Lewsey, J.D. et al. (2014) A cardiovascular disease policy model that predicts life expectancy taking into account socioeconomic deprivation. Heart, 101(3), pp. 201-208. (doi: 10.1136/heartjnl-2014-305637)
|
Text
98666.pdf - Published Version Available under License Creative Commons Attribution Non-commercial. 3MB |
Publisher's URL: http://heart.bmj.com/content/101/3/201
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.<p></p> 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.<p></p> 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.<p></p> 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.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Neilson, Dr Matthew and Watt, Professor Graham and Lewsey, Professor Jim and Ford, Professor Ian and Briggs, Professor Andrew and Kent, Mr Seamus |
| Authors: | Lewsey, J.D., Lawson, K.D., Ford, I., Fox, K.A.A., Ritchie, L.D., Tunstall-Pedoe, H., Watt, G.C.M., Woodward, M., Kent, S., Neilson, M., and Briggs, A.H. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
| Journal Name: | Heart |
| Publisher: | BMJ Publishing Group |
| ISSN: | 1355-6037 |
| ISSN (Online): | 1468-201X |
| Copyright Holders: | Copyright © 2014 The Authors |
| First Published: | First published in Heart 2014 |
| Publisher Policy: | Reproduced under a Creative Commons License |
University Staff: Request a correction | Enlighten Editors: Update this record
Funder and Project Information
Funder and Project Information