Cardiff Model

Developer: Phil McEwan

Participated in following Mt Hood Diabetes Challenge Meetings: 2003,2004,2010,2012,2014 and 2016.

Publicly accessible?: Model not publicly available; however the modelling methods, including risk equation implementation have been published in detail.

​Funding source for model development: Funding for the development of the Cardiff Model was provided by AstraZeneca plc.

Is the model continuing to be developed?: Yes

Brief Description:


The Cardiff Model is a fixed-time increment stochastic simulation model programmed in C++ and Visual Basic for Applications. It is designed to evaluate the impact of therapeutic intervention in Type 1 and Type 2 diabetes.


The Type 1 Diabetes Model utilises data from the Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Interventions and Complications (EDIC) study (microvascular complications) and the Swedish National Diabetes Registry (cardiovascular complications). The Type 2 diabetes model fully implements UKPDS 68 and 82 risk equations.


The model requires specification of demographic and established diabetes specific modifiable risk factors. In both Type 1 and Type 2 models, simulated patients are initialised with baseline profiles and, following the application of a treatment effect, are modelled over a lifetime. Pre-specified HbA1c threshold values, or a specified duration of therapy, may be used to invoke escalation to subsequent therapy lines (up to three in total).


Event costs are applied in the year of occurrence and maintenance costs applied in all subsequent years. The costs of diabetes-related complications are drawn primarily from UKPDS 65 and 84 and utilities from UKPDS 62, and supplemented with Type 1-specific data where published. The relationship between both weight change and the frequency and severity of hypoglycaemia on costs and quality of life is also captured.


Model output includes the incidence of microvascular and macrovascular complications, hypoglycaemia, diabetes-specific mortality and all-cause mortality and point estimates of costs, life years and quality adjusted life years in addition to probabilistic cost-effectiveness output.


Key Publications:

McEwan P, Ward T, Bennett H, Bergenheim K. Validation of the UKPDS 82 risk equations within the Cardiff Diabetes Model. Cost Eff Resour Alloc. 2015.

McEwan P, Peters JR, Bergenheim K, Currie CJ. Evaluation of the costs and outcomes from changes in risk factors in type 2 diabetes using the Cardiff stochastic simulation cost-utility model. Current Medical Research and Opinion 2006.

McEwan P, Bennett H, Fellows J, Priaulx J and Bergenheim K. The Health Economic Value of Changes in Glycaemic Control, Weight and Rates of Hypoglycaemia in Type 1 Diabetes Mellitus.  PlosOne 2016.

0.5% red. HbA1c
10mmHg in SBP
0.5mmol/l red. LDL
1-unit red BMI
All combined
Cardiff (UKPDS82)
Cardiff (UKPDS82)

Reference simulation

The values below are simulated Quality Adjusted life Years (QALYs) for a set of reference simulations