Med Decis Making - Do different methods of modeling statin treatment effectiveness influence the optimal decision?

Tópicos

{ risk(3053) factor(974) diseas(938) }
{ estim(2440) model(1874) function(577) }
{ cost(1906) reduc(1198) effect(832) }
{ method(1969) cluster(1462) data(1082) }
{ age(1611) year(1155) adult(843) }
{ studi(1410) differ(1259) use(1210) }
{ treatment(1704) effect(941) patient(846) }
{ take(945) account(800) differ(722) }
{ perform(1367) use(1326) method(1137) }
{ model(3404) distribut(989) bayesian(671) }
{ model(2341) predict(2261) use(1141) }
{ clinic(1479) use(1117) guidelin(835) }
{ care(1570) inform(1187) nurs(1089) }
{ case(1353) use(1143) diagnosi(1136) }
{ data(2317) use(1299) case(1017) }
{ high(1669) rate(1365) level(1280) }
{ result(1111) use(1088) new(759) }
{ data(1737) use(1416) pattern(1282) }
{ imag(1057) registr(996) error(939) }
{ error(1145) method(1030) estim(1020) }
{ control(1307) perform(991) simul(935) }
{ search(2224) databas(1162) retriev(909) }
{ blood(1257) pressur(1144) flow(957) }
{ health(3367) inform(1360) care(1135) }
{ state(1844) use(1261) util(961) }
{ activ(1138) subject(705) human(624) }
{ structur(1116) can(940) graph(676) }
{ decis(3086) make(1611) patient(1517) }
{ detect(2391) sensit(1101) algorithm(908) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ inform(2794) health(2639) internet(1427) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ featur(1941) imag(1645) propos(1176) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ research(1218) medic(880) student(794) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ intervent(3218) particip(2042) group(1664) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(2212) result(1239) propos(1039) }

Resumo

RPOSE: Modeling studies that evaluate statin treatment for the prevention of cardiovascular disease (CVD) use different methods to model the effect of statins. The aim of this study was to evaluate the impact of using different modeling methods on the optimal decision found in such studies.METHODS: We used a previously developed and validated Monte Carlo-Markov model based on the Rotterdam study (RISC model). The RISC model simulates coronary heart disease (CHD), stroke, cardiovascular death, and death due to other causes. Transition probabilities were based on 5-year risks predicted by Cox regression equations, including (among others) total and high-density lipoprotein (HDL) cholesterol as covariates. In a cost-effectiveness analysis of implementing the ATP-III guidelines, we evaluated the impact of using 3 different modeling methods of statin effectiveness: 1) through lipid level modification: statins lower total cholesterol and increase HDL cholesterol, which through the covariates in the Cox regression equations leads to a lower incidence of CHD and stroke events; 2) fixed risk reduction of CVD events: statins decrease the odds of CHD and stroke with an associated odds ratio that is assumed to be the same for each individual; 3) risk reduction of CVD events proportional to individual change in low-density lipoprotein (LDL) cholesterol: the relative risk reduction with statin therapy on the incidence of CHD and stroke was assumed to be proportional to the absolute reduction in LDL cholesterol levels for each individual. The probability that the ATP-III strategy was cost-effective, compared to usual care as observed in the Rotterdam study, was calculated for each of the 3 modeling methods for varying willingness-to-pay thresholds.RESULTS: Incremental cost-effectiveness ratios for the ATP-III strategy compared with the reference strategy were ?56,642/quality-adjusted life year (QALY), ?21,369/QALY, and ?22,131/QALY for modeling methods 1, 2, and 3, respectively. At a willingness-to-pay threshold of ?50,000/QALY, the probability that the ATP-III strategy was cost-effective was about 40% for modeling method 1 and more than 90% for both methods 2 and 3. Differences in results between the modeling methods were sensitive to both the time horizon modeled and age distribution of the targetCONCLUSIONS: Modeling the effect of statins on CVD through the modification of lipid levels produced different results and associated uncertainty than modeling it directly through a risk reduction of events. This was partly attributable to the modeled effect of cholesterol on the incidence of stroke.

Resumo Limpo

rpose model studi evalu statin treatment prevent cardiovascular diseas cvd use differ method model effect statin aim studi evalu impact use differ model method optim decis found studiesmethod use previous develop valid mont carlomarkov model base rotterdam studi risc model risc model simul coronari heart diseas chd stroke cardiovascular death death due caus transit probabl base year risk predict cox regress equat includ among other total highdens lipoprotein hdl cholesterol covari costeffect analysi implement atpiii guidelin evalu impact use differ model method statin effect lipid level modif statin lower total cholesterol increas hdl cholesterol covari cox regress equat lead lower incid chd stroke event fix risk reduct cvd event statin decreas odd chd stroke associ odd ratio assum individu risk reduct cvd event proport individu chang lowdens lipoprotein ldl cholesterol relat risk reduct statin therapi incid chd stroke assum proport absolut reduct ldl cholesterol level individu probabl atpiii strategi costeffect compar usual care observ rotterdam studi calcul model method vari willingnesstopay thresholdsresult increment costeffect ratio atpiii strategi compar refer strategi qualityadjust life year qali qali qali model method respect willingnesstopay threshold qali probabl atpiii strategi costeffect model method method differ result model method sensit time horizon model age distribut targetconclus model effect statin cvd modif lipid level produc differ result associ uncertainti model direct risk reduct event part attribut model effect cholesterol incid stroke

Resumos Similares

Med Decis Making - The Impact of Uncertainty in Barrett's Esophagus Progression Rates on Hypothetical Screening and Treatment Decisions. ( 0,708417556142985 )
Med Decis Making - Use of a catalytic model to estimate hepatitis A incidence in a low-endemicity country: implications for modeling immunization policies. ( 0,688938076351524 )
Lifetime Data Anal - Applying competing risks regression models: an overview. ( 0,678811288189322 )
Comput Methods Programs Biomed - The Lindley distribution applied to competing risks lifetime data. ( 0,673402090442484 )
Lifetime Data Anal - Maximum likelihood analysis of semicompeting risks data with semiparametric regression models. ( 0,663882688572268 )
Comput Methods Programs Biomed - Historical data enhances safety supervision system performance in T1DM insulin therapy risk management. ( 0,651219139727329 )
Med Decis Making - Whose costs and benefits? Why economic evaluations should simulate both prevalent and all future incident patient cohorts. ( 0,632599247328887 )
Med Decis Making - Cost-saving tree-structured survival analysis for hip fracture of study of osteoporotic fractures data. ( 0,627875173487527 )
Spat Spatiotemporal Epidemiol - Space-time confounding adjusted determinants of child HIV/TB mortality for large zero-inflated data in rural South Africa. ( 0,625129064402458 )
Lifetime Data Anal - Evaluating incremental values from new predictors with net reclassification improvement in survival analysis. ( 0,623116376450456 )
Med Decis Making - Multiple imputation methods for handling missing data in cost-effectiveness analyses that use data from hierarchical studies: an application to cluster randomized trials. ( 0,616896583705527 )
Med Decis Making - Clarifying differences in natural history between models of screening: the case of colorectal cancer. ( 0,60972856201737 )
J Chem Inf Model - Jackknife-based selection of Gram-Schmidt orthogonalized descriptors in QSAR. ( 0,607808269899906 )
Med Decis Making - Eliciting benefit-risk preferences and probability-weighted utility using choice-format conjoint analysis. ( 0,60693489766852 )
Lifetime Data Anal - Nonparametric estimation of the cumulative intensities in an interval censored competing risks model. ( 0,606702242570744 )
J. Med. Internet Res. - Can an Internet-based health risk assessment highlight problems of heart disease risk factor awareness? A cross-sectional analysis. ( 0,603035774171279 )
Med Decis Making - Calibration of risk prediction models: impact on decision-analytic performance. ( 0,601552342161889 )
Lifetime Data Anal - Population-based absolute risk estimation with survey data. ( 0,599296357709928 )
Lifetime Data Anal - Estimation of cumulative incidence functions when the lifetime distributions are uniformly stochastically ordered. ( 0,598341405327884 )
Lifetime Data Anal - Estimation in a competing risks proportional hazards model under length-biased sampling with censoring. ( 0,595679793996536 )
Med Decis Making - Adjusting survival time estimates to account for treatment switching in randomized controlled trials--an economic evaluation context: methods, limitations, and recommendations. ( 0,590483451744515 )
Med Decis Making - A bias-corrected net reclassification improvement for clinical subgroups. ( 0,590264826905347 )
Med Decis Making - Derivation of background mortality by smoking and obesity in cancer simulation models. ( 0,587312667090035 )
Comput Methods Programs Biomed - A simulation procedure based on copulas to generate clustered multi-state survival data. ( 0,586566653133702 )
BMC Med Inform Decis Mak - Evaluating risk factor assumptions: a simulation-based approach. ( 0,586395717539404 )
Lifetime Data Anal - Competing risks with missing covariates: effect of haplotypematch on hematopoietic cell transplant patients. ( 0,585916133593671 )
Brief. Bioinformatics - Using cross-validation to evaluate predictive accuracy of survival risk classifiers based on high-dimensional data. ( 0,58119498040826 )
Lifetime Data Anal - Efficiency improvement in a class of survival models through model-free covariate incorporation. ( 0,580837901806523 )
Neural Comput - A nonparametric clustering algorithm with a quantile-based likelihood estimator. ( 0,580727468020889 )
Comput Methods Programs Biomed - Weighted comparison of two cumulative incidence functions with R-CIFsmry package. ( 0,580674472776853 )
Int J Health Geogr - Geospatial analyses to identify clusters of adverse antenatal factors for targeted interventions. ( 0,580132961597445 )
Res Synth Methods - Combining the evidence using stable weights. ( 0,579748448436289 )
Res Synth Methods - A multivariate model for the meta-analysis of study level survival data at multiple times. ( 0,577733525238412 )
Spat Spatiotemporal Epidemiol - Spatial-temporal analysis of non-Hodgkin lymphoma risk using multiple residential locations. ( 0,575614773350278 )
Int J Health Geogr - A multilevel non-hierarchical study of birth weight and socioeconomic status. ( 0,575164899057949 )
BMC Med Inform Decis Mak - Interdisciplinary decision making in prostate cancer therapy - 5-years' time trends at the Interdisciplinary Prostate Cancer Center (IPC) of the Charit? Berlin. ( 0,574988691368877 )
Med Decis Making - Bias associated with failing to incorporate dependence on event history in Markov models. ( 0,573051975243404 )
Lifetime Data Anal - Semiparametric additive marginal regression models for multiple type recurrent events. ( 0,571918285890064 )
J Biomed Inform - Extension of the survival dimensionality reduction algorithm to detect epistasis in competing risks models (SDR-CR). ( 0,570911534218051 )
Lifetime Data Anal - Pseudo-observations for competing risks with covariate dependent censoring. ( 0,570040175482467 )
BMC Med Inform Decis Mak - Quantification of population benefit in evaluation of biomarkers: practical implications for disease detection and prevention. ( 0,569199956425667 )
Int J Health Geogr - A two-stage cluster sampling method using gridded population data, a GIS, and Google Earth(TM) imagery in a population-based mortality survey in Iraq. ( 0,569094991321283 )
Lifetime Data Anal - Estimating treatment effects on the marginal recurrent event mean in the presence of a terminating event. ( 0,567796894100044 )
Med Decis Making - Bayesian inference for comorbid disease risks using marginal disease risks and correlation information from a separate source. ( 0,567684283438039 )
Lifetime Data Anal - Predictive comparison of joint longitudinal-survival modeling: a case study illustrating competing approaches. ( 0,561291566328648 )
Int J Health Geogr - Geographically weighted regression of land cover determinants of Plasmodium falciparum transmission in the Ashanti Region of Ghana. ( 0,558900638812031 )
Med Decis Making - Methods for estimating subgroup effects in cost-effectiveness analyses that use observational data. ( 0,558381737404303 )
Res Synth Methods - Meta-analysis of time-to-event data: a comparison of two-stage methods. ( 0,557781536017938 )
Med Biol Eng Comput - Non-invasive continuous glucose monitoring: improved accuracy of point and trend estimates of the Multisensor system. ( 0,557017671104909 )
IEEE Trans Image Process - A tuned mesh-generation strategy for image representation based on data-dependent triangulation. ( 0,554935995891699 )
Lifetime Data Anal - A hierarchical frailty model applied to two-generation melanoma data. ( 0,554624602580269 )
Comput Biol Chem - piClust: a density based piRNA clustering algorithm. ( 0,554447409179526 )
Spat Spatiotemporal Epidemiol - The use of sampling weights in Bayesian hierarchical models for small area estimation. ( 0,553735913530089 )
Comput Methods Programs Biomed - PSHREG: a SAS macro for proportional and nonproportional subdistribution hazards regression. ( 0,553259292327309 )
Med Decis Making - Influence of graphic format on comprehension of risk information among American Indians. ( 0,551563615848494 )
Med Decis Making - Determining the length of posttherapeutic follow-up for cancer patients using competing risks modeling. ( 0,551184766762069 )
Neural Comput - Entropy estimation in Turing's perspective. ( 0,55061318170672 )
Int J Health Geogr - Infant mortality in South Africa--distribution, associations and policy implications, 2007: an ecological spatial analysis. ( 0,550323970454425 )
Comput Math Methods Med - Mucus distribution model in a lung with cystic fibrosis. ( 0,550107081436987 )
Med Decis Making - Generalized additive models for the analysis of EQ-5D utility data. ( 0,549453110538428 )
Int J Health Geogr - East-West gradient in cardio-vascular mortality in Austria: how much can we explain by following the pattern of risk factors? ( 0,548895302112644 )
Lifetime Data Anal - Misclassification of current status data. ( 0,54873472487529 )
BMC Med Inform Decis Mak - Is pathology necessary to predict mortality among men with prostate-cancer? ( 0,547725269141742 )
Comput Math Methods Med - Maximum equilibrium prevalence of mosquito-borne microparasite infections in humans. ( 0,547295238168751 )
BMC Med Inform Decis Mak - Impact of unlinked deaths and coding changes on mortality trends in the Swiss National Cohort. ( 0,546887898135901 )
Res Synth Methods - Robust variance estimation in meta-regression with dependent effect size estimates. ( 0,546313145339315 )
Lifetime Data Anal - A general joint model for longitudinal measurements and competing risks survival data with heterogeneous random effects. ( 0,545874837927086 )
Lifetime Data Anal - A generalization of Turnbull's estimator for nonparametric estimation of the conditional survival function with interval-censored data. ( 0,542804501143135 )
AMIA Annu Symp Proc - Spatial analysis in support of community health intervention strategies. ( 0,542334831058306 )
Lifetime Data Anal - Events per variable for risk differences and relative risks using pseudo-observations. ( 0,54168649494234 )
Int J Health Geogr - Cardiovascular disease occurrence in two close but different social environments. ( 0,541418131860318 )
Med Decis Making - Expected value of sample information for multi-arm cluster randomized trials with binary outcomes. ( 0,541333826561999 )
Lifetime Data Anal - Isotonic estimation of survival under a misattribution of cause of death. ( 0,54123869207455 )
IEEE J Biomed Health Inform - Novel approaches for predicting risk factors of atherosclerosis. ( 0,540528073695827 )
Lifetime Data Anal - Comparison of estimators in nested case-control studies with multiple outcomes. ( 0,540137974063714 )
Int J Health Geogr - An exact test to detect geographic aggregations of events. ( 0,539428903987953 )
Med Decis Making - Regression estimators for generic health-related quality of life and quality-adjusted life years. ( 0,538829222696769 )
AMIA Annu Symp Proc - Divisive Hierarchical Clustering towards Identifying Clinically Significant Pre-Diabetes Subpopulations. ( 0,538121349363891 )
Lifetime Data Anal - Nonparametric quasi-likelihood for right censored data. ( 0,538010722955019 )
J. Comput. Biol. - An optimization-based sampling scheme for phylogenetic trees. ( 0,536378578052375 )
Lifetime Data Anal - Cross-ratio estimation for bivariate failure times with left truncation. ( 0,536187335716692 )
Lifetime Data Anal - Evaluating subject-level incremental values of new markers for risk classification rule. ( 0,535645116667576 )
Lifetime Data Anal - Regression analysis for cumulative incidence probability under competing risks and left-truncated sampling. ( 0,535401776460785 )
Comput Methods Programs Biomed - mmm: an R package for analyzing multivariate longitudinal data with multivariate marginal models. ( 0,535344120229824 )
Int J Health Geogr - Correlations between meteorological parameters and prostate cancer. ( 0,535302791599529 )
Med Decis Making - Nutritional policy changes in the supplemental nutrition assistance program: a microsimulation and cost-effectiveness analysis. ( 0,534784207338218 )
Comput Methods Programs Biomed - A warning concerning the estimation of multinomial logistic models with correlated responses in SAS. ( 0,533135165413142 )
Med Decis Making - Quality of life and time to death: have the health gains of preventive interventions been underestimated? ( 0,532276652952761 )
Comput Math Methods Med - Application of seemingly unrelated regression in medical data with intermittently observed time-dependent covariates. ( 0,531580427833951 )
Comput Methods Programs Biomed - A Windows application for computing standardized mortality ratios and standardized incidence ratios in cohort studies based on calculation of exact person-years at risk. ( 0,529520899008361 )
Res Synth Methods - Combining study outcome measures using dominance adjusted weights. ( 0,52896542842834 )
J Med Syst - A multiple stage approach for performance improvement of primary healthcare practice. ( 0,52754097348807 )
Neural Comput - ParceLiNGAM: a causal ordering method robust against latent confounders. ( 0,527211626952302 )
Int J Health Geogr - Detection of clusters of a rare disease over a large territory: performance of cluster detection methods. ( 0,527086659040978 )
Lifetime Data Anal - Quadratic fractional age assumption revisited. ( 0,526537119929725 )
Lifetime Data Anal - Regression analysis based on conditional likelihood approach under semi-competing risks data. ( 0,525834566917948 )
Lifetime Data Anal - Semicompeting risks in aging research: methods, issues and needs. ( 0,52532971451338 )
Comput. Biol. Med. - Analytic gain in probabilistic decompression sickness models. ( 0,524978251832146 )
Lifetime Data Anal - Estimation of treatment effects based on possibly misspecified Cox regression. ( 0,524786752705335 )
Med Decis Making - Prevalence of antibodies associated with herd immunity: a new indicator to evaluate the establishment of herd immunity and to decide immunization strategies. ( 0,522200193300413 )