Table.
Base Case Values for Decision Model and Ranges Examined in Sensitivity Analyses of Efforts to Reduce Risk of Type 2 Diabetes and Cardiovascular Disease, Southwestern Pennsylvania, 2005-2007
| Parameter | Base Case Value | Type of Distribution | Range Examined | Reference |
|---|---|---|---|---|
| Cohort characteristics | ||||
| Starting age, y | 55 | Uniform | 45–65 | Assumption |
| Women, % | 75 | Beta | 48.2-94.0 | mDPP data (8,16) |
| African American, % | 27.1 | Beta | 6.5-55.8 | mDPP data (8,16) |
| Angina, % | 3.8 | Beta | 1.0-8.3 | mDPP data (8,16) |
| Hypertension, treated, % | 84.9 | Beta | 4.5-100 | mDPP data (8,16) |
| History of cardiac arrest or MI, % | 1.9 | Beta | 0.5-4.2 | mDPP data (8,16) |
| History of stroke, % | 1.9 | Beta | 0.5-4.2 | mDPP data (8,16) |
| Peripheral vascular disease, % | 4.7 | Beta | 1.3-10.2 | mDPP data (8,16) |
| Probabilities, % | ||||
| Probability of screening risk-factor–positive | 31.0 | Beta | 7.2-63.5 | mDPP data (8,16) |
| Probability of enrollment | 47.0 | Beta | 9.2-86.7 | mDPP data (8,16) |
| Yearly probability of acquiring diabetes, % | ||||
| Not in prevention program, risk-factor–positive | 10.8 | Beta | 2.9-23.3 | Herman et al (12) |
| Not in prevention program, risk-factor–negative | 0.4 | Beta | 0.05-0.75 | Fox et al (20) |
| In prevention program | 4.8 | Beta | 1.3-10.5 | Herman et al (12) |
| Yearly probability of becoming risk-factor–positive | 4.0 | Beta | 1.0-8.7 | Orchard et al (19) |
| Yearly probability of progressing to complicated diabetes | 7.5 | Beta | 2.0-16.3 | Herman et al (12), Kothari et al (21), Wilson et al (22) |
| Yearly probability of reducing risk factors, % | ||||
| Not in prevention program | 12.1 | Beta | 3.2-25.9 | Orchard et al (19) |
| In prevention program | 16.2 | Beta | 4.2-34.4 | mDPP data (8,16) |
| Relative risk of death | ||||
| Risk-factor–positive | 1.7 | Log-normal | 1.5-1.8 | Lakka et al (23) |
| Risk-factor–negative | 1.0 | NA | Not varied | Assumption |
| Stable diabetes | 2.0 | Log-normal | 1.8-2.2 | Moss et al (24) |
| Complicated diabetes | 2.4 | Log-normal | 2.2-2.6 | Fuller et al (25) |
| Utilities | ||||
| No diabetes, risk-factor–positive, not in prevention program | 0.73 | Uniform | 0.71-0.75 | Herman et al (12), Coffey et al (26) |
| No diabetes, risk-factor–positive, in prevention program | 0.75 | Uniform | 0.73-0.77 | Herman et al (12), Coffey et al (26) |
| No diabetes, risk-factor–negative | 0.88 | Uniform | 0.84-0.92 | Gold et al (27) |
| Stable diabetes | 0.69 | Uniform | 0.66-0.72 | Herman et al (12), Coffey et al (26), Zhou et al (28) |
| Complicated diabetes | 0.59 | Uniform | 0.51-0.68 | Herman et al (12), Coffey et al (26), Zhou et al (28) |
| Costs and multipliers | ||||
| Screening, risk-factor–positive, $ | 35 | Uniform | 18-53 | mDPP data (8,16) |
| Screening, risk-factor–negative, $ | 32 | Uniform | 16-48 | mDPP data (8,16) |
| Prevention program, $ | 219 | Uniform | 110-329 | mDPP data (8,16) |
| Risk-factor–positive (yearly), $ | 1,296 | NA | Not varied | Herman et al (12) |
| Multiplier for female | 1.14 | Normal | 1.05-1.25 | Herman et al (12) |
| Multiplier for African American | 0.82 | Normal | 0.70-0.95 | Herman et al (12) |
| Risk-factor–negative (yearly), $ | 616 | NA | Not varied | MEPSa |
| Base diabetes cost (yearly), $ | 1,684 | NA | Not varied | Herman et al (12) |
| Multiplier for female | 1.25 | Normal | 1.14-1.35 | Herman et al (12) |
| Multiplier for African American | 0.82 | Normal | 0.70-0.95 | Herman et al (12) |
| Base complicated diabetes cost (yearly), $ | 1,684 | NA | Not varied | Herman et al (12) |
| Multiplier for female | 1.25 | Normal | 1.14-1.35 | Herman et al (12) |
| Multiplier for African American | 0.82 | Normal | 0.70-0.95 | Herman et al (12) |
| Multiplier for angina | 1.73 | Normal | 1.31-2.14 | Herman et al (12) |
| Multiplier for hypertension, treated | 1.24 | Normal | 1.10-1.37 | Herman et al (12) |
| Multiplier for history of cardiac arrest or MI | 1.90 | Normal | 1.64-2.17 | Herman et al (12) |
| Multiplier for history of stroke | 1.30 | Normal | 1.20-1.40 | Herman et al (12) |
| Multiplier for peripheral vascular disease | 1.31 | Normal | 1.10-1.53 | Herman et al (12) |
Abbreviations: mDPP, modified Diabetes Prevention Program; MI, myocardial infarction; NA, not applicable; MEPS, Medical Expenditure Panel Survey.
a
The yearly cost for risk-factor–negative ($616) was computed using the subset of MEPS respondents who had incurred health care expenses during the year and who reported a perceived health status of good, very good, or excellent (29).