Development and Validation of the Evaluation Platform in COPD (EPIC): A Population-Based Outcomes Model of COPD for Canada

Mohsen Sadatsafavi, Shahzad Ghanbarian, Amin Adibi, Kate Johnson, J. Mark FitzGerald, William Flanagan, Stirling Bryan and Don Sin
Additional contact information
Mohsen Sadatsafavi: Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
Shahzad Ghanbarian: Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
Amin Adibi: Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
Kate Johnson: Faculty of Medicine and Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
J. Mark FitzGerald: Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
William Flanagan: Statistics Canada, Ottawa, ON, Canada
Stirling Bryan: Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Institute, Vancouver, BC, Canada
Don Sin: Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

Medical Decision Making, 2019, vol. 39, issue 2, 152-167

Abstract: Background . We report the development, validation, and implementation of an open-source population-based outcomes model of chronic obstructive pulmonary disease (COPD) for Canada. Methods . Evaluation Platform in COPD (EPIC) is a discrete-event simulation model of Canadians 40 years of age or older. Three core features of EPIC are its open-population design (incorporating projections of future population growth, aging, and smoking trends), its incorporation of heterogeneity in lung function decline and burden of exacerbations, and its modeling of the natural history of COPD from inception. Multiple original data analyses, as well as values reported in the literature, were used to populate the model. Extensive face validity and internal and external validity evaluations were performed. Results . The model was internally validated on demographic projections, mortality rates, lung function trajectories, COPD exacerbations, costs and health state utility values, and stability of COPD prevalence over time within strata of risk factors. In external validation, it moderately overestimated the rate of overall exacerbations in 2 independent trials but generated consistent estimates of rate of severe exacerbations and mortality. Limitations . In its current version, EPIC does not consider uncertainty in the evidence. Several components such as additional (e.g., environmental and occupational) risk factors, treatment, symptoms, and comorbidity will have to be added in future iterations. Predictive validity of EPIC needs to be examined prospectively against future empirical studies. Conclusions . EPIC is the first multipurpose, open-source, outcome- and policy-focused model of COPD for Canada. Platforms of this type have the capacity to be iteratively updated to incorporate the latest evidence and to project the outcomes of many different scenarios within a consistent framework.

Keywords: chronic obstructive pulmonary disease; disease simulation; whole-disease modeling; cost-effectiveness analysis; epidemiological projection (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X18824098 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:2:p:152-167

DOI: 10.1177/0272989X18824098

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().