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MICADO: Modelling Integrated Care for Diabetes based on Observational data

Contact: Talitha Feenstra

Brief Description:

 

Simulation models can assist in comparing the cost-effectiveness of interventions. Most models concentrate on existing diabetes patients. However, the MICADO model was developed for the evaluation of long term cost-effectiveness of interventions in both diabetes patients and the general population. Its basic structure is that of a dynamic population model, with either overlapping birth-cohorts or a cohort of diabetes patients being followed over annual time cycles. MICADO is a Markov-type, multistate transition model linking risk factors to incidence of diabetes and to micro- and macrovascular complications. Being based on GP registry data, as well as other population-wide data sources, it contains a mixed diabetes population of mainly type 2. Microvascular complications modelled are diabetic foot, nephropathy and retinopathy, macrovascular complications modelled are AMI, other CHD, CVA, and CHF. Outcomes are prevalence of complications, and quality of life. Costs are being added. Parameter uncertainty analysis can be performed concerning estimated disease/complication prevalence and treatment effectiveness parameters.

 

Key Publications:

A. A. W. A. van der Heijden, T. L. Feenstra, R. T. Hoogenveen, L. W. Niessen, M. C. de Bruijne, J. M. Dekker, C. A. Baan and G. Nijpels. Policy evaluation in diabetes prevention and treatment using a population-based macro simulation model: the MICADO model  Diabetic Medicine Volume 32, Issue 12,  pages 1580–1587, December 2015

Reference simulation

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

Model
Sex
Control
0.5% red. HbA1c
10mmHg in SBP
0.5mmol/l red. LDL
1-unit red BMI
All combined
Date
MICADO model (med def no drift)
Male
9.49
9.63
9.68
9.56
9.62
9.99
5/10/2018
MICADO model (med def no drift)
Female
11.26
11.42
11.45
11.33
11.37
11.77
5/10/2018
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