Michigan Model for Diabetes
The Michigan Model for Diabetes (MMD) is a computerized disease model that enables the users to simulate the progression of diabetes over time, its complications (retinopathy, neuropathy and nephropathy), and its major comorbidities (cardiovascular and cerebrovascular disease), and death. Transition probabilities can be a function of individual characteristics, current disease states or treatment states. The model also estimates the medical costs of diabetes and its comorbidities, as well as the quality of life related to the current health state of the subject. MMD is implemented in a disease modeling software, Indirect Estimation and Simulation Tool, programmed in python language.
In contrast to other models, the transition probabilities implemented in the MMD were obtained by synthesizing the published literature. Most of the risk equations adapted in the coronary heart disease sub-model and cerebrovascular disease sub-model are from the UKPDS Outcomes Model I. Transition probabilities were derived by calibrating these equations to contemporary population-based epidemiologic studies and randomized controlled clinical trials.
MMD explicitly models diabetes management strategies and allows users to modify them to match the specific scenarios that they are simulating. Changes in risk factors (HbA1c, BMI, lipid profiles and systolic and diastolic blood pressures) over time in simulated individual patients are determined by both treatment states and aging/disease progression. MMD allows a user to control risk factor changes by defining treatment thresholds and compliance rates for hyperglycemia, dyslipidemia, and hypertension, and compliance to quitting smoking and taking aspirin.
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The values below are simulated Quality Adjusted life Years (QALYs) for a set of reference simulations