> Details

Hoogenveen, Rudolf T.; Boshuizen, Hendriek C.; Engelfriet, Peter M.; van Baal, Pieter H. M.

You Only Die Once: Accounting for Multi-Attributable Mortality Risks in Multi-Disease Models for Health-Economic Analyses

Reference
management

Bookmarks

Remove from
bookmarks

Share this on Whatsapp

Close

Bookmarks



You can manage bookmarks using lists, please log in to your user account for this.
  • Media type: E-Article
  • Title: You Only Die Once: Accounting for Multi-Attributable Mortality Risks in Multi-Disease Models for Health-Economic Analyses
  • Contributor: Hoogenveen, Rudolf T.; Boshuizen, Hendriek C.; Engelfriet, Peter M.; van Baal, Pieter H. M.
  • Published: SAGE Publications, 2017
  • Published in: Medical Decision Making, 37 (2017) 4, Seite 403-414
  • Language: English
  • DOI: 10.1177/0272989x16658661
  • ISSN: 0272-989X; 1552-681X
  • Origination:
  • Footnote:
  • Description: Mortality rates in Markov models, as used in health economic studies, are often estimated from summary statistics that allow limited adjustment for confounders. If interventions are targeted at multiple diseases and/or risk factors, these mortality rates need to be combined in a single model. This requires them to be mutually adjusted to avoid ‘double counting’ of mortality. We present a mathematical modeling approach to describe the joint effect of mutually dependent risk factors and chronic diseases on mortality in a consistent manner. Most importantly, this approach explicitly allows the use of readily available external data sources. An additional advantage is that existing models can be smoothly expanded to encompass more diseases/risk factors. To illustrate the usefulness of this method and how it should be implemented, we present a health economic model that links risk factors for diseases to mortality from these diseases, and describe the causal chain running from these risk factors (e.g., obesity) through to the occurrence of disease (e.g., diabetes, CVD) and death. Our results suggest that these adjustment procedures may have a large impact on estimated mortality rates. An improper adjustment of the mortality rates could result in an underestimation of disease prevalence and, therefore, disease costs.