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Development of the Galaxy Chronic Obstructive Pulmonary Disease (COPD) Model Using Data from ECLIPSE: Internal Validation of a Linked-Equations Cohort Model

Author

Listed:
  • Andrew H. Briggs
  • Timothy Baker
  • Nancy A. Risebrough
  • Mike Chambers
  • Sebastian Gonzalez-McQuire
  • Afisi S. Ismaila
  • Alex Exuzides
  • Chris Colby
  • Maggie Tabberer
  • Hana Muellerova
  • Nicholas Locantore
  • Maureen P. M. H. Rutten�van Mölken
  • David A. Lomas

Abstract

Background . The recent joint International Society for Pharmacoeconomics and Outcomes Research / Society for Medical Decision Making Modeling Good Research Practices Task Force emphasized the importance of conceptualizing and validating models. We report a new model of chronic obstructive pulmonary disease (COPD) (part of the Galaxy project) founded on a conceptual model, implemented using a novel linked-equation approach, and internally validated. Methods . An expert panel developed a conceptual model including causal relationships between disease attributes, progression, and final outcomes. Risk equations describing these relationships were estimated using data from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study, with costs estimated from the TOwards a Revolution in COPD Health (TORCH) study. Implementation as a linked-equation model enabled direct estimation of health service costs and quality-adjusted life years (QALYs) for COPD patients over their lifetimes. Internal validation compared 3 years of predicted cohort experience with ECLIPSE results. Results . At 3 years, the Galaxy COPD model predictions of annual exacerbation rate and annual decline in forced expiratory volume in 1 second fell within the ECLIPSE data confidence limits, although 3-year overall survival was outside the observed confidence limits. Projections of the risk equations over time permitted extrapolation to patient lifetimes. Averaging the predicted cost/QALY outcomes for the different patients within the ECLIPSE cohort gives an estimated lifetime cost of £25,214 (undiscounted)/£20,318 (discounted) and lifetime QALYs of 6.45 (undiscounted/5.24 [discounted]) per ECLIPSE patient. Conclusions . A new form of model for COPD was conceptualized, implemented, and internally validated, based on a series of linked equations using epidemiological data (ECLIPSE) and cost data (TORCH). This Galaxy model predicts COPD outcomes from treatment effects on disease attributes such as lung function, exacerbations, symptoms, or exercise capacity; further external validation is required.

Suggested Citation

  • Andrew H. Briggs & Timothy Baker & Nancy A. Risebrough & Mike Chambers & Sebastian Gonzalez-McQuire & Afisi S. Ismaila & Alex Exuzides & Chris Colby & Maggie Tabberer & Hana Muellerova & Nicholas Loca, 2017. "Development of the Galaxy Chronic Obstructive Pulmonary Disease (COPD) Model Using Data from ECLIPSE: Internal Validation of a Linked-Equations Cohort Model," Medical Decision Making, , vol. 37(4), pages 469-480, May.
    • Handle: RePEc:sae:medema:v:37:y:2017:i:4:p:469-480
    DOI: 10.1177/0272989X16653118
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    References listed on IDEAS

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    1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
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    1. Elizabeth G Bond & Lusine Abrahamyan & Mohammad K A Khan & Andrea Gershon & Murray Krahn & Ping Li & Rajibul Mian & Nicholas Mitsakakis & Mohsen Sadatsafavi & Teresa To & Petros Pechlivanoglou & for t, 2020. "Understanding resource utilization and mortality in COPD to support policy making: A microsimulation study," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-16, August.

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    Keywords

    COPD; QALY; cost; risk; model;
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