Table 1.
Key model parameters for the Markov model.
| Parameter | Value | Range | Distr. | Source |
|---|---|---|---|---|
| Starting age | 65 (W) 65 (M) |
Curry et al. (8) Asm. |
||
| oQCT screening | ||||
| Sensitivity Specificity Screening rate (year 1) |
0.59 (W/M) 0.81 (W/M) 1.0 |
0.5–0.7 | β β β |
Löffler et al. (31) Löffler et al. (31) Asm. |
| DXA screening | ||||
| Sensitivity/specificity Screening rates (years 1–5) |
0.565/0.688 (W) 0.215/0.967 (M) 0.095 (W) 0.017 (M) |
0.5–0.65 0.15–0.4 0.04–0.15 0.005–0.030 |
β β β β |
Iki et al. (32) Chalhoub et al. (33) Zhang et al. (34) Zhang et al. (34) |
| Risks | ||||
| Incidence of VFs (per 1,000 patients) 65–75 years |
17.0 (W) 5.1 (M) |
12.0–22.0 3.5–6.5 |
β β |
Van Der Klift et al. (35) Van Der Klift et al. (35) |
| Probability of dying after a VF (age 60) | ||||
| Year 0 Year 1 Year 2 Year 3 Year 4 Year 5 |
0.129 (W)/0.134 (M) 0.103 (W)/0.107 (M) 0.083 (W)/0.085 (M) 0.066 (W)/0.068 (M) 0.053 (W)/0.054 (M) 0.043 (W)/0.043 (M) |
β β β β β β |
Johnell et al. (36) Johnell et al. (36) Johnell et al. (36) Johnell et al. (36) Johnell et al. (36) Johnell et al. (36) |
|
| Probability of dying from other causes | ||||
| 65–66 66–67 67–68 68–69 69–70 |
0.009638 (W)/0.016078 (M) 0.010386 (W)/0.017216 (M) 0.011235 (W)/0.018401 (M) 0.012237 (W)/0.019666 (M) 0.013393 (W)/0.021099 (M) |
β β β β β |
Arias et al. (37) Arias et al. (37) Arias et al. (37) Arias et al. (37) Arias et al. (37) |
|
| RR of VF with bisphosphonate treatment | 0.55 (W) 0.44 (M) |
β β |
Byun and Black et al. (38, 39) Zeng et al. (40) |
|
| RR of re-fracture after sustaining a VF | ||||
| Year 1 Years 2–5 |
5.0 (W/M) 2.5 (W/M) |
β β |
Lindsay et al. (5) and Asm. Van Geel et al. (2) and Asm. |
|
| Costs | ||||
| oQCT screening DXA screening |
$82,61 $111,19 |
Variable ± 30% |
γ γ |
Medicare Services (41) Medicare Services (41) |
| Costs of VF (Medicare insurance) | (inflated to 2022 $) | |||
| Year 1 Year 2 Year 3 Year 4 Year 5 Yearly treatment costs Annual discount rate |
$24,012 $5,958 $4,234 $3,033 $2,245 $100 3% |
γ γ γ γ γ γ |
Tran et al. (42) Tran et al. (42) Tran et al. (42) Tran et al. (42) Tran et al. (42) Federal Supply Schedule (43) Sanders et al. (25) |
|
| Treatment | ||||
| Treatment duration Adherence to treatment |
2 years 0.5 |
0.3–0.7 | β | Kothawala et al. (44) |
| Utility | ||||
| Utility weights | 0.84 (W) 0.87 (M) |
β β |
Fryback et al. (45) Fryback et al. (45) |
|
| Disutility multiplier | ||||
| First year Subsequent years |
0.860 0.965 |
β β |
Hiligsmann et al. (46) Hiligsmann et al. (46) |
|
Distr., distribution; VF, vertebral fracture; RR, relative risk; Asm., assumption; oQCT, opportunistic quantitative computed tomography; DXA, dual-energy X-ray absorptiometry.