PMID- 30132342
OWN - NLM
STAT- MEDLINE
DCOM- 20191101
LR  - 20221207
IS  - 2042-6313 (Electronic)
IS  - 2042-6305 (Linking)
VI  - 7
IP  - 8
DP  - 2018 Aug
TI  - Development and validation of a Health Policy Model of Type 2 diabetes in Chinese 
      setting.
PG  - 749-763
LID - 10.2217/cer-2018-0001 [doi]
AB  - Aim: Due to the difference in epidemiology and outcomes between eastern and 
      western populations with Type 2 diabetes mellitus (T2DM), an important challenge 
      is determining how useful the outcomes from diabetes models based on western 
      populations are for eastern patients. Consequently, the principal aim of this 
      study was to develop and validate a Health Policy Model (Chinese Outcomes Model 
      for T2DM [COMT]) for supporting Chinese medical and health economic studies. 
      Methods: The model is created to simulate a series of important complications of 
      T2DM diabetes based on the latest Risk Equations for Complications of Type 2 
      Diabetes, which was adjusted by adding the adjustment regulator to the linear 
      predictor within the risk equation. The validity of the model was conducted by 
      using a total of 171 validation outcomes from seven studies in eastern 
      populations and ten studies in western populations. The simulation cohorts in the 
      COMT model were generated by copying each validation study's baseline 
      characteristics. Concordance was tested by assessing the difference between the 
      identity (45 degrees ) line and the best-fitting regression of the scatterplots for the 
      predicted versus observed outcomes. Results: The slope coefficients of the 
      best-fitting regression line between the predicted and corresponding observed 
      actual outcomes was 0.9631 and the R(2) was 0.8701. There were major differences 
      between western and eastern populations. The slope and R(2) of predictions were 
      0.9473 and 0.9272 in the eastern population and 1.0566 and 0.8863 in the western 
      population, which showed more perfect agreement with the observed values in the 
      eastern population than the western populations. The subset of macro-vascular and 
      micro-vascular outcomes in the eastern population showed an identical tendency 
      (the slope coefficient was close to 1), and mortality outcomes showed a slight 
      tendency toward overestimation (the slope coefficient was close to 0.9208). Some 
      degree of underprediction of macro-vascular and micro-vascular end points and 
      overprediction of mortality end point was found in the western population. 
      Conclusion: The COMT diabetes model simulated the long-term patient outcomes 
      observed in eastern Asian T2DM patients with prediction accuracy. This study 
      supports the COMT as a credible tool for Chinese healthcare decision makers. 
      Further work is necessary to incorporate new local data to improve model validity 
      and credibility.
FAU - Wu, Bin
AU  - Wu B
AD  - Medical Decision & Economic Group, Department of Pharmacy, Ren Ji Hospital, South 
      Campus, School of Medicine, Shanghai Jiaotong University, PR China.
FAU - Ma, Jing
AU  - Ma J
AD  - Department of Endocrinology, Ren Ji Hospital, South Campus, School of Medicine, 
      Shanghai Jiao Tong University, Shanghai, PR China.
FAU - Zhang, Suhua
AU  - Zhang S
AD  - Department of Nephrology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong 
      University, Shanghai, PR China.
FAU - Zhou, Lei
AU  - Zhou L
AD  - Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiaotong 
      University, Shanghai, PR China.
FAU - Wu, Haixiang
AU  - Wu H
AD  - Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, PR 
      China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180822
PL  - England
TA  - J Comp Eff Res
JT  - Journal of comparative effectiveness research
JID - 101577308
SB  - IM
MH  - Adult
MH  - Asian People
MH  - Diabetes Mellitus, Type 2/*complications
MH  - *Health Policy
MH  - Humans
MH  - Male
MH  - *Models, Theoretical
MH  - Reproducibility of Results
MH  - Risk Factors
MH  - White People
OTO - NOTNLM
OT  - Chinese Health Policy Model
OT  - Type 2 diabetes mellitus
OT  - development
OT  - economic outcome
OT  - validation
EDAT- 2018/08/23 06:00
MHDA- 2019/11/02 06:00
CRDT- 2018/08/23 06:00
PHST- 2018/08/23 06:00 [pubmed]
PHST- 2019/11/02 06:00 [medline]
PHST- 2018/08/23 06:00 [entrez]
AID - 10.2217/cer-2018-0001 [doi]
PST - ppublish
SO  - J Comp Eff Res. 2018 Aug;7(8):749-763. doi: 10.2217/cer-2018-0001. Epub 2018 Aug 
      22.