculares
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Límite:
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Heart
Asunto de la revista:
CARDIOLOGIA
Año:
2015
Tipo del documento:
Article
País de afiliación:
Reino Unido