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Development and Validation of the Evaluation Platform in COPD (EPIC): A Population-Based Outcomes Model of COPD for Canada

Author

Listed:
  • Mohsen Sadatsafavi

    (Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada)

  • Shahzad Ghanbarian

    (Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada)

  • Amin Adibi

    (Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada)

  • Kate Johnson

    (Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada)

  • J. Mark FitzGerald

    (Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada)

  • William Flanagan

    (Statistics Canada, Ottawa, ON, Canada)

  • Stirling Bryan

    (Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, Vancouver, BC, Canada
    School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada)

  • Don Sin

    (Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada)

Abstract

Background . We report the development, validation, and implementation of an open-source population-based outcomes model of chronic obstructive pulmonary disease (COPD) for Canada. Methods . Evaluation Platform in COPD (EPIC) is a discrete-event simulation model of Canadians 40 years of age or older. Three core features of EPIC are its open-population design (incorporating projections of future population growth, aging, and smoking trends), its incorporation of heterogeneity in lung function decline and burden of exacerbations, and its modeling of the natural history of COPD from inception. Multiple original data analyses, as well as values reported in the literature, were used to populate the model. Extensive face validity and internal and external validity evaluations were performed. Results . The model was internally validated on demographic projections, mortality rates, lung function trajectories, COPD exacerbations, costs and health state utility values, and stability of COPD prevalence over time within strata of risk factors. In external validation, it moderately overestimated the rate of overall exacerbations in 2 independent trials but generated consistent estimates of rate of severe exacerbations and mortality. Limitations . In its current version, EPIC does not consider uncertainty in the evidence. Several components such as additional (e.g., environmental and occupational) risk factors, treatment, symptoms, and comorbidity will have to be added in future iterations. Predictive validity of EPIC needs to be examined prospectively against future empirical studies. Conclusions . EPIC is the first multipurpose, open-source, outcome- and policy-focused model of COPD for Canada. Platforms of this type have the capacity to be iteratively updated to incorporate the latest evidence and to project the outcomes of many different scenarios within a consistent framework.

Suggested Citation

  • Mohsen Sadatsafavi & Shahzad Ghanbarian & Amin Adibi & Kate Johnson & J. Mark FitzGerald & William Flanagan & Stirling Bryan & Don Sin, 2019. "Development and Validation of the Evaluation Platform in COPD (EPIC): A Population-Based Outcomes Model of COPD for Canada," Medical Decision Making, , vol. 39(2), pages 152-167, February.
    • Handle: RePEc:sae:medema:v:39:y:2019:i:2:p:152-167
    DOI: 10.1177/0272989X18824098
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    References listed on IDEAS

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    1. Petra Menn & Reiner Leidl & Rolf Holle, 2012. "A Lifetime Markov Model for the Economic Evaluation of Chronic Obstructive Pulmonary Disease," PharmacoEconomics, Springer, vol. 30(9), pages 825-840, September.
    2. Martin J. Buxton & Michael F. Drummond & Ben A. Van Hout & Richard L. Prince & Trevor A. Sheldon & Thomas Szucs & Muriel Vray, 1997. "Modelling in Ecomomic Evaluation: An Unavoidable Fact of Life," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 217-227, May.
    3. Mehdi Najafzadeh & Carlo A Marra & Larry D Lynd & Mohsen Sadatsafavi & J Mark FitzGerald & Bruce McManus & Don Sin, 2012. "Future Impact of Various Interventions on the Burden of COPD in Canada: A Dynamic Population Model," PLOS ONE, Public Library of Science, vol. 7(10), pages 1-12, October.
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    Cited by:

    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.
    2. Talitha Feenstra & Isaac Corro-Ramos & Dominique Hamerlijnck & George Voorn & Salah Ghabri, 2022. "Four Aspects Affecting Health Economic Decision Models and Their Validation," PharmacoEconomics, Springer, vol. 40(3), pages 241-248, March.

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