Towards Renewed Health Economic Simulation of Type 2 Diabetes: Risk Equations for First and Second Cardiovascular Events from Swedish Register Data
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{"title"=>"Towards Renewed Health Economic Simulation of Type 2 Diabetes: Risk Equations for First and Second Cardiovascular Events from Swedish Register Data", "type"=>"journal", "authors"=>[{"first_name"=>"Aliasghar", "last_name"=>"Ahmad Kiadaliri", "scopus_author_id"=>"57199100665"}, {"first_name"=>"Ulf G.", "last_name"=>"Gerdtham", "scopus_author_id"=>"7003513848"}, {"first_name"=>"Peter", "last_name"=>"Nilsson", "scopus_author_id"=>"7202850334"}, {"first_name"=>"Björn", "last_name"=>"Eliasson", "scopus_author_id"=>"7006751378"}, {"first_name"=>"Soffia", "last_name"=>"Gudbjörnsdottir", "scopus_author_id"=>"6602830193"}, {"first_name"=>"Katarina Steen", "last_name"=>"Carlsson", "scopus_author_id"=>"7005715154"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"sgr"=>"84877328748", "doi"=>"10.1371/journal.pone.0062650", "pui"=>"368882635", "pmid"=>"23671618", "scopus"=>"2-s2.0-84877328748", "issn"=>"19326203", "isbn"=>"1932-6203"}, "id"=>"3a28925e-c41e-3b72-a1b2-9fe60f128b96", "abstract"=>"OBJECTIVE: Predicting the risk of future events is an essential part of health economic simulation models. In pursuit of this goal, the current study aims to predict the risk of developing first and second acute myocardial infarction, heart failure, non-acute ischaemic heart disease, and stroke after diagnosis in patients with type 2 diabetes, using data from the Swedish National Diabetes Register.\\n\\nMATERIAL AND METHODS: Register data on 29,034 patients with type 2 diabetes were analysed over five years of follow up (baseline 2003). To develop and validate the risk equations, the sample was randomly divided into training (75%) and test (25%) subsamples. The Weibull proportional hazard model was used to estimate the coefficients of the risk equations, and these were validated in both the training and the test samples.\\n\\nRESULTS: In total, 4,547 first and 2,418 second events were observed during the five years of follow up. Experiencing a first event substantially elevated the risk of subsequent events. There were heterogeneities in the effects of covariates within as well as between events; for example, while for females the hazard ratio of having a first acute myocardial infarction was 0.79 (0.70-0.90), the hazard ratio of a second was 1.21 (0.98-1.48). The hazards of second events decreased as the time since first events elapsed. The equations showed adequate calibration and discrimination (C statistics range: 0.70-0.84 in test samples).\\n\\nCONCLUSION: The accuracy of health economic simulation models of type 2 diabetes can be improved by ensuring that they account for the heterogeneous effects of covariates on the risk of first and second cardiovascular events. Thus it is important to extend such models by including risk equations for second cardiovascular events.", "link"=>"http://www.mendeley.com/research/towards-renewed-health-economic-simulation-type-2-diabetes-risk-equations-first-second-cardiovascula", "reader_count"=>26, "reader_count_by_academic_status"=>{"Professor > Associate Professor"=>5, "Librarian"=>1, "Researcher"=>8, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>2, "Other"=>1, "Student > Bachelor"=>3, "Professor"=>1}, "reader_count_by_user_role"=>{"Professor > Associate Professor"=>5, "Librarian"=>1, "Researcher"=>8, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>2, "Student > Postgraduate"=>1, "Student > Master"=>2, "Other"=>1, "Student > Bachelor"=>3, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Engineering"=>1, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>17, "Agricultural and Biological Sciences"=>2, "Business, Management and Accounting"=>1, "Computer Science"=>1, "Economics, Econometrics and Finance"=>2}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>17}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Computer Science"=>{"Computer Science"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "reader_count_by_country"=>{"Netherlands"=>1, "United Kingdom"=>1, "Portugal"=>1, "Spain"=>2}, "group_count"=>3}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1057609"], "description"=>"<p>Cumulative hazards for a non-smoking 58-year-old male with diabetes duration 10 years, total cholesterol 4.3 mmol/l, HDL cholesterol 1.0 mmol/l, LDL cholesterol 2.0 mmol/l, HbA1c 8.0%, systolic BP 150 mmHg, macroalbuminuria, no history of previous AMI before diagnosis, and no CHF during follow-up. For second AMI, it was assumed that the patient had his first AMI in the 10<sup>th</sup> year after diagnosis.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Epidemiological methods", "cardiovascular", "Myocardial infarction", "stroke", "Clinical research design", "Endocrinology", "Diabetic endocrinology", "Diabetes mellitus type 2", "Cardiovascular disease epidemiology", "cumulative", "grey"], "article_id"=>700740, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Aliasghar Ahmad Kiadaliri", "Ulf-G. Gerdtham", "Peter Nilsson", "Björn Eliasson", "Soffia Gudbjörnsdóttir", "Katarina Steen Carlsson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0062650.g001", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Predicted_cumulative_hazard_of_first_dashed_grey_line_and_second_solid_black_line_AMI_/700740", "title"=>"Predicted cumulative hazard of first (dashed grey line) and second (solid black line) AMI.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-05-09 00:12:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/1057611"], "description"=>"<p>Abbreviations: NAIHD, non-acute ischaemic heart disease; HF, heart failure; AMI, acute myocardial infarction.</p>a<p>. Hosmer-Lemeshow X<sup>2</sup> statistics.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Epidemiological methods", "cardiovascular", "Myocardial infarction", "stroke", "Clinical research design", "Endocrinology", "Diabetic endocrinology", "Diabetes mellitus type 2", "Cardiovascular disease epidemiology", "equations"], "article_id"=>700742, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Aliasghar Ahmad Kiadaliri", "Ulf-G. Gerdtham", "Peter Nilsson", "Björn Eliasson", "Soffia Gudbjörnsdóttir", "Katarina Steen Carlsson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0062650.t004", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Performance_of_equations_for_the_first_and_second_events_in_training_and_test_subsamples_/700742", "title"=>"Performance of equations for the first and second events in training and test subsamples.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-05-09 00:12:22"}
  • {"files"=>["https://ndownloader.figshare.com/files/1057612"], "description"=>"<p>All covariates are significant at the 5% level.</p><p>Weibull proportional hazards regression with the Prentice, Williams, and Peterson gap time model was used for estimation.</p><p>Abbreviations: NAIHD, non-acute ischaemic heart disease; HF, heart failure; AMI, acute myocardial infarction; TC/HDL, total to HDL cholesterol ratio.</p>a<p>. not significant, but significant interaction with macroalbuminuria;</p>b<p>. applied as splines in the equation;</p>c<p>. history of event before diagnosis of type 2 diabetes.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Epidemiological methods", "cardiovascular", "Myocardial infarction", "stroke", "Clinical research design", "Endocrinology", "Diabetic endocrinology", "Diabetes mellitus type 2", "Cardiovascular disease epidemiology", "estimates", "equations", "naihd"], "article_id"=>700743, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Aliasghar Ahmad Kiadaliri", "Ulf-G. Gerdtham", "Peter Nilsson", "Björn Eliasson", "Soffia Gudbjörnsdóttir", "Katarina Steen Carlsson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0062650.t003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Parameter_estimates_of_the_risk_equations_for_first_and_second_stroke_and_NAIHD_events_/700743", "title"=>"Parameter estimates of the risk equations for first and second stroke and NAIHD events.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-05-09 00:12:23"}
  • {"files"=>["https://ndownloader.figshare.com/files/1057613"], "description"=>"<p>All covariates are significant at the 5% level.</p><p>Weibull proportional hazards regression with the Prentice, Williams, and Peterson gap time model was used for estimation.</p><p>Abbreviations: HF, heart failure; AMI, acute myocardial infarction; TC/HDL, total to HDL cholesterol ratio.</p>a<p>. Significant at the 10% level, but significant interaction with LDL;</p>b<p>. applied as splines in the equation;</p>c<p>. history of event before diagnosis of type 2 diabetes;</p>d<p>. HF before first AMI.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Epidemiological methods", "cardiovascular", "Myocardial infarction", "stroke", "Clinical research design", "Endocrinology", "Diabetic endocrinology", "Diabetes mellitus type 2", "Cardiovascular disease epidemiology", "estimates", "equations", "ami", "hf"], "article_id"=>700744, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Aliasghar Ahmad Kiadaliri", "Ulf-G. Gerdtham", "Peter Nilsson", "Björn Eliasson", "Soffia Gudbjörnsdóttir", "Katarina Steen Carlsson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0062650.t002", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Parameter_estimates_of_the_risk_equations_for_first_and_second_AMI_and_HF_events_/700744", "title"=>"Parameter estimates of the risk equations for first and second AMI and HF events.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-05-09 00:12:24"}
  • {"files"=>["https://ndownloader.figshare.com/files/1057614"], "description"=>"<p>There were no statistically significant differences between training and test samples.</p><p>Abbreviation: BP, blood pressure; TC/HDL, total to HDL cholesterol ratio.</p>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Epidemiological methods", "cardiovascular", "Myocardial infarction", "stroke", "Clinical research design", "Endocrinology", "Diabetic endocrinology", "Diabetes mellitus type 2", "Cardiovascular disease epidemiology", "patients"], "article_id"=>700745, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Aliasghar Ahmad Kiadaliri", "Ulf-G. Gerdtham", "Peter Nilsson", "Björn Eliasson", "Soffia Gudbjörnsdóttir", "Katarina Steen Carlsson"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0062650.t001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_clinical_and_demographic_characteristics_of_patients_in_training_and_test_subsamples_/700745", "title"=>"Baseline clinical and demographic characteristics of patients in training and test subsamples.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-05-09 00:12:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/1057615", "https://ndownloader.figshare.com/files/1057616", "https://ndownloader.figshare.com/files/1057617"], "description"=>"<div><p>Objective</p><p>Predicting the risk of future events is an essential part of health economic simulation models. In pursuit of this goal, the current study aims to predict the risk of developing first and second acute myocardial infarction, heart failure, non-acute ischaemic heart disease, and stroke after diagnosis in patients with type 2 diabetes, using data from the Swedish National Diabetes Register.</p><p>Material and Methods</p><p>Register data on 29,034 patients with type 2 diabetes were analysed over five years of follow up (baseline 2003). To develop and validate the risk equations, the sample was randomly divided into training (75%) and test (25%) subsamples. The Weibull proportional hazard model was used to estimate the coefficients of the risk equations, and these were validated in both the training and the test samples.</p><p>Results</p><p>In total, 4,547 first and 2,418 second events were observed during the five years of follow up. Experiencing a first event substantially elevated the risk of subsequent events. There were heterogeneities in the effects of covariates within as well as between events; for example, while for females the hazard ratio of having a first acute myocardial infarction was 0.79 (0.70–0.90), the hazard ratio of a second was 1.21 (0.98–1.48). The hazards of second events decreased as the time since first events elapsed. The equations showed adequate calibration and discrimination (C statistics range: 0.70–0.84 in test samples).</p><p>Conclusion</p><p>The accuracy of health economic simulation models of type 2 diabetes can be improved by ensuring that they account for the heterogeneous effects of covariates on the risk of first and second cardiovascular events. Thus it is important to extend such models by including risk equations for second cardiovascular events.</p></div>", "links"=>[], "tags"=>["Population biology", "epidemiology", "Epidemiological methods", "cardiovascular", "Myocardial infarction", "stroke", "Clinical research design", "Endocrinology", "Diabetic endocrinology", "Diabetes mellitus type 2", "Cardiovascular disease epidemiology", "renewed", "simulation", "equations", "swedish"], "article_id"=>700746, "categories"=>["Medicine", "Biological Sciences"], "users"=>["Aliasghar Ahmad Kiadaliri", "Ulf-G. Gerdtham", "Peter Nilsson", "Björn Eliasson", "Soffia Gudbjörnsdóttir", "Katarina Steen Carlsson"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0062650.s001", "https://dx.doi.org/10.1371/journal.pone.0062650.s002", "https://dx.doi.org/10.1371/journal.pone.0062650.s003"], "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Towards_Renewed_Health_Economic_Simulation_of_Type_2_Diabetes_Risk_Equations_for_First_and_Second_Cardiovascular_Events_from_Swedish_Register_Data_/700746", "title"=>"Towards Renewed Health Economic Simulation of Type 2 Diabetes: Risk Equations for First and Second Cardiovascular Events from Swedish Register Data", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2013-05-09 00:12:26"}

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Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Biochemistry", "average_usage"=>[266, 468, 593, 703, 804, 903, 993, 1084, 1171, 1256, 1339, 1422, 1492]}, {"subject_area"=>"/Medicine and health sciences/Diagnostic medicine", "average_usage"=>[244, 425, 535, 636, 728, 814, 900, 982, 1063, 1139, 1221, 1296, 1361]}]}
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