A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)
A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68)
Aims/hypothesis: the aim of this study was to develop a simulation model for Type 2 diabetes that can be used to estimate the likely occurrence of major diabetes-related complications over a lifetime, in order to calculate health economic outcomes such as quality-adjusted life expectancy.
Methods: equations for forecasting the occurrence of seven diabetes-related complications and death were estimated using data on 3642 patients from the United Kingdom Prospective Diabetes Study (UKPDS). After examining the internal validity, the UKPDS Outcomes Model was used to simulate the mean difference in expected quality-adjusted life years between the UKPDS regimens of intensive and conventional blood glucose control.
Results: the model's forecasts fell within the 95% confidence interval for the occurrence of observed events during the UKPDS follow-up period. When the model was used to simulate event history over patients' lifetimes, those treated with a regimen of conventional glucose control could expect 16.35 undiscounted quality-adjusted life years, and those receiving treatment with intensive glucose control could expect 16.62 quality-adjusted life years, a difference of 0.27 (95% CI: -0.48 to 1.03).
Conclusions/interpretations: the UKPDS Outcomes Model is able to simulate event histories that closely match observed outcomes in the UKPDS and that can be extrapolated over patients' lifetimes. Its validity in estimating outcomes in other groups of patients, however, remains to be evaluated. The model allows simulation of a range of long-term outcomes, which should assist in informing future economic evaluations of interventions in Type 2 diabetes.
Blood glucose, Diabetes, Diabetes-related complications, Economic evaluation, Life expectancy, Quality-adjusted life years, Risk equation simulation model, UKPDS
1747-1759
Clarke, P.M.
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Gray, A.M.
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Briggs, A.
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Farmer, A.J.
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Fenn, P.
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Stevens, R.J.
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Matthews, D.R.
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Stratton, I.M.
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Holman, R.R.
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the UK Prospective Diabetes Study (UKPDS) Group
October 2004
Clarke, P.M.
e9e4808e-9969-4ec6-8c38-0bb642a3fc85
Gray, A.M.
bc2a3d27-286d-4c77-b60b-5d761c0c8d84
Briggs, A.
81e42475-f734-4223-ae0e-fabe64c774ea
Farmer, A.J.
64fb9236-2a12-462f-940c-36b6b030ea9a
Fenn, P.
9df4bbe2-1892-44f0-bae8-319014301fb1
Stevens, R.J.
8b90b66f-4a6e-4b1d-9132-6e96e4156ef0
Matthews, D.R.
29083eb2-3084-459c-b439-530cd7a71f44
Stratton, I.M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Holman, R.R.
336fb2f7-edb5-4d65-a7b0-465111cbd047
Clarke, P.M., Gray, A.M., Briggs, A., Farmer, A.J., Fenn, P., Stevens, R.J., Matthews, D.R., Stratton, I.M. and Holman, R.R.
,
the UK Prospective Diabetes Study (UKPDS) Group
(2004)
A model to estimate the lifetime health outcomes of patients with Type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68).
Diabetologia, 47 (10), .
(doi:10.1007/s00125-004-1527-z).
Abstract
Aims/hypothesis: the aim of this study was to develop a simulation model for Type 2 diabetes that can be used to estimate the likely occurrence of major diabetes-related complications over a lifetime, in order to calculate health economic outcomes such as quality-adjusted life expectancy.
Methods: equations for forecasting the occurrence of seven diabetes-related complications and death were estimated using data on 3642 patients from the United Kingdom Prospective Diabetes Study (UKPDS). After examining the internal validity, the UKPDS Outcomes Model was used to simulate the mean difference in expected quality-adjusted life years between the UKPDS regimens of intensive and conventional blood glucose control.
Results: the model's forecasts fell within the 95% confidence interval for the occurrence of observed events during the UKPDS follow-up period. When the model was used to simulate event history over patients' lifetimes, those treated with a regimen of conventional glucose control could expect 16.35 undiscounted quality-adjusted life years, and those receiving treatment with intensive glucose control could expect 16.62 quality-adjusted life years, a difference of 0.27 (95% CI: -0.48 to 1.03).
Conclusions/interpretations: the UKPDS Outcomes Model is able to simulate event histories that closely match observed outcomes in the UKPDS and that can be extrapolated over patients' lifetimes. Its validity in estimating outcomes in other groups of patients, however, remains to be evaluated. The model allows simulation of a range of long-term outcomes, which should assist in informing future economic evaluations of interventions in Type 2 diabetes.
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More information
Accepted/In Press date: 1 June 2004
e-pub ahead of print date: 27 October 2004
Published date: October 2004
Additional Information:
Funding Information:
The cooperation of the patients and staff at the UKPDS centres is much appreciated. The UKPDS received funding from the UK Medical Research Council, the British Diabetic Association, the UK Department of Health, the National Eye Institute and the National Institute of Diabetes and Digestive and Kidney Disease (the US National Institutes of Health), the British Heart Foundation, The Wellcome Trust, the Charles Wolfson Charitable Trust, the Clothworkers’ Foundation, the Health Promotion Research Trust, the Alan and Babette Sains-bury Trust, the Oxford University Medical Research Fund Committee. Funding was also provided by pharmaceutical companies including Novo-Nordisk, Bayer, Bristol-Myers Squibb, Hoechst, Lilly, Lipha and Farmitalia Carlo Erba, Glax-oWellcome, SmithKline Beecham, Pfizer, Zeneca, Pharmacia and Upjohn, and Roche provided grants for health economics and epidemiological studies.
Keywords:
Blood glucose, Diabetes, Diabetes-related complications, Economic evaluation, Life expectancy, Quality-adjusted life years, Risk equation simulation model, UKPDS
Identifiers
Local EPrints ID: 487025
URI: http://eprints.soton.ac.uk/id/eprint/487025
ISSN: 0012-186X
PURE UUID: 00113e9e-6e6f-4c76-a413-efb46f7e9e33
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Date deposited: 09 Feb 2024 17:47
Last modified: 18 Mar 2024 04:01
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Contributors
Author:
P.M. Clarke
Author:
A.M. Gray
Author:
A. Briggs
Author:
A.J. Farmer
Author:
P. Fenn
Author:
R.J. Stevens
Author:
D.R. Matthews
Author:
I.M. Stratton
Author:
R.R. Holman
Corporate Author: the UK Prospective Diabetes Study (UKPDS) Group
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