Zafar Zafari1, Stirling Bryan2, Don D Sin3, Tania Conte4, Rahman Khakban5, Mohsen Sadatsafavi6. 1. Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: zafar.zafari@ubc.ca. 2. Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, University of British Columbia, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. 3. Center for Heart and Lung Innovation (James Hogg Research Center), St. Paul's Hospital, Vancouver, British Columbia, Canada; Institute for Heart and Lung Health, University of British Columbia, Vancouver, British Columbia, Canada; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; The PROOF Centre of Excellence, Vancouver, British Columbia, Canada. 4. Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, University of British Columbia, Vancouver, British Columbia, Canada. 5. The PROOF Centre of Excellence, Vancouver, British Columbia, Canada; Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada. 6. Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, University of British Columbia, Vancouver, British Columbia, Canada; Institute for Heart and Lung Health, University of British Columbia, Vancouver, British Columbia, Canada; Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: Many decision-analytic models with varying structures have been developed to inform resource allocation in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To review COPD models for their adherence to the best practice modeling recommendations and their assumptions regarding important aspects of the natural history of COPD. METHODS: A systematic search of English articles reporting on the development or application of a decision-analytic model in COPD was performed in MEDLINE, Embase, and citations within reviewed articles. Studies were summarized and evaluated on the basis of their adherence to the Consolidated Health Economic Evaluation Reporting Standards. They were also evaluated for the underlying assumptions about disease progression, heterogeneity, comorbidity, and treatment effects. RESULTS: Forty-nine models of COPD were included. Decision trees and Markov models were the most popular techniques (43 studies). Quality of reporting and adherence to the guidelines were generally high, especially in more recent publications. Disease progression was modeled through clinical staging in most studies. Although most studies (n = 43) had incorporated some aspects of COPD heterogeneity, only 8 reported the results across subgroups. Only 2 evaluations explicitly considered the impact of comorbidities. Treatment effect had been mostly modeled (20) as both reduction in exacerbation rate and improvement in lung function. CONCLUSIONS: Many COPD models have been developed, generally with similar structural elements. COPD is highly heterogeneous, and comorbid conditions play an important role in its burden. These important aspects, however, have not been adequately addressed in most of the published models.
BACKGROUND: Many decision-analytic models with varying structures have been developed to inform resource allocation in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To review COPD models for their adherence to the best practice modeling recommendations and their assumptions regarding important aspects of the natural history of COPD. METHODS: A systematic search of English articles reporting on the development or application of a decision-analytic model in COPD was performed in MEDLINE, Embase, and citations within reviewed articles. Studies were summarized and evaluated on the basis of their adherence to the Consolidated Health Economic Evaluation Reporting Standards. They were also evaluated for the underlying assumptions about disease progression, heterogeneity, comorbidity, and treatment effects. RESULTS: Forty-nine models of COPD were included. Decision trees and Markov models were the most popular techniques (43 studies). Quality of reporting and adherence to the guidelines were generally high, especially in more recent publications. Disease progression was modeled through clinical staging in most studies. Although most studies (n = 43) had incorporated some aspects of COPD heterogeneity, only 8 reported the results across subgroups. Only 2 evaluations explicitly considered the impact of comorbidities. Treatment effect had been mostly modeled (20) as both reduction in exacerbation rate and improvement in lung function. CONCLUSIONS: Many COPD models have been developed, generally with similar structural elements. COPD is highly heterogeneous, and comorbid conditions play an important role in its burden. These important aspects, however, have not been adequately addressed in most of the published models.
Authors: Job F M van Boven; Breda Cushen; Imran Sulaiman; Garrett Greene; Elaine MacHale; Matshediso C Mokoka; Frank Doyle; Richard B Reilly; Kathleen Bennett; Richard W Costello Journal: NPJ Prim Care Respir Med Date: 2018-06-27 Impact factor: 2.871
Authors: Mafalda Ramos; Mark Lamotte; Laetitia Gerlier; Per Svangren; Anna Miquel-Cases; John Haughney Journal: Int J Chron Obstruct Pulmon Dis Date: 2019-01-15