Brazilian analytical decision model for cardiovascular disease: an adaptation of the Scottish Cardiovascular Disease Policy Model

Salgado Riveros, B., Torelli Reis, W. C., Lucchetta, R. C., Moreira, L. B., Lewsey, J. , Correr, C. J. and Wu, O. (2018) Brazilian analytical decision model for cardiovascular disease: an adaptation of the Scottish Cardiovascular Disease Policy Model. Value in Health Regional Issues, 17, pp. 210-216. (doi:10.1016/j.vhri.2018.01.002) (PMID:30502691)

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Abstract

Introduction: Despite the significant impact of cardiovascular disease (CVD), there is not yet an analytical decision tool for assessing efficiency of interventions to prevent primary CVD events in Brazil. Therefore, we sought to adapt a Scottish CVD Policy Model to be used in the proposed population. Methods: Calibration consisted of identifying multiplicative factors for linear predictors of existing survival analysis models to produce predictions that closely match observed data (Life-table and Brazilian cohort study). Target data were life expectancy (LE) and cumulative incidence of coronary heart disease (CHD), cerebrovascular disease (CBVD), fatal CVD and fatal non-CVD. Root-Mean-Square-Error (RMSE) was used to estimate differences between predictions and observations. Acceptance criteria were defined as a fit of less than one year for LE and 1% for cumulative incidence. Male and female models were built separately. Results: The original model underestimated LE (RMSE=2.85 for men and 1.91 for women), CHD and CBVD for women (RMSE=0.044 and 0.041, respectively). The calibration process identified multiplicative factors to reach acceptance criteria for the four target data mentioned above (RMSE=0.61, 0.21, 0.016 and 0.017, respectively). Over prediction was identified only for CHD events in men (RMSE=0.031) being further calibrated (RMSE=0.008). All other target data met the acceptance criteria. Overall, the calibrated model predicts properly to individuals aging 35-80 years old, diabetics or not, smokers or not, with or without family history of CVD, and presenting at least one of the risk factors uncontrolled: Systolic Blood Pressure, Total Cholesterol or HDL-Cholesterol. Discussion: This is the first decision analytic model capable of assessing efficiency of interventions that prevent primary CVD events in Brazil. In future research, independent external validation should be carried out to corroborate the reliability of the model outputs.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wu, Professor Olivia and Lewsey, Professor James and Salgado Riveros, Mr Bruno
Authors: Salgado Riveros, B., Torelli Reis, W. C., Lucchetta, R. C., Moreira, L. B., Lewsey, J., Correr, C. J., and Wu, O.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
Journal Name:Value in Health Regional Issues
Publisher:Elsevier
ISSN:2212-1099
ISSN (Online):2212-1102
Published Online:28 November 2018

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