Krankheitsmodell am Beispiel Diabetes - das EAGLE-Modell

Zusammenfassung

EAGLE (Economic Assessment of Glycemic Control and Long-term Effects) ist ein Diabetes-Simulationsmodell, das anhand modernster mathematisch-statistischer Methoden entwickelt und validiert wurde. Das Modell besteht aus einem epidemiologischen Modul, welches den klinischen Verlauf des Diabetes anhand verschiedener Einflussfaktoren und Behandlungen simuliert, und einem gesundheitsökonomischen Modul, welches den klinisch-epidemiologischen Ergebnissen Kosten zuordnet und modernste ökonomische Analysen ermöglicht. Die mathematische Basis des Modells bilden Daten aus drei großen Diabetes-Studien: United Kingdom Prospective Diabetes Study (UKPDS), Diabetes Control and Complications Trial (DCCT) und Wisconsin Epidemiology Study of Diabetic Retinopathy (WESDR). Im Weiteren wird auf die ausführliche Bezeichnung des EAGLE-Modells Version 2.0_IV verzichtet und lediglich auf das EAGLE-Modell verwiesen.

Abstract

EAGLE (Economic Assessment of Glycemic Control and Long-term Effects) is a diabetes simulation model, which was developed and validated according to state-of-the-art statistic and mathematic methods. The model consists of an epidemiological module, which simulates the clinical development of diabetes according to various influence parameters and treatments, and a health economic module, which assigns costs to the epidemiological results and permits up to date economic analyses. The mathematic basis of the model is built on data of three big clinical trials: United Kingdom Prospective Diabetes Study (UKPDS), Diabetes Control and Complications Trial (DCCT) und Wisconsin Epidemiology Study of Diabetic Retinopathy (WESDR).

Schlüsselwörter

Krankheitsmodelle - Kosteneffektivität - Diabetes mellitus - Gesundheitsökonomie

Key words

Modelling - simulation - diabetes mellitus - cost effectiveness - health economics

Literatur

• 1 Clarke P M, Gray A M, Briggs A. et al . UK Prospective Diabetes Study (UKDPS) Group. A model to estimate the lifetime health outcomes of patients with type 2 diabetes mellitus: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS no. 68).  Diabetologia. 2004;  47 1747-1759
• 2 Klein R, Klein B E, Moss S E. et al . Prevalence of diabetes mellitus in southern Wisconsin.  Am J Epidemiol. 1984;  119 54-61
• 3 The Diabetes Control and Complications Trial Research Group . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group.  N Engl J Med. 1993;  329 977-986
• 4 The UK Prospective Diabetes Study Group . Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group.  Lancet. 1998;  352 837-853
• 5 World Health Organisation life tables for France, Germany, Spain, UK, USA . http://www3.who.int/whosis/life/life_tables/life_tables.cfm= evidence,life,life_tables&language = english (last accessed 16.6.2005). 
• 6 Stratton I M, Adler A I, Neil H A. et al . Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.  Br Med J. 2000;  321 405-412
• 7 Adler A I, Stratton I M, Neil H A. et al . Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study.  Br Med J. 2000;  321 412-419
• 8 National Institute for Clinical Excellence (NICE) - Guide to the Methods of Technology Appraisal (2004). http://www.nice.org.uk/pdf/TAP_Methods.pdf (last accessed: 1.6.2005). 
• 9 van Hout B A, Al M J, Gordon G S. et al . Costs, effects and C/E-ratios alongside a clinical trial.  Health Economics. 1994;  3 309-319
• 10 American D iabetes Association Consensus Panel. Guidelines for Computer Modeling of Diabetes and Its Complications.  Diabetes Care. 2004;  27 2262-2265
• 11 Analytica International . EAGLE technical documentation: Auf Anfrage erhältlich. 
• 12 Bergemann R. Charakteristika valider Health-Outcomes Modelle.  Gesundh ökon Qual manag. 2005;  (Suppl 2) S59-S63
• 13 The Diabetes Control and Complications Trial Research Group . The effect of intensive diabetes therapy on the development and progression of neuropathy. The Diabetes Control and Complications Trial Research Group.  Ann Intern Med. 1995;  122 561-568
• 14 Moss S E, Klein R, Klein B E. The prevalence and incidence of lower extremity amputation in a diabetic population.  Arch Intern Med. 1992;  152 610-616
• 15 Eastman R C, Javitt J C, Herman W H. et al . Model of complications of NIDDM. I. Model construction and assumptions.  Diabetes Care. 1997;  20 725-734
• 16 Eastman R C, Javitt J C, Herman W H. et al . Model of complications of NIDDM. II. Analysis of the health benefits and cost-effectiveness of treating NIDDM with the goal of normoglycemia.  Diabetes Care. 1997;  20 735-744
• 17 Colhoun H M. et al . Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial.  Lancet. 2004;  364 685-696