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)

Clarke, P.M., Gray, A.M., Briggs, A. , Farmer, A.J., Fenn, P.,, Stevenson, R.J., Matthews, D.R., Stratton, I.M. and Holman, R.R. (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), pp. 1747-1759. (doi: 10.1007/s00125-004-1527-z)

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Publisher's URL: http://dx.doi.org/10.1007/s00125-004-1527-z

Abstract

<i>Aims/hypothesis</i> 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. <i>Methods</i> 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. <i>Results</i> The models 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). <i>Conclusions/interpretations</i> 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.

Item Type:Articles
Additional Information:The original publication is available at www.springerlink.com
Keywords:Blood glucose; Diabetes; Diabetes-related complications; Economic evaluation; Life expectancy; Quality-adjusted life years - Risk equation simulation model - UKPDS
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Briggs, Professor Andrew
Authors: Clarke, P.M., Gray, A.M., Briggs, A., Farmer, A.J., Fenn, P.,, Stevenson, R.J., Matthews, D.R., Stratton, I.M., and Holman, R.R.
Subjects:R Medicine > RC Internal medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences
Journal Name:Diabetologia
Publisher:Springer Verlag
ISSN:1432-0428
Copyright Holders:Copyright © 2004 Springer Verlag
First Published:First published in Diabetologia 47(10):1747-1759
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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