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Si L, Eisman JA, Winzenberg T, Sanders KM, Center JR, Nguyen TV, Tran T, Palmer AJ. Development and validation of the risk engine for an Australian Health Economics Model of Osteoporosis. Osteoporos Int 2021; 32:2073-2081. [PMID: 33856500 DOI: 10.1007/s00198-021-05955-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
UNLABELLED The Australian Health Economics Model of Osteoporosis (AusHEMO) has shown good face, internal and cross validities, and can be used to assist healthcare decision-making in Australia. PURPOSE This study aimed to document and validate the risk engine of the Australian Health Economics Model of Osteoporosis (AusHEMO). METHODS AusHEMO is a state-transition microsimulation model. The fracture risks were simulated using fracture incidence rates from the Dubbo Osteoporosis Epidemiology Study. The AusHEMO was validated regarding its face, internal and cross validities. Goodness-of-fit analysis was conducted and Lin's coefficient of agreement and mean absolute difference with 95% limits of agreement were reported. RESULTS The development of AusHEMO followed general and osteoporosis-specific health economics guidelines. AusHEMO showed good face validity regarding the model's structure, evidence, problem formulation and results. In addition, the model has been proven good internal and cross validities in goodness-of-fit test. Lin's coefficient was 0.99, 1 and 0.94 for validation against the fracture incidence rates, Australian life expectancies and residual lifetime fracture risks, respectively. CONCLUSIONS In summary, the development of the risk engine of AusHEMO followed the best practice for osteoporosis disease modelling and the model has been shown to have good face, internal and cross validities. The AusHEMO can be confidently used to predict long-term fracture-related outcomes and health economic evaluations when costs data are included. Health policy-makers in Australia can use the AusHEMO to select which osteoporosis interventions such as medications and public health interventions represent good value for money.
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Affiliation(s)
- L Si
- The George Institute for Global Health, UNSW Sydney, Kensington, Australia.
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China.
| | - J A Eisman
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
- School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia
- St Vincent's Hospital, UNSW Sydney, Sydney, New South Wales, Australia
| | - T Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - K M Sanders
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - J R Center
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
- St Vincent's Hospital, UNSW Sydney, Sydney, New South Wales, Australia
| | - T V Nguyen
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
- St Vincent's Hospital, UNSW Sydney, Sydney, New South Wales, Australia
- School of Biomedical Engineering, University of Technology Sydney, Sydney, Australia
| | - T Tran
- Bone Biology Division, Garvan Institute of Medical Research, Sydney, Australia
| | - A J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
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Kamaraj A, Agarwal N, Seah KTM, Khan W. Understanding cost-utility analysis studies in the trauma and orthopaedic surgery literature. EFORT Open Rev 2021; 6:305-315. [PMID: 34150325 PMCID: PMC8183147 DOI: 10.1302/2058-5241.6.200115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cost-utility analysis (CUA) studies are becoming increasingly important due to the need to reduce healthcare spending, especially in the field of trauma and orthopaedics. There is an increasing need for trauma and orthopaedic surgeons to understand these economic evaluations to ensure informed cost-effective decisions can be made to benefit the patient and funding body. This review discusses the fundamental principles required to understand CUA studies in the literature, including a discussion of the different methods employed to assess the health outcomes associated with different management options and the various approaches used to calculate the costs involved. Different types of model design may be used to conduct a CUA which can be broadly categorized into real-life clinical studies and computer-simulated modelling. We discuss the main types of study designs used within each category. We also cover the different types of sensitivity analysis used to quantify uncertainty in these studies and the commonly employed instruments used to assess the quality of CUAs. Finally, we discuss some of the important limitations of CUAs that need to be considered. This review outlines the main concepts required to understand the CUA literature and provides a basic framework for their future conduct.
Cite this article: EFORT Open Rev 2021;6:305-315. DOI: 10.1302/2058-5241.6.200115
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Affiliation(s)
- Achi Kamaraj
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Nikhil Agarwal
- Department of Surgery, University of Cambridge, Cambridge, UK
| | | | - Wasim Khan
- Department of Surgery, University of Cambridge, Cambridge, UK
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