A Patient-Level Model to Estimate Lifetime Health Outcomes of Patients With Type 1 Diabetes.
Abstract
To develop a patient-level simulation model for predicting lifetime health outcomes of patients with type 1 diabetes and as a tool for economic evaluation of type 1 diabetes treatment based on data from a large, longitudinal cohort. Data for model development were obtained from the Swedish National Diabetes Register. We derived parametric proportional hazards models predicting the absolute risk of diabetes complications and death based on a wide range of clinical variables and history of complications. We used linear regression models to predict risk factor progression. Internal validation was performed, estimates of life expectancies for different age-sex strata were computed, and the impact of key risk factors on life expectancy was assessed. The study population consisted of 27,841 patients with type 1 diabetes with a mean duration of follow-up of 7 years. Internal validation showed good agreement between the predicted and observed cumulative incidence of death and 10 complications. Simulated life expectancy was ∼13 years lower than that of the sex- and age-matched general population, and patients with type 1 diabetes could expect to live with one or more complications for ∼40% of their remaining life. Sensitivity analysis s...Continue Reading
References
The UKPDS risk engine: a model for the risk of coronary heart disease in Type II diabetes (UKPDS 56)
The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research.
Severe hypoglycemia and mortality after cardiovascular events for type 1 diabetic patients in Sweden
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