Centre for Musculoskeletal Outcomes Research, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Osteoarthritis Cartilage. 2018 Apr;26(4):531-539. doi: 10.1016/j.joca.2018.01.004. Epub 2018 Jan 10.
To describe the construction and preliminary validation of a new population-based microsimulation model developed to analyse the health and economic burden and cost-effectiveness of treatments for knee osteoarthritis (OA) in New Zealand (NZ).
We developed the New Zealand Management of Osteoarthritis (NZ-MOA) model, a discrete-time state-transition microsimulation model of the natural history of radiographic knee OA. In this article, we report on the model structure, derivation of input data, validation of baseline model parameters against external data sources, and validation of model outputs by comparison of the predicted population health loss with previous estimates.
The NZ-MOA model simulates both the structural progression of radiographic knee OA and the stochastic development of multiple disease symptoms. Input parameters were sourced from NZ population-based data where possible, and from international sources where NZ-specific data were not available. The predicted distributions of structural OA severity and health utility detriments associated with OA were externally validated against other sources of evidence, and uncertainty resulting from key input parameters was quantified. The resulting lifetime and current population health-loss burden was consistent with estimates of previous studies.
The new NZ-MOA model provides reliable estimates of the health loss associated with knee OA in the NZ population. The model structure is suitable for analysis of the effects of a range of potential treatments, and will be used in future work to evaluate the cost-effectiveness of recommended interventions within the NZ healthcare system.
描述一种新的基于人群的微观模拟模型的构建和初步验证，该模型旨在分析新西兰（NZ）治疗膝骨关节炎（OA）的健康和经济负担以及成本效益。
我们开发了新西兰骨关节炎管理（NZ-MOA）模型，这是一种放射性膝 OA 自然史的离散时间状态转移微观模拟模型。在本文中，我们报告了模型结构、输入数据的推导、根据外部数据源验证基线模型参数以及通过比较预测的人群健康损失与先前估计来验证模型输出。
NZ-MOA 模型模拟了放射性膝 OA 的结构进展和多种疾病症状的随机发展。输入参数尽可能来自基于 NZ 的人群数据，在 NZ 特定数据不可用时，来自国际来源。与其他证据来源验证了与 OA 相关的结构 OA 严重程度和健康效用损害的预测分布，并量化了关键输入参数的不确定性。由此产生的终生和当前人群健康损失负担与先前研究的估计相符。
新的 NZ-MOA 模型为评估新西兰人群中与膝 OA 相关的健康损失提供了可靠的估计。该模型结构适合分析一系列潜在治疗方法的效果，并将在未来的工作中用于评估新西兰医疗保健系统中推荐干预措施的成本效益。
