School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Osteoarthritis Cartilage. 2010 Mar;18(3):303-11. doi: 10.1016/j.joca.2009.10.010. Epub 2009 Oct 23.
The purpose of the study was to develop a population-based simulation model of osteoarthritis (OA) in Canada that can be used to quantify the future health and economic burden of OA under a range of scenarios for changes in the OA risk factors and treatments. In this article we describe the overall structure of the model, sources of data, derivation of key input parameters for the epidemiological component of the model, and preliminary validation studies.
We used the Population Health Model (POHEM) platform to develop a stochastic continuous-time microsimulation model of physician-diagnosed OA. Incidence rates were calibrated to agree with administrative data for the province of British Columbia, Canada. The effect of obesity on OA incidence and the impact of OA on health-related quality of life (HRQL) were modeled using Canadian national surveys.
Incidence rates of OA in the model increase approximately linearly with age in both sexes between the ages of 50 and 80 and plateau in the very old. In those aged 50+, the rates are substantially higher in women. At baseline, the prevalence of OA is 11.5%, 13.6% in women and 9.3% in men. The OA hazard ratios for obesity are 2.0 in women and 1.7 in men. The effect of OA diagnosis on HRQL, as measured by the Health Utilities Index Mark 3 (HUI3), is to reduce it by 0.10 in women and 0.14 in men.
We describe the development of the first population-based microsimulation model of OA. Strengths of this model include the use of large population databases to derive the key parameters and the application of modern microsimulation technology. Limitations of the model reflect the limitations of administrative and survey data and gaps in the epidemiological and HRQL literature.
本研究旨在开发一种基于人群的加拿大骨关节炎（OA）模拟模型，该模型可用于量化 OA 风险因素和治疗方法变化的各种情景下 OA 的未来健康和经济负担。本文介绍了模型的总体结构、数据来源、模型流行病学部分关键输入参数的推导以及初步验证研究。
我们使用人群健康模型（POHEM）平台开发了一种基于医生诊断的 OA 的随机连续时间微观模拟模型。通过对加拿大不列颠哥伦比亚省的行政数据进行校准，使发病率符合数据。使用加拿大全国性调查来模拟肥胖对 OA 发病率的影响以及 OA 对健康相关生活质量（HRQL）的影响。
模型中，两性 50 岁至 80 岁之间 OA 的发病率随年龄呈近似线性增加，80 岁以后趋于平稳。在 50 岁以上人群中，女性发病率明显高于男性。基线时，OA 的患病率为 11.5%，女性为 13.6%，男性为 9.3%。肥胖对女性 OA 的危害比为 2.0，对男性为 1.7。OA 诊断对 HRQL 的影响，以健康效用指数 3 版（HUI3）衡量，女性降低 0.10，男性降低 0.14。
我们描述了首个基于人群的 OA 微观模拟模型的开发。该模型的优势在于使用大型人群数据库来推导关键参数，并应用现代微观模拟技术。模型的局限性反映了行政和调查数据的局限性以及流行病学和 HRQL 文献中的空白。
