UKPDS Outcomes Model
Information last updated: Feb 2019
Participated in following Mt Hood Diabetes Challenge Meetings: 2004, 2010, 2012, 2014, 2016, 2018.
Publicly accessible?: The equations of the model have been published in sufficient detail to enable the model to be replicated by other researchers. A software implementation of the model is available under license from University of Oxford (for further details see model website)
Is the model continuing to be developed?: Yes.
The UKPDS Outcomes Model (UKPDS-OM) is based on patient-level data from the United Kingdom Prospective Diabetes Study (UKPDS). It simulates type 2 diabetic populations modelling the occurrence of eight diabetes-related complications (MI, angina, stroke, heart failure, amputation, renal failure, diabetic ulcer and blindness in one eye) and death to estimate quality-adjusted life expectancy, life expectancy, and costs. In brief, the UKPDS-OM is based on an integrated system of parametric equations that predict the annual probability of any of the above complications and Monte Carlo methods to predict the occurrence of events. The likelihood of the events is based on patient demographics, duration of diabetes, risk factor levels, and history of diabetes-related complications. Different treatment and management strategies are evaluated through their impact on risk factor levels. A key aspect of the model is its ability to capture the clustering or interaction of different types of complications at the individual patient level. The model is a probabilistic discrete-time multi-state model. Patients start with a given health status (e.g., age, sex, duration of diabetes, risk factor values, and no complications) and can have one or more nonfatal complications and/or die in any model cycle. When a patient experiences a complication, their utility is permanently decremented such that they accumulate quality-adjusted life-years at a slower rate. Utility decrements and costs associated with events are estimated from the same patient-level data set. The first version of the model was published in 2004 (known as UKPDS OM I) and an enhanced version that was based on up to 10 years of additional information from UKPDS study was published in 2013 (UKPDS OM2). Elements of the UKPDS Outcomes Models have been widely used in many other diabetes simulation models.
Funding source for model development:
The UKPDS study received funding from the UK Medical Research Council, the British Diabetic Association, the UK Department of Health, the National Eye Institute and the National Institute of Diabetes and Digestive and Kidney Disease (the US National Institutes of Health), the British Heart Foundation, The Wellcome Trust, the Charles Wolfson Charitable Trust, the Clothworkers’ Foundation, the Health Promotion Research Trust, the Alan and Babette Sainsbury rust, the Oxford University Medical Research Fund Committee. Funding was also provided by pharmaceutical companies including Novo-Nordisk, Bayer, Bristol-Myers Squibb, Hoechst, Lilly, Lipha and Farmitalia Carlo Erba, GlaxoWellcome, SmithKline Beecham, Pfizer, Zeneca, Pharmacia and Upjohn, and Roche provided grants for health economics and epidemiological studies.
The development of the UKPDS OM 2 was supported by the following grants: Australian National Health and Medical Research Council project grant no. 512463 and capacity building grant no. 571372. and UK Medical Research Council project grant on disease modelling (grant ID: 87386).
Clarke PM, Gray AM, Briggs A, Farmer AJ, Fenn P, Stevens RJ, Matthews DR, Stratton IM, Holman RR. A model to estimate the lifetime health outcomes of patients with type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model (UKPDS 68). Diabetologia 2004;47:1747-1759.
Leal J, Hayes AJ, Gray AM, Holman RR, Clarke PM. Temporal Validation of the UKPDS Outcomes Model Using 10-Year Post trial Monitoring Data. Diabetes Care 2013;36:1541-1546
Hayes AJ, Leal J, Gray AM, Holman RR, Clarke PM. UKPDS Outcomes Model 2: a new version of a model to simulate lifetime health outcomes of patients with type 2 diabetes mellitus using data from the 30 year United Kingdom Prospective Diabetes Study: UKPDS 82. Diabetologia 2013;56:1925-1933.
Alva M, Gray A, Mihaylova B, Clarke P. The effect of diabetes complications on health-related quality of life: the importance of longitudinal data to address patient heterogeneity. Health Econ 2014; 23(4):487-500.
Alva ML, Gray A, Mihaylova B, Leal J, Holman RR. The impact of diabetes-related complications on healthcare costs: new results from the UKPDS (UKPDS 84). Diabetic Medicine 2015;32:459-466
The values below are simulated Quality Adjusted life Years (QALYs) for a set of reference simulations